37 results on '"Hamzany, Y."'
Search Results
2. Treating paediatric anterior glottic web: single-centre experience of 20 patients with comparison among techniques
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Alkan, U., primary, Nachalon, Y., additional, Vaisbuch, Y., additional, Katz, O., additional, Hamzany, Y., additional, and Stern, Y., additional
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- 2016
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3. Proposition d’une sous-classification des cordectomies par voie endoscopique au laser des cancers glottiques
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Hamzany, Y., Schvero, Y., Hans, S., Crevier Buchman, Lise, M.-C., Monfrais-Pfauwadel, Brasnu, Daniel, École Nationale des Travaux Publics de l'État (ENTPE), LPP - Laboratoire de Phonétique et Phonologie - UMR 7018 (LPP), Université Sorbonne Nouvelle - Paris 3-Centre National de la Recherche Scientifique (CNRS), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Lo Bue, Gwénaëlle, École Nationale des Travaux Publics de l'État, Université de Lyon, and Université Sorbonne Nouvelle - Paris 3 - Centre National de la Recherche Scientifique (CNRS)
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cancers glottiques ,cordectomies par voie endoscopique au laser ,[SHS.LANGUE]Humanities and Social Sciences/Linguistics ,[SHS.LANGUE] Humanities and Social Sciences/Linguistics ,ComputingMilieux_MISCELLANEOUS - Abstract
National audience
- Published
- 2012
4. Treating paediatric anterior glottic web: single-centre experience of 20 patients with comparison among techniques.
- Author
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Alkan, U., Nachalon, Y., Vaisbuch, Y., Katz, O., Hamzany, Y., and Stern, Y.
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DISEASE risk factors ,LARYNGEAL diseases ,PREVENTION ,PATIENTS ,DIAGNOSIS ,THERAPEUTICS - Abstract
The article reports on the results of single-centre experience of 20 patients with comparison among techniques. Congenital laryngeal web malformation is caused by incomplete recanalisation of the primitive larynx. The objectives of this study is to describe clinicalexperience in treating anterior laryngeal webs and also to evaluateand compare different surgical techniques used to establishthe best treatment method according to the web severity.
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- 2017
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5. Évaluation longitudinale multiparamétrique de la qualité de la voix après cordectomies au Laser
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Hans, S., primary, Hamzany, Y., additional, Hoffman, C., additional, De corgnol, A., additional, Ménard, M., additional, Crevier-Buchman, L., additional, and Brasnu, D., additional
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- 2013
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6. Laryngectomies supraglottiques par voie trans-orale assistées au robot
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Hans, S., primary, Hamzany, Y., additional, Luna Azoulay, B., additional, De Corgnol, A., additional, Menard, M., additional, and Brasnu, D., additional
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- 2012
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7. Intérêts de l’association de la chirurgie minimale invasive au Laser CO2 par voie endoscopique à la chirurgie assistée par robot
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De Corgnol, A., primary, Hans, S., additional, Luna Azoulay, B., additional, Menard, M., additional, Hamzany, Y., additional, and Brasnu, D., additional
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- 2012
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8. ORIGINAL ARTICLE: Squamous cell carcinoma of the oral tongue in patients younger than 30 years: clinicopathologic features and outcome
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Soudry, E., primary, Preis, M., additional, Hod, R., additional, Hamzany, Y., additional, Hadar, T., additional, Bahar, G., additional, Strenov, Y., additional, and Shpitzer, T., additional
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- 2010
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9. Salivary analysis of oral cancer biomarkers
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Shpitzer, T, primary, Hamzany, Y, additional, Bahar, G, additional, Feinmesser, R, additional, Savulescu, D, additional, Borovoi, I, additional, Gavish, M, additional, and Nagler, R M, additional
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- 2009
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10. Early death from papillary thyroid carcinoma.
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Hamzany Y, Soudry E, Strenov Y, Lipschitz N, Segal K, Hadar T, Hilly O, and Feinmesser R
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- 2012
11. Management of laryngeal chondroradionecrosis: A single-center experience.
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Levin EG, Ritter A, Bachar G, Mizrachi A, Shoffel-Havakuk H, Kurman N, Popovtzer A, and Hamzany Y
- Abstract
Background: Laryngeal chondroradionecrosis (LCRN) is a rare but severe complication of radiation therapy. The study aimed to review the management of LCRN and evaluate the clinical benefit of hyperbaric oxygen therapy (HBOT)., Methods: We retrospectively analyzed all radiation-induced LCRN patients between 2006 and 2019 at a tertiary medical center. Diagnosis was based on signs and symptoms of Chandler's classification, imaging, and/or histopathology report. The primary outcome was improvement in Chandler's grade after HBOT., Results: Of 678 irradiated laryngeal cancer patients, 29 (4.3%) were diagnosed with LCRN. The most common primary management was tracheostomy with intravenous steroids and antibiotics (59%). Ten patients received HBOT (34.5%), and six underwent total laryngectomy (21%). In HBOT-treated patients, Chandler's grade significantly improved from a median of 4 (range 2-4) to 2.5 (range 1-4; p = 0.005)., Conclusions: HBOT may benefit in the management of patients with persistence and unresponsive symptoms of LCRN following radiation therapy for laryngeal SCC., (© 2024 The Author(s). Head & Neck published by Wiley Periodicals LLC.)
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- 2024
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12. Gender-Related Aspects of Laryngeal Squamous Cell Carcinoma: A Retrospective Cohort Study.
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Tsur N, Zloczower E, Tunik M, Amir I, Yosefof E, Havakuk HS, Hamzany Y, and Kurman N
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Objectives: Laryngeal squamous cell carcinoma (SCC) is a predominantly male illness. Although the rate of female patients increased, a knowledge gap exists in the medical literature regarding gender-based differences., Design: Retrospective cohort study., Setting: Adult patients treated for laryngeal SCC in a tertiary medical centre between 2006 and 2020. Data were collected on demographics, clinical presentation, treatment modalities, disease recurrence and survival status., Participants: Two hundred ninety-one patients with laryngeal SCC, 50 (17.2%) females and 241 (82.8%) males., Main Outcome Measures: Disease-specific survival (DSS), overall survival (OS) and disease-free survival (DFS), as well as differences in disease characteristics and treatment modalities., Results: Tumour subsites differed significantly between females and males (36% vs. 19.5% supraglottic, 62% vs. 80.5% glottic and 2% vs. 0% subglottic, respectively; p = 0.006). Females were diagnosed at younger ages (61.7 ± 10.58 vs. 65.87 ± 11.11 years, p = 0.016) and advanced-stage disease (58% vs. 39.4%, p = 0.018). Females were treated with combined modalities at higher rates (36% vs. 54.8% for single modality, p = 0.031). DSS rates did not differ between genders (log-rank p = 0.12). Despite being diagnosed at more advanced disease stages, females demonstrated prolonged median OS compared to males (130.17 vs. 106.17 months, log-rank p = 0.017). No significant differences in DFS were observed (log-rank p = 0.32). In a multivariate Cox proportional hazards model, male gender remained an independent negative OS predictor (HR = 2.08; CI, 1.10-3.96; p = 0.025), along with increasing age (HR = 1.06; CI, 1.04-1.09; p < 0.001) and advanced disease stage (HR = 1.7; CI, 1.08-2.67; p = 0.023)., Conclusions: Our findings suggest the importance of considering gender-specific factors in the management of laryngeal SCC., (© 2024 The Author(s). Clinical Otolaryngology published by John Wiley & Sons Ltd.)
