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Laser-assisted tonsillar ablation: A preliminary report
P 180
Otolaryngology Head and Neck Surgery August 1996
Scientific Posters
the above findings to cultural values and belief with respect to attitudes about seeking medical care, as well as socioeconomic factors, are implicated. 61 Laser-Assisted Tonsillar Ablation: A Preliminary Report REGINA P. WALKER, MD, CHELLAM GOPALSAMI, PhD, and ABHAY M. VAIDYA; MD, Maywood, III.
Objective: Tonsillectomy has been the standard surgical procedure for the treatment of chronic cryptic tonsillitis and obstructive tonsillar hypertrophy. Recently laser-assisted tonsillar ablation (LATA) has been popularized as an alternative treatment for these conditions. The objective of this study is to review the surgical technique, outcome, and complications associated with this new procedure. Methods: Twenty-two patients were evaluated for LATA, and 14 patients underwent LATA for chronic tonsillitis and obstructive tonsillar hypertrophy. LATA was performed in the clinic with the patient under only local anesthesia. Results: Fourteen patients underwent between one and seven sessions to complete their treatment. All treatments were done in the clinic, no patients were admitted at any time, and there were no cases of postoperative hemorrhage. Conclusion: LATA is an alternative treatment for chronic cryptic tonsillitis or obstructive tonsillar hypertrophy. Because it is done in the clinic with the patient under local anesthesia, it may be a preferable method in patients who cannot tolerate or refuse a general anesthetic. 62 Mutations of P16, PRAD-I/CCNDI Polymorphlsm and Amplification of HST-I Are Related with Nodal Status in Head and Neck Squamous Cell Carcinoma JESUS GARCIA-FONCILLAS, MD, JUAN ALCALDE, MD, MARISOL GONZALEZ, MARIA-JESUS MARTINEZ, and MARIA GUZMAN, Pamplona, Spain
Objective: Abnormalities in chromosome 1 lql3 regions have been frequently found in head and neck squamous cell carconoma (HNSCC). The mechanisms by which genes located in this site promote tumorigenesis remains unclear but may play a role in regulation of the cell cycle. MTSI/ CDKN2/pl6 prevents the association of CDK4 with cyclin D and the subsequent substrates necessary for transit through the GI phase. Thus alterations in these genes could result in abnormal proliferation via defective cell cycle control. This study aims to analyze these oncogene abnormalities and the involvement of these alterations in the clinical behavior of the tumors. Methods: Forty-seven primary HNSCC and 29 metastatic lymph nodes were evaluated. Distribution of clinical staging was as follows: stage I, 12% (5 of 47); stage II, 18% (9 of 47); stage III, 39% (18 of 47); and stage IV, 41% (20 of 47). DNA was isolated from frozen tissue samples. Gene amplification was performed, and subsequent PCR products
were analyzed by direct sequencing. RFLP analysis of the PRAD-I/CCND1 polymorphism was used. Aneuploidy was assessed by flow cytometry. Results: Mutations of p16 were found in 1 (5%) of 18 of stage III and 2 (10%) of 20 of stage IV tumors. Node samples showed 5 (17%) of 29 p16 mutations. On the basis of the CCND1/PRAD-1 polymorphism, patients were subdivided into GG group versus AG and AA groups. The GO group was more frequent in stages I and II (8 of 14, 57%), and the AG/AA group was more frequent in stages III and IV (25 of 38, 65%; p = 0.02). Metastatic lymph nodes showed 21 (69%) of 29 samples with genotype AG/ AA (p = 0.04). Amplification of hst-I was detected in 3 (21%) of 14 of stages I-II and 22 (57%) of 38 of stages IIIIV (p = 0.04). Node samples showed 21 (69%) of 29 positive hst-1 amplifications. No statistical significance was found with histologic differentiation. DNA aneuploidy was more frequent with hst-I amplification and AG/AA CCND1/PRAD1 polymorphism. Conclusions: These data suggest that node involvement in HNSCC is associated with mutations of p16, AG/AA PRADl-polymorphism, and hst-I amplification.
63 Differential Dlgital Image Analysls of Nasal Epitheliumm Polypold Versus Nondiseased Mucosa DANNY HERNANDEZ, BA, HARRY CANTRELL, MD, FACS, and CHARLES W, HEWITr