Jeong Kyu Kim

Background: The prognostic significance of p16/HPV discordance in oropharyngeal squamous cell carcinoma (OPSCC) remains incompletely characterized, particularly in Asian populations. We evaluated the prevalence and prognostic significance of p16/HPV discordance using the nationwide Korean Oropharyngeal Cancer (K-OPC) cohort.Methods: We retrospectively analyzed patients with OPSCC treated at 24 institutions in Korea between 2013 and 2022. Patients with available results for both p16 immunohistochemistry and HPV testing were classified into four subtypes: HPV-negative/p16-negative, HPV-negative/p16-positive, HPV-positive/p16-negative, and HPV-positive/p16-positive. Overall survival (OS) and disease-free survival (DFS) were compared using Kaplan-Meier analysis. Multivariable Cox regression for DFS was adjusted for age, sex, smoking status, alcohol consumption, primary tumor subsite, and tumor stage.Findings: Among 1,522 patients, 316 (20·8%) were HPV-negative/p16-negative, 193 (12·7%) were HPV-negative/p16-positive, 23 (1·5%) were HPV-positive/p16-negative, and 990 (65·0%) were HPV-positive/p16-positive, yielding an overall discordance rate of 14·2%. In multivariable analysis, the HPV-negative/p16-positive and HPV-positive/p16-positive groups had significantly better DFS than the HPV-negative/p16-negative group, whereas the HPV-positive/p16-negative group showed no significant difference from the HPV-negative/p16-negative group. In adjusted pairwise comparisons, DFS did not differ significantly according to HPV status among tumors with the same p16 status, whereas p16-positive tumors had significantly better DFS than p16-negative tumors within both HPV-negative and HPV-positive groups.Interpretation: In a nationwide Korean cohort, p16/HPV discordance occurred in 14·2% of OPSCC and was predominantly HPV-negative/p16-positive. Prognosis in discordant tumors tracked with p16 status rather than HPV status, independently of stage and other clinical covariates.

This case report investigates the effects of semi-occluded vocal tract exercises (SOVTEs) on voice improvement in elderly female patients with presbyphonia. Elderly female patients with presbyphonia commonly present with symptoms such as hoarseness, decreased vocal intensity, and phonatory difficulties. These symptoms are often associated with age-related vocal fold atrophy, leading to compensatory muscle tension and inefficient phonation, which necessitate targeted therapeutic interventions. In this study, two elderly female patients, aged 73 years and 71 years, participated in a voice therapy program centered on SOVTEs designed to promote vocal fold vibration efficiency and reduce compensatory tension. Case 1 underwent five therapy sessions, while Case 2 completed sixteen sessions. Pre- and post-treatment voice assessments revealed notable improvements in vocal quality, suggesting that SOVTEs may be an effective therapeutic approach for managing presbyphonia in elderly women.

임상이비인후과(Journal of Clinical Otolaryngology Head and Neck Surgery)

서 론 여포성 수지상세포 육종은 서서히 자라나는 무통성 종 괴로 발견되는 암종 중 하나로 전체 육종의 약 0.4%를 차지하는 드문 유형에 속한다.

Background: Head and neck squamous cell carcinoma (HNSCC) is closely associated with alcohol consumption and individual genetic susceptibility, such as single nucleotide polymorphism (SNP) of alcohol dehydrogenase (ADH). This study aimed to investigate the association of ADH7 SNPs with the risk of HNSCC. Methods: We analyzed ADH7 rs1573496C>G, rs3737482T>C, rs1154460G>A, and rs284787T>C SNPs in 250 patients with HNSCC and 322 controls in the Korean populations. Genotyping was conducted using the TaqMan assay. Linkage disequilibrium and haplotypes were analyzed. Results: The odds ratios (OR) and 95% confidence intervals (CI) of the CT and CC genotypes of ADH7 rs3737482T>C were 0.48 (0.29–0.78) and 0.69 (0.49–0.96), indicating a significantly decreased risk. In SNP of rs1154460G>A, the OR and 95% CI of the AA genotype was 1.63 (1.11–2.40), showing a significant increase in the risk. Furthermore, SNPs of ADH7 rs3737482T>C and ADH7 rs1154460G>A exhibit synergistic interactions with alcohol composition on the risk of HNSCC. None of the haplotypes were associated with the risk of HNSCC. Conclusions: ADH7 rs3737482T>C and rs1154460G>A SNPs are associated with the risk of development of HNSCC in Koreans. They could serve as molecular biological markers to screen high-risk groups for HNSCC.

임상이비인후과(Journal of Clinical Otolaryngology Head and Neck Surgery)

Background: This study aimed to evaluate the feasibility, safety, and early surgical outcomes of transoral robotic and endoscopic thyroidectomy conducted by a novice surgeon. Methods: We analyzed 27 patients who underwent transoral thyroidectomy between December 2018 and November 2021. All the surgeries were performed by a novice surgeon without prior endoscopic or robotic surgery experience; the surgeon had experienced 12 cases of transcervical thyroidectomy before adopting transoral thyroidectomy. Results: Of the 27 cases, 1 was converted to the transcervical approach due to poor bleeding control. Four cases had transient recurrent laryngeal nerve palsy, and three had transient hypoparathyroidism. Most of the patients were very satisfied with the postoperative cosmetic outcome. Conclusions: Transoral robotic and endoscopic thyroidectomies are feasible for the novice surgeon, with reasonable results in the early adoption stage if preparations are according to the suggested framework.

Purpose: We aimed to evaluate the true prevalence and characteristics of vagus nerve (VN) variations using the carotid artery (CA) and the internal jugular vein (C-I axis).Methods: We examined patients who underwent neck ultrasonography (US) conducted by a single operator. A VN variation was defined as a VN located anterior or medial to the C-I axis. The subtypes of VN variation were classified as anterolateral, anteromiddle, anteromedial, and medial based on the relative location of the VN to the CA. The primary outcome parameters were the prevalence of VN variations and differences according to side, age, and sex.Results: Out of 536 patients, right and left VN variations were identified in 20 (3.7%) and 186 (34.7%), respectively (P<0.001). The anteromiddle type was the commonest type observed on both sides. Eight right (1.5%) and 50 left VNs (9.3%) were located <2 mm from the lateral border of the ipsilateral thyroid gland (P<0.001). The prevalence of VN variations in male and female patients was 42.1% and 32.7%, respectively (P=0.029), and that in patients aged <20, 20-39, 40-59, and ≥60 years was 23.8%, 22.5%, 34.4%, and 47.4%, respectively (P<0.001).Conclusion: Variations in the VN position were relatively common on US. The variations primarily involved the left VN in the lower cervical region, and an increasing prevalence with age was observed.

임상이비인후과(Journal of Clinical Otolaryngology Head and Neck Surgery)