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- 2024
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13. Zoom in: factors affecting vocal habits during online meetings, a prospective trial on 40 subjects.
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Pinhas S, Shteinberg S, Lahav Y, Tessler I, Hamzany Y, Assi S, and Shoffel-Havakuk H
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- Humans, Prospective Studies, Male, Female, Adult, Middle Aged, Young Adult, Habits, Speech Acoustics, Language, Phonation physiology, Voice Quality physiology
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Purpose: To identify factors that influence vocal habits during online meetings (OMs)., Methods: A prospective trial of forty participants without any known hearing or vocal cord disorders. Subjects participated in an OM divided into six randomly ordered sections, with alterations in audio/speaking equipment and language: the computer's speaker-microphone, a single earbud, two-earbuds or headphones; with/without video, native-language-speaking (Hebrew) versus second language-speaking (English). Each section included free speech, sustained phonation, and a standardized passage. Participants ranked their vocal-effort for each section. Three blinded raters independently scored the voice using the GRBAS scale, and acoustic analyses were performed., Results: No significant difference in self-reported vocal effort was demonstrated between sections. Second-language speaking resulted in significantly increased intensity (p < 0.0001), frequency (p = 0.015), GRBAS (p = 0.008), and strain (p < 0.0001) scores. Using the computer's speaker/microphone resulted in significantly higher strain (p < 0.0001). Using headphones, single or two earbuds resulted in lower intensity and a lower strain score. No differences were detected between OMs with or without video., Conclusions: Using the computer's microphone/speaker or speaking in a second language during OMs, may result in vocal habits associated with vocal trauma., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2024
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14. Too Deep: The Rate of Inappropriate Deep Resections while Practicing a Single Stage Laser Cordectomy.
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Ben Ner D, Hamzany Y, Reuven Y, Ben-Mordechai N, Bar-On DY, Najman TM, and Shoffel-Havakuk H
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Objective: Whenever a cortectomy is indicated, obviating preoperative biopsy and practicing a single-stage-laser-cordectomy (SSLC) may expedite treatment and preserve surgical planes. This may result in more superficial resections and improved vocal function. Yet, SSLC holds a risk for over-treating nonmalignant lesions. Our study aims to evaluate this risk., Methods: A retrospective cohort of patients who underwent SSLC. Cordectomy types were compared with final pathology. Type-1 cordectomy was subcategorized into superficial-type-1 (superficial-lamina-propria preserved) and deep-type-1 (ligament exposed). Superficial-type-1 cordectomy was considered adequate for epithelial lesions not invading the basement membrane: nonmalignant, dysplasia, and carcinoma-in-situ (CIS). Deeper resections for these pathologies were considered inappropriately deep. All resections were considered appropriate for squamous cell carcinoma (SCC)., Results: Ninety-seven patients who underwent 139 SSLC were included. SCC was found in 30% (N = 42), CIS/severe-dysplasia in 15% (N = 21), mild/moderate-dysplasia in 23% (N = 32), nondysplastic lesions in 31% (N = 43), and lymphoma in 0.5% (N = 1). Superficial-type-1 cordectomy was performed in 64% (N = 89). Altogether, 15 lesions (11%) underwent inappropriately deep resections. Smoking history, current smoking status, prior glottic surgery, radiation or fungal infection, did not increase the rate of inappropriate deep resection. While the general rate of inappropriately deep resection is 11%, for deep-type-1 cordectomy or deeper the rate was 29.4%. The highest rate was associated with deep-type-1 cordectomy, reaching 52.9%., Conclusion: The general rate of inappropriately deep resection during a SSLC is low. However, when the depth of resection involves exposure of the vocal ligament or deeper, the rate increases. Hence, to avoid unnecessary morbidity, whenever a deep resection is considered, the authors recommend preceding a deeper resection with frozen section sampling., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)
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- 2024
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15. Subtotal Submucosal Arytenoidectomy with Lateralization Sutures (SMALS) Covered by a Mucosal Flap.
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Shoffel-Havakuk H, Lahav Y, Reuven Y, Shopen Y, Shapira-Galitz Y, and Hamzany Y
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- Humans, Retrospective Studies, Constriction, Pathologic surgery, Arytenoid Cartilage surgery, Sutures, Laryngoscopy methods, Vocal Cord Paralysis surgery
- Abstract
Objective: Glottic airway stenosis (GAWS) may result from bilateral paralysis (BVFP) or posterior glottic stenosis (PGS). Since the glottis is the principal airway sphincter, surgeons shift on the balance between airway, aspirations, and voice. We aim to describe our surgical technique and outcome of the SMALS procedure for GAWS correction., Methods: A retrospective cohort of patients who underwent SMALS for PGS between 2018 and 2021. SMALS involves: endoscopic submucosal subtotal arytenoidectmy (preserving medial mucosal flap) and lateralization sutures. The sutures lateralize the mucosal flap to cover the arytenoidectomy bed without lateralization of the membranous vocal fold; expanding the posterior glottis, while preserving a relatively good voice. Covering the arytenoidectomy bed enhances healing. Medical and surgical data, airway, voice, and swallowing symptoms were collected. Relative glottic opening area (RGOA) and relative glottic insufficiency area (RGIA) were calculated., Results: Eleven PGS patients who underwent 15 SMALS were included (4 bilateral), all patients had post-intubation PGS, 1 patient also had prior radiation to the larynx. All patients were tracheostomy-dependent. There were no major complications. No granulation or retracting scar was observed at follow-up. None had a persistent voice or swallowing disability. Successful outcome (decannulation) was achieved in 8 (73%); RGOA increased in all (Δ = 0.37; p = 0.003), while RGIA remained relatively stable (Δ = 0.02; p = 0.055)., Conclusions: SMALS is a safe and effective, novel modification of the classic arytenoidectomy, for GAWS correction that can be easily applied and may expand the airway without significant glottic insufficiency symptoms., Level of Evidence: 4 Laryngoscope, 134:353-360, 2024., (© 2023 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)
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- 2024
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16. The Value of Computed Tomography in Recurrent Laryngeal Cancer Following Organ Preservation Therapy.
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Dekalo S, Shoffel-Havakuk H, Mizrachi A, Lukman Y, Shpitzer T, Hamzany Y, and Bachar G
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Aim: This study aims to assess the accuracy of computed tomography (CT) in detecting recurrent laryngeal tumors after failed chemoradiation therapy (CRT)., Background: Local recurrence of laryngeal tumors following CRT has been reported in approximately 25%, yet it is often difficult to detect., Methods: Ten patients with laryngeal cancer who failed CRT and subsequently underwent salvage total laryngectomy were included. The laryngeal subsites involved in the tumor were identified based on postoperative pathology. The corresponding preoperative CT scans were selected for review by seven experts (head-and-neck surgeons or radiologists) who scored the extent of tumor spread on each scan on a 5-point scale, from no tumor detected to clearly visible tumor., Results: The rates of high tumor detectability (scores 4-5) varied according to laryngeal subsite, from 75% in the glottic region, to 45% in the subglottic region, and to 19% in the supraglottic region (P=0.01). The detectability rates were higher on scans performed 2 years or more after CRT., Conclusion: The CT evaluation of laryngeal cancer after CRT has limited value, particularly in the epiglottis and subglottis., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
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- 2023
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17. Post-radiotherapy osteomyelitis of the cervical spine in head and neck cancer patients.
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Tsur N, Segal E, Kurman N, Tzelnick S, Wiesel O, Wilk L, Hamzany Y, Bachar G, and Shoffel-Havakuk H
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Objective: To evaluate patient characteristics, risk factors, disease course, and management of cervical vertebral osteomyelitis in patients who had radiation for head and neck cancers., Methods: A retrospective cohort study (case series) of patients diagnosed with post-radiation osteomyelitis of the cervical spine between 2012 and 2021. Data were collected from the patient's medical files., Results: Seven patients (71% male) with post-radiation cervical osteomyelitis were reviewed. The median patient age was 64 years. The mean interval between diagnosis of osteomyelitis and the first and last radiotherapy course was 8.3 and 4.0 years, respectively. A medical or surgical event preceded the diagnosis in four patients (57%) by a mean of 46.25 days. Common imaging findings were free air within the cervical structures and fluid collection. Four patients recovered from osteomyelitis during the follow-up within an average of 65 days., Conclusion: Post-radiation osteomyelitis is characterized by a subtle presentation, challenging diagnosis, prolonged treatment, and poor outcome. Clinicians should maintain a high index of suspicion for the long-term after radiotherapy. Multidisciplinary evaluation and management are warranted., Advances in Knowledge: The study describes post-radiotherapy osteomyelitis of the cervical spine, a rare and devastating complication. Literature data regarding this complication are sparse., (© 2023 The Authors. Published by the British Institute of Radiology.)
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- 2023
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18. The Predictors of Persistent Posttracheostomy Tracheocutaneous Fistula and Successful Surgical Closure.
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Yosefof E, Tsur N, Boldes T, Najjar E, Mizrachi A, Shpitzer T, Hamzany Y, and Bachar G
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- Adult, Humans, Retrospective Studies, Trachea, Tracheostomy adverse effects, Postoperative Complications epidemiology, Postoperative Complications surgery, Postoperative Complications etiology, Cutaneous Fistula etiology, Cutaneous Fistula surgery, Tracheal Diseases etiology, Tracheal Diseases surgery
- Abstract
Objective: Persistent tracheocutaneous fistula is a well-described complication of prolonged tracheostomy, with a prevalence of about 70% when decannulation is performed after more than 16 weeks. Predictors of its occurrence and outcome of treatment in adults remain unclear. The aim of the study was to describe our experience with the treatment of persistent posttracheostomy tracheocutaneous fistula in adults and to investigate factors associated with its formation and with the success of surgical closure., Study Design: Retrospective cohort., Setting: Tertiary medical center., Methods: Patients who underwent open-approach tracheostomy between 2000 and 2020 were identified by database review. Data on background, need for surgical closure, and the surgical outcome was collected from the medical files and analyzed statistically between groups., Results: Of 516 patients identified, 127 with sufficient long-term follow-up data were included in the study. Compared to patients whose fistula closed spontaneously (n = 85), patients who required surgical closure (n = 42) had significantly higher rates of smoking, laryngeal or thyroid malignancy, and airway obstruction as the indication for tracheostomy, on both univariate and multivariate analysis. In a comparison of patients with successful (n = 29) or failed (n = 11) surgical closure, factors significantly associated with failure were prior radiotherapy and lower preoperative albumin level, on univariate analysis., Conclusion: Smoking, thyroid or laryngeal malignancy, and airway obstruction indication are risk factors for persistent posttracheostomy tracheocutaneous fistula. Patients should be closely followed after tracheostomy and referred for surgery if the fistula fails to close. Before surgery, careful evaluation of the patient's nutritional status and consideration of prior radiation treatment is mandatory., (© 2023 The Authors. Otolaryngology-Head and Neck Surgery published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology-Head and Neck Surgery Foundation.)
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- 2023
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19. Dilation, Steroid Injection, and Cough Exercise for Correction of Posterior Glottic Stenosis.
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Shoffel-Havakuk H, Lahav Y, Shopen Y, Reuven Y, Bachar G, and Hamzany Y
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- Adult, Humans, Constriction, Pathologic complications, Retrospective Studies, Dilatation methods, Cicatrix complications, Steroids, Cough complications, Laryngostenosis etiology, Laryngostenosis surgery
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Objective: To describe the DISCO protocol (Dilation, Steroid injection, and post-operative Cough Exercise); a novel treatment for posterior glottic stenosis (PGS). Restoring glottic mobility in PGS is a major challenge. In orthopedic and plastic surgery, post-operative physical therapy is associated with improved motion range and flexibility; yet, this principle was never applied to laryngeal surgery., Methods: A retrospective cohort of PGS adult patients, treated by the DISCO protocol during 2018-2020. DISCO involves the following: scar release, glottic dilation, and steroid injection, followed by post-operative cough as glottic physical therapy. Maximal glottic opening angle (MGOA), relative glottic opening area (RGOA), and relative glottic insufficiency area (RGIA) were calculated before and post-operatively., Results: Seventeen patients were included; PGS etiology was post-intubation (n = 10), post-irradiation (n = 3), both (n = 1) and joint sclerosis (n = 3). Six patients also had additional airway disorders. Sixteen patients were tracheostomy-dependent. 2 (12%), 8 (47%) and 7 (41%) patients had type II, III and IV stenosis, respectively. Surgery included scar release, dilation and steroid injection alone in 7 patients; and additional unilateral sub-mucosal arytenoidectomy in 10. The mean follow-up was 17.5 months. There were no major complications. Successful outcomes (e.g., decannulation or permanent capping) were achieved in 14 (82%) patients with some restoration of joint movement. None had a persistent voice or swallowing complaints. Both MGOA and RGOA increased in all patients (p < 0.001). RGIA remained unchanged (p = 0.878)., Conclusions: The DISCO protocol is a novel, effective and safe approach for PGS correction that can be easily applied. It can restore vocal fold mobility and may expand the glottic airway without causing glottic insufficiency., Level of Evidence: 4 Laryngoscope, 133:883-889, 2023., (© 2022 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)
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- 2023
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20. Supraglottic Carcinoma in Intravenous Opioid Drug Abusers: A Distinct Disease with Improved Survival.
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Yaniv D, Reuven Y, Lahav Y, Cohen O, Hamzany Y, Moore A, Rapana OG, Argaman N, Halperin D, Popovtzer A, Bachar G, and Shoffel-Havakuk H
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- Aged, Case-Control Studies, Female, Humans, Male, Middle Aged, Prognosis, Retrospective Studies, Survival Rate, Laryngeal Neoplasms etiology, Laryngeal Neoplasms mortality, Opioid-Related Disorders complications
- Abstract
Objectives/hypothesis: Recent evidence indicates an increased prevalence of intravenous opioid drug abusers (IVDAs) among supraglottic squamous cell carcinoma (SG-SCC) patients. This study investigates whether the clinical course of SG-SCC in IVDA differs from SG-SCC in non-IVDA., Study Design: A retrospective case-control study conducted in a in two tertiary referral centers., Methods: This case-control study compares IVDA with non-IVDA patients diagnosed and treated for SG-SCC in between 2005 and 2018. Disease-free survival (DFS) and overall survival (OS) were calculated using the Kaplan-Meier estimator. Adjusted odds ratios (ORs) for mortality were calculated using multivariant analyses., Results: A total of 124 patients were included; 21% (26) were IVDA, and 79% (98) were non-IVDA. Age at diagnosis in the IVDA group versus the non-IVDA group was 53 and 66 years, respectively (P = .001). Nevertheless, the age hazard ratio for OS was calculated and found to have minimal to no effect, 1.05 (95% Cl: 1.025-1.076). Otherwise, the two groups were comparable regarding demographics, other risk factors (i.e., gender, smoking, and alcohol), and comorbidities status, as well as the comparable stage at diagnosis, histologic grading, and treatment modalities. Although the DFS was comparable in both groups, the 5-year OS was 55% in the IVDA group compared with 34% among the non-IVDA patients (P = .04). In multivariant analyses for mortality, positive IVDA history was found to be protective, adjusted OR: 0.263 (95% CI: 0.081-0.854). Similarly, within the subgroup of 100 patients with advanced-stage disease (III and IV), the adjusted OR was 0.118 (95% CI: 0.028-0.495)., Conclusions: SG-SCC in IVDA patients has a distinct clinical course, presenting at a younger age, and may have improved prognosis., Level of Evidence: NA Laryngoscope, 131:E1190-E1197, 2021., (© 2020 American Laryngological, Rhinological and Otological Society Inc, "The Triological Society" and American Laryngological Association (ALA).)
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- 2021
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21. Multidimensional Voice Quality Evaluation After Transoral CO 2 Laser Cordectomy: A Prospective Study.
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Hamzany Y, Crevier-Buchman L, Lechien JR, Bachar G, Brasnu D, and Hans S
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- Adult, Aged, Aged, 80 and over, Carbon Dioxide, Glottis pathology, Glottis surgery, Humans, Laryngeal Neoplasms pathology, Laryngeal Neoplasms physiopathology, Male, Middle Aged, Mouth surgery, Postoperative Period, Prospective Studies, Treatment Outcome, Laryngeal Neoplasms surgery, Lasers, Gas therapeutic use, Natural Orifice Endoscopic Surgery methods, Vocal Cords surgery, Voice Quality
- Abstract
Objective: To investigate voice quality changes of patients treated by transoral laser cordectomy (TLC) for early glottic cancer according to the type of cordectomies., Methods: A total of 164 consecutive male patients with an early glottic cancer were prospectively recruited from the Department of Otolaryngology-Head and Neck Surgery of the Georges Pompidou European Hospital. Depending on the tumor characteristics, patients benefited from type I to VI CO
2 cordectomy regarding the European Laryngological Society classification. The following voice quality outcomes were pre- to postoperatively assessed: voice handicap index (VHI), perceptual grade of dysphonia, roughness, breathiness, maximum phonation time, and acoustic parameters., Results: Fifty-five patients with Tis, T1, or T2 vocal fold cancer completed the study (mean age: 61.7 years). Of these patients, 34 and 21 composed group 1 (types I-III TLC) and group 2 (types IV-VI TLC), respectively. Voice handicap index, grade of dysphonia, and breathiness significantly improved from pre- to 3- and 6-month posttreatment in group 1. In group 2, only VHI significantly improved from pre- to 3- and 6-month posttreatment. Acoustic and aerodynamic measurements did not change throughout the postoperative course. Patients with types I to III TLC exhibited better postoperative voice outcomes compared to those treated by types IV to VI TLC., Conclusion: Irrespective to the types of TLC, the subjective voice quality of patients treated by CO2 laser cordectomy for early glottic cancer significantly improved from pre- to 3- and 6-month posttreatment. The usefulness of aerodynamic and acoustic measurements as postoperative outcomes of voice quality changes remain controversial and require future studies considering multidimensional assessment of voice.- Published
- 2021
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22. Forceful sneeze: An uncommon cause of laryngeal fracture.
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Tsur N, Amitai N, Shoffel-Havakuk H, Abuhasira S, and Hamzany Y
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Laryngeal fractures are generally induced by direct blunt or penetrating trauma to the neck. Coughing vigorously or sneezing forcefully is extremely rare causes of laryngeal fractures, with only 4 cases found after thorough literature search. Herein we present a case of a 34-year-old male presenting to the ENT emergency room with throat pain, odynophagia, dysphagia, and hoarseness. Following primary evaluation, through physical examination and imaging he was diagnosed with thyroid cartilage fracture and treated conservatively. The triad of odynophagia, dysphagia, and dysphonia after a severe episode of coughing or sneezing in a young adult male patient should prompt suspicion of a laryngeal fracture., (© 2021 The Authors.)
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- 2021
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23. Recurrence predictability by various staging systems in 283 patients after thyroidectomy and radioactive iodine treated for papillary thyroid carcinoma.
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Yaniv D, Mizrachi A, Raz R, Tzelnick S, Feinmesser R, Hamzany Y, Vaisbuch Y, and Hilly O
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- Adolescent, Adult, Aged, Aged, 80 and over, Biomarkers, Tumor analysis, Combined Modality Therapy, Female, Humans, Male, Middle Aged, Neoplasm Staging, Retrospective Studies, Risk Factors, Iodine Radioisotopes therapeutic use, Neoplasm Recurrence, Local pathology, Thyroid Cancer, Papillary pathology, Thyroid Cancer, Papillary therapy, Thyroid Neoplasms pathology, Thyroid Neoplasms therapy, Thyroidectomy
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- 2019
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24. Single Stage Transoral Laser Microsurgery for Early Glottic Cancer.
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Hamzany Y, Shoffel-Havakuk H, Devons-Sberro S, Shteinberg S, Yaniv D, and Mizrachi A
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Objectives: The purpose of the study was to present the outcome of our management protocol of a single stage transoral laser microsurgery (SSTLM), with the intention of complete removal of a lesion, considered to be an early glottic cancer. Methods: Between January 2015 to February 2017 patients with the clinical appearance of an early glottic cancer, who were candidates for (SSTLM) management protocol, were included in this study. Type of cordectomy was determined by pre- and intra-operative evaluation of the extent of lesion in cord layers. Results: Thirty patients (6 females, 24 males; mean age 65 years) underwent SSTLM. Twenty-two patients had malignant histopathological diagnosis of severe dysplasia or Cis in 4 patients, microinvasice carcinoma in 3 patients and invasive carcinoma in 15 patients (T1a tumor in 14 and T1b tumor in 1). Eight patients had a nonmalignant histological diagnosis of keratosis without atypia in 2 patients, mild dysplasia in 2 patients and moderate dysplasia in 3 patients. Based on pre- and intra-operative evaluation, 14 subepithelial (type I), 10 subligamental (type II), and 6 transmuscular (type III) cordectomies were performed. Comparison of cordectomies types with postoperative histopathologic diagnosis showed an adequate extent of resection in 26 out of 30 patients (87%). Considering only patients without recent background of direct laryngoscopy and biopsy, an adequate resection was performed in 90% of patients. None of the patients was further treated by external beam radiation. At average follow-up of 21 months, none of the patients developed local recurrence. Conclusion: In selected cases, a SSTLM for clinical appearance of an early glottic cancer, allows a reliable histopathologic diagnosis and a high local control rate with favorable cost effectiveness. A careful pre- and intraoperative evaluation for selecting the appropriate cases for this management is required in order to avoid under- or over-treatment.
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- 2018
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25. Expression of Topoisomerase II-α protein in salivary gland tumors.
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Shvero A, Hilly O, Bubis G, Hamzany Y, Koren R, and Rath-Wolfson L
- Abstract
Salivary glands give rise to approximately 30 histological distinct tumor types, which results in a diagnostic challenge for the pathologist. The present retrospective, immunohistochemical study aimed to evaluate the expression of Topoisomerase II-α, a nuclear enzyme, as a diagnostic and prognostic marker in benign and malignant salivary gland tumors, including leomorphic adenoma, mucoepidermoid carcinoma, acinic cell carcinoma and carcinoma ex-pleomorphic adenoma. A total of 59 cases of benign and malignant salivary gland tumors were included in the present study. Representative paraffin-embedded sections were immunostained for Topoisomerase II-α (Topo II-α). The expression level was semi-quantified for each case and then correlated with the histological diagnosis using hematoxylin and eosin-stained slides, grade of tumor and total survival. Significant differences were revealed between the expression level of Topo II-α in pleomorphic adenoma and mucoepidermoid carcinoma (P<0.001), carcinoma ex-pleomorphic adenoma (P<0.001), acinic cell carcinoma (P=0.005) and a group composed of all the malignant tumors (P<0.001). Cancer-specific survival rates were insignificantly increased in tumors expressing low levels of Topo II-α (P=0.464). Thus, the present study demonstrated different expression levels of Topo II-α in benign and malignant salivary gland tumors. These differing expression levels may act as valuable biomarkers for the correct histological diagnosis. Further studies conducted on a larger scale may lead to even more conclusive results.
- Published
- 2017
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26. Does narrow band imaging improve preoperative detection of glottic malignancy? A matched comparison study.
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Shoffel-Havakuk H, Lahav Y, Meidan B, Haimovich Y, Warman M, Hain M, Hamzany Y, Brodsky A, Landau-Zemer T, and Halperin D
- Subjects
- Case-Control Studies, Disease-Free Survival, Female, Glottis diagnostic imaging, Humans, Laryngeal Neoplasms mortality, Laryngeal Neoplasms pathology, Laryngeal Neoplasms surgery, Laryngectomy methods, Laryngectomy mortality, Light, Male, Observer Variation, Preoperative Care methods, Risk Assessment, Sensitivity and Specificity, Survival Rate, Treatment Outcome, Vocal Cords pathology, Vocal Cords surgery, Glottis pathology, Laryngeal Neoplasms diagnostic imaging, Laryngoscopy methods, Narrow Band Imaging methods, Vocal Cords diagnostic imaging
- Abstract
Objectives/hypothesis: The primary suspicion for glottic malignancy during office laryngoendoscopy is based on lesion appearance. Previous studies investigating laryngeal use of narrow band imaging (NBI) are mostly descriptive. The additive value of NBI relative to white light (WL) requires further investigation., Study Design: Observational matched study., Methods: NBI was compared with WL images of 45 vocal fold lesions suspected for malignancy (21 carcinoma, 22 dysplasia, two benign). All images were presented randomly and evaluated by six independent otolaryngology specialists. The observers were asked to estimate lesion size, location, and pathology. The results for the two imaging modalities were compared with each other and with the final pathology., Results: The observers estimated lesion size to be larger in the NBI images by an average of 9% (2.4 mm
2 ; P =.04) compared to WL. In 64.6% of cases, the observers estimated similar pathology for NBI and WL. When there was a discrepancy, the estimated pathology was "malignant" in 24.3% by NBI, compared with 11.1% by WL. Overall, 44.7% of the lesions were estimated to be malignant by NBI, compared with 33.8% by WL (P =.001). The sensitivity and specificity rates for malignancy detection by NBI were 58.6% and 61.2%, respectively, compared to 48.7% and 76.1% by WL., Conclusions: Observers tend to estimate vocal fold lesions to be larger and more frequently suspect malignancy while assessing NBI images. Compared with WL, NBI demonstrates increased sensitivity and decreased specificity for detection of malignancy. Nevertheless, the specificity and sensitivity of NBI alone are considerably low., Level of Evidence: 4 Laryngoscope, 127:894-899, 2017., (© 2016 The American Laryngological, Rhinological and Otological Society, Inc.)- Published
- 2017
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27. Malignant external otitis: Factors predicting patient outcomes.
- Author
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Stern Shavit S, Soudry E, Hamzany Y, and Nageris B
- Subjects
- Aged, Aged, 80 and over, Diabetes Complications complications, Female, Humans, Male, Middle Aged, Otitis Externa microbiology, Prognosis, Retrospective Studies, Risk Factors, Survival Rate, Otitis Externa diagnosis, Otitis Externa epidemiology
- Abstract
Objective: Malignant external otitis (MEO) is an aggressive infection, primarily affecting elderly diabetic patients. It begins in the external ear canal and spreads to adjacent structures. This study investigated the clinical characteristics of patients diagnosed and treated for MEO and analyzed factors affecting patient outcomes., Study Design: Historical cohort., Setting: Tertiary medical center., Methods: Medical records of all patients diagnosed and treated for MEO from 1990 to 2013, were retrospectively reviewed. Clinical features, laboratory, imaging and outcomes were analyzed., Results: 88 patients were included, mean age was 73±11.5years, 61 (69%) were male. Of these, 75% had diabetes. Mean follow-up was 60months. The most common presenting symptoms were otalgia (89%), external ear canal edema (86%) and otorrhea (84%). Pseudomonas aeruginosa was isolated in 61% of ear cultures. All patients were treated with antibiotics, 22% had surgery and 8% hyperbaric oxygen. Overall survival rate was 38% in 5years, with disease specific mortality 14%. DM, facial nerve palsy, positive CT scan and age above 70 were found to correlate and predict disease-specific mortality., Conclusions: MEO carries a grave prognosis. The presence of two or more of the following features, DM, facial nerve palsy, positive CT scan and age above 70, predicts poor outcome, and highlights the need for prolonged, vigorous treatment., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
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28. CD1a-positive dendritic cell density predicts disease-free survival in papillary thyroid carcinoma.
- Author
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Hilly O, Rath-Wolfson L, Koren R, Mizrachi A, Hamzany Y, Bachar G, and Shpitzer T
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinoma mortality, Carcinoma pathology, Carcinoma therapy, Carcinoma, Papillary, Cell Count, Dendritic Cells pathology, Disease-Free Survival, Female, Humans, Immunohistochemistry, Kaplan-Meier Estimate, Male, Middle Aged, Neoplasm Recurrence, Local, Predictive Value of Tests, Retrospective Studies, Risk Factors, Thyroid Cancer, Papillary, Thyroid Neoplasms mortality, Thyroid Neoplasms pathology, Thyroid Neoplasms therapy, Time Factors, Treatment Outcome, Young Adult, Antigens, CD1 analysis, Biomarkers, Tumor analysis, Carcinoma immunology, Dendritic Cells immunology, Thyroid Neoplasms immunology
- Abstract
Objectives: Dendritic cells are common in inflammatory processes and in papillary thyroid carcinoma (PTC). Previous studies of the predictive value of S100-positive dendritic cell density for PTC outcome yielded inconsistent results. This study investigated the association of dendritic cell density and PTC recurrence based on CD1a expression., Methods: Representative slides from 56 consecutive specimens of PTC were immunostained with anti-CD1a antibodies, and dendritic cell density was analyzed by disease-free survival., Results: Dendritic cells were abundant in the tumoral tissue and sparse in the normal peritumoral tissue. Peritumoral dendritic cell density >1.1 cells/HPF was inversely associated with the risk of recurrence. Similar results were obtained with tumoral dendritic cell density (>12 cells/HPF), although the statistical significance was marginal., Conclusions: High CD1a-positive dendritic cell density is associated with improved disease-free survival in PTC. The specificity of anti-CD1a immunostain for activated dendritic cells may explain the better outcome prediction in this study than in studies using S100 protein., (Copyright © 2015 Elsevier GmbH. All rights reserved.)
- Published
- 2015
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29. Robot-assisted transaxillary thyroid surgery-feasibility and safety of a novel technique.
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Rabinovics N, Feinmesser R, Aidan P, Hamzany Y, and Bachar G
- Abstract
Developments in technology have led to a rapid progress in robotic endocrine surgery applications. With the advent of minimally invasive techniques in thyroid surgery, robot-assisted transaxillary thyroid surgery (RATS) has emerged as one of the most promising approaches. Its main advantages are improved cosmetic outcome, avoiding cervical incisions, thereby increasing patient satisfaction, and improved visualization, arms articulations, and precision, resulting in fewer surgical complications. The main disadvantages are potential new injuries to the brachial plexus, esophagus, and trachea, longer operative time, and increased cost compared to conventional thyroidectomy. In skilled hands, RATS is a safe alternative to conservative thyroidectomy and should be presented to patients with aesthetic concerns. As with any new emerging technique, careful patient selection is crucial, and further evidence must be sought to confirm its indications over time.
- Published
- 2014
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30. Assessment of margins in transoral laser and robotic surgery.
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Hamzany Y, Brasnu D, Shpitzer T, and Shvero J
- Abstract
The growing practice of endoscopic surgery has changed the therapeutic management of selected head and neck cancers. Although a negative surgical margin in resection of neoplasm is the most important surgical principle in oncologic surgery, controversies exist regarding assessment and interpretation of the status of margin resection. The aim of this review was to summarize the literature considering the assessment and feasibility of negative margins in transoral laser microsurgery (TLM) and transoral robotic surgery (TORS). Free margin status is being approached differently in vocal cord cancer (1-2 mm) compared with other sites in the upper aerodigestive tract (2-5 mm). Exposure, orientation of the pathological specimen, and co-operation with the pathologist are crucial principles needed to be followed in transoral surgery. Piecemeal resection to better expose deep tumor involvement and biopsies taken from surgical margins surrounding site of resection can improve margin assessment. High rates of negative surgical margins can be achieved with TLM and TORS. Adjuvant treatment decision should take into consideration also the surgeon's judgment with regard to the completeness of tumor resection.
- Published
- 2014
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31. Carcinoma of the oral tongue in patients younger than 30 years: comparison with patients older than 60 years.
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Hilly O, Shkedy Y, Hod R, Soudry E, Mizrachi A, Hamzany Y, Bachar G, and Shpitzer T
- Subjects
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Carcinoma, Squamous Cell surgery, Disease-Free Survival, Female, Glossectomy, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Prognosis, Risk Factors, Tongue Neoplasms surgery, Young Adult, Carcinoma, Squamous Cell pathology, Neoplasm Recurrence, Local pathology, Tongue Neoplasms pathology
- Abstract
Objectives: The incidence of oral tongue squamous cell carcinoma is rising in young patients. This study evaluated the clinical, pathological, and prognostic characteristics of oral tongue squamous cell carcinoma in the under-30-year age group., Materials and Methods: The computerized database of the Department of Otolaryngology-Head and Neck Surgery of a tertiary, university-affiliated medical center was searched for all patients with oral tongue squamous cell carcinoma treated by glossectomy with curative intent in 1996-2012. Data were collected by chart review., Results: Of the 113 patients identified, 16 (14%) were aged ⩽30years at presentation and 62 (55%) >60years. Mean follow-up time was 30months. Comparison by age group revealed no sex predilection and no differences in histologic grade or rates of advanced T-stage, perineural and vascular invasion, or nodal extracapsular extension. Rates of node-positive disease were 75% in the younger group and 19% in the older group (p<0.001). Kaplan-Meier analysis yielded no between-group difference in disease-free or overall survival. Recurrence was documented in a similar proportion of patients (38% and 29.9%, respectively), but half the recurrences in the younger group were distant versus none in the older group (p=0.01) All younger patients with recurrent disease died within 16months of its appearance compared to 50% 3-year disease-specific survival in the older group., Conclusions: Oral tongue squamous cell carcinoma is more advanced at presentation in younger than in older patients, with higher rates of regional metastases and distant failure. Recurrent disease is more aggressive, with a fatality rate of 100%., (Copyright © 2013 Elsevier Ltd. All rights reserved.)
- Published
- 2013
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32. Is human saliva an indicator of the adverse health effects of using mobile phones?
- Author
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Hamzany Y, Feinmesser R, Shpitzer T, Mizrachi A, Hilly O, Hod R, Bahar G, Otradnov I, Gavish M, and Nagler RM
- Subjects
- Adult, Aged, Aged, 80 and over, Amylases analysis, Female, Humans, Male, Middle Aged, Persons With Hearing Impairments, Proteins analysis, Saliva metabolism, Cell Phone, Electromagnetic Radiation, Oxidative Stress radiation effects, Saliva radiation effects
- Abstract
Increasing use of mobile phones creates growing concerns regarding harmful effects of radiofrequency nonionizing electromagnetic radiation on human tissues located close to the ear, where phones are commonly held for long periods of time. We studied 20 subjects in the mobile-phone group who had a mean duration of mobile phone use of 12.5 years (range 8-15) and a mean time use of 29.6 h per month (range 8-100). Deaf individuals served as controls. We compared salivary outcomes (secretion, oxidative damage indices, flow rate, and composition) between mobile phone users and nonusers. We report a significant increase in all salivary oxidative stress indices studied in mobile phone users. Salivary flow, total protein, albumin, and amylase activity were decreased in mobile phone users. These observations lead to the hypothesis that the use of mobile phones may cause oxidative stress and modify salivary function.
- Published
- 2013
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33. The role of s100-positive dendritic cells in the prognosis of papillary thyroid carcinoma.
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Hilly O, Koren R, Raz R, Rath-Wolfson L, Mizrachi A, Hamzany Y, Bachar G, and Shpitzer T
- Subjects
- Adult, Aged, Aged, 80 and over, Biomarkers, Tumor metabolism, Carcinoma metabolism, Carcinoma mortality, Carcinoma, Papillary, Cell Count, Comorbidity, Dendritic Cells metabolism, Disease-Free Survival, Female, Humans, Male, Middle Aged, Neoplasm Recurrence, Local, Retrospective Studies, Survival Rate, Thyroid Cancer, Papillary, Thyroid Neoplasms metabolism, Thyroid Neoplasms mortality, Thyroiditis, Autoimmune metabolism, Thyroiditis, Autoimmune mortality, Young Adult, Carcinoma diagnosis, Dendritic Cells pathology, S100 Proteins metabolism, Thyroid Neoplasms diagnosis, Thyroiditis, Autoimmune diagnosis
- Abstract
Dendritic cells are potent antigen-presenting cells, common in inflammatory processes. We sought to investigate dendritic cell expression in papillary thyroid carcinoma and the relationship of dendritic cell density with the extent of thyroiditis and prognosis. Specimens from 69 consecutive patients with papillary thyroid carcinoma were immunohistochemically stained for the S100 protein, and the number of positive dendritic cells was counted. Cells were sparse in normal thyroid tissue and common in areas of thyroiditis and papillary carcinoma. Dendritic cell density in papillary carcinoma correlated with the thyroiditis grade and dendritic cell density in surrounding areas of thyroiditis. High-grade thyroiditis (42% of patients) was inversely associated with 3-year recurrence. Dendritic cell density was not associated with disease-free survival. The lack of prognostic value of dendritic cell density is not compliant with the only other relevant study in the literature, and further research is required.
- Published
- 2013
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34. Squamous cell carcinoma of the oral tongue in patients over 75 years old.
- Author
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Soudry E, Preis M, Hod R, Hamzany Y, Hadar T, Bahar G, Sternov Y, and Shpitzer T
- Subjects
- Aged, Aged, 80 and over, Cohort Studies, Combined Modality Therapy, Disease-Free Survival, Female, Humans, Male, Middle Aged, Neoplasm Staging, Prognosis, Retrospective Studies, Survival Rate, Treatment Outcome, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell therapy, Tongue Neoplasms pathology, Tongue Neoplasms therapy
- Abstract
Background and Aims: Squamous cell carcinoma (SCC) of the oral tongue is one of the most frequent head and neck cancers. The over-70-year age group is the fastest growing segment of the population. Age, however, is not considered a prognostic factor in oral tongue SCC. This study investigated the clinical and histopathological characteristics, disease course, and outcome of SCC of the oral tongue in patients over 75 years old compared with younger patients., Methods: We reviewed the files of 85 patients with histologically proven SCC of the oral tongue who were treated in our department in 1992-2007 and followed for a minimum of 2 years. Findings were compared between those aged 75 years or more and younger patients., Results: Twenty-eight patients (33%) were aged 75 to 94 years (average 80.5±4.5 yrs), including 14 who were over 80 years old, and 57 patients were aged 15-74 years (average 51.1±18.2 yrs). No statistically significant differences were found between the groups in clinical or histopathological characteristics or patient outcome. The 5-year disease-free survival rate was 65% for patients over 75 and 58% for younger patients. Corresponding rates for 5-year disease-specific survival were 69% and 70%. These differences were not statistically significant., Conclusions: Patients over 75 with oral tongue SCC should be managed like younger patients in terms of clinical staging and co-morbidities. They should be given a chance for treatment, as their prognosis is no different from that of younger patients.
- Published
- 2011
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35. Malignant external otitis: analysis of severe cases.
- Author
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Soudry E, Hamzany Y, Preis M, Joshua B, Hadar T, and Nageris BI
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Otitis Externa classification, Otitis Externa mortality, Severity of Illness Index, Survival Rate, Otitis Externa diagnosis
- Abstract
Objective: To study the effect of specific clinical, laboratory, and imaging parameters on the course of severe (type 1) malignant external otitis (MEO)., Study Design: Case series with chart review., Setting: Tertiary, university-affiliated medical center., Subjects and Methods: Fifty-seven patients hospitalized with severe MEO were followed for disease course and survival in a tertiary center between 1990 and 2008., Results: In 20% of patients, disease was persistent and/or aggressive despite prolonged and extensive treatment. Of this subgroup, 45% died of the disease. Prognostic factors of persistent/aggressive disease were facial nerve paralysis, bilateral disease, and significant major computed tomography findings (temporomandibular joint destruction, infratemporal fossa or nasopharyngeal soft tissue involvement). Cultures grew fungi in 5 patients, and follow-up imaging revealed disease progression. The overall 5-year survival was 55% for patients with short-term disease and 40% for patients with persistent/ aggressive disease (P = .086). By age, 5-year survival was 75% in patients younger than 70 years old and 44% in older patients (P = .029)., Conclusions: A significant subset of patients with MEO has a prolonged, aggressive, and highly fatal disease that needs to be identified early. These patients more frequently have bilateral disease, cranial nerve paralysis, and positive computed tomography findings. Their follow-up should routinely include imaging studies to evaluate disease progression, and every effort should be made to identify and treat underlying fungal infection.
- Published
- 2011
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36. Fungal malignant external otitis.
- Author
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Hamzany Y, Soudry E, Preis M, Hadar T, Hilly O, Bishara J, and Nageris BI
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Fungi classification, Fungi isolation & purification, Humans, Hyperbaric Oxygenation, Male, Middle Aged, Mycoses microbiology, Mycoses therapy, Otitis Externa microbiology, Otitis Externa therapy, Treatment Outcome, Mycoses mortality, Mycoses pathology, Otitis Externa mortality, Otitis Externa pathology
- Abstract
Objective: To investigate the clinical characteristics and outcome of fungal malignant external otitis (MEO)., Methods: The files of 60 patients treated for MEO in 1990-2008 at a tertiary medical center were reviewed for clinical characteristics and outcome, and findings were compared between patients with fungal and nonfungal infection., Results: Mean duration of follow-up was 4 years. Nine patients (15%) had fungal disease; the main pathogen was Candida spp. Compared with the nonfungal MEO group, patients with a fungal infection were younger at diagnosis (average 68 vs. 74 years, p = 0.01) and had more facial nerve palsies (55% vs. 14%, p = 0.01), fewer positive bacterial cultures at presentation (33% vs. 75%, p = 0.02), and higher rates of surgery (78% vs. 18%, p = 0.0008) and hyperbaric treatment (78% vs. 4%, p = 0.0001). Eighty-nine percent had persistent infection (>2 courses of systemic antibiotics before antifungal treatment) compared with 12% in the nonfungal group (p = 0.0001). Fungal disease was associated with more persistently positive imaging findings (87.5% vs. 25%, p = 0.0001). There was no significant between-group difference in survival., Conclusion: Fungal MEO probably occurs secondary to prolonged antibiotic treatment for bacterial MEO. The fungal disease is more invasive than the bacterial disease, although survival is the same. Treatment should be aggressive and hyperbaric oxygen therapy should be considered., (Copyright © 2011 The British Infection Association. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2011
- Full Text
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37. Laryngeal carcinoma in nonsmoking patients.
- Author
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Hamzany Y, Hadar T, Feinmesser R, Guttman D, and Shvero J
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinoma epidemiology, Carcinoma radiotherapy, Female, Glottis pathology, Humans, Laryngeal Neoplasms epidemiology, Laryngeal Neoplasms radiotherapy, Male, Middle Aged, Neoplasm Staging, Prevalence, Carcinoma pathology, Laryngeal Neoplasms pathology, Smoking epidemiology, Smoking Cessation statistics & numerical data
- Abstract
Objectives: Smoking is a known risk factor for laryngeal carcinoma. We sought to describe the clinicopathologic characteristics and outcomes of nonsmoking patients with laryngeal carcinoma., Methods: Of 1,443 patients treated for laryngeal carcinoma between 1960 and 2006, 55 (3.8%) were nonsmokers: 40 (73%) had never smoked and 15 (27%) had stopped smoking 12 years or more before diagnosis. Patient characteristics and outcomes were reviewed., Results: The study group consisted of 87% men; the mean age at diagnosis was 67 years. All lesions but one were located in the glottis. The 5-year survival rate for the whole group was 85%. Most tumors were detected early. Of 38 patients (69%) with stage T1 disease, there was no significant difference in prognostic features between those who had never smoked and those who had smoked in the past., Conclusions: Fewer than 5% of patients with laryngeal carcinoma were nonsmokers. Like smokers, this subgroup was characterized by a male predominance and an approximate age at diagnosis in the seventh decade. Unlike smokers, nonsmokers show a greater predilection for glottic rather than supraglottic disease. There was no difference in prognosis between smokers and nonsmokers, regardless of whether they had smoked in the past.
- Published
- 2008
- Full Text
- View/download PDF
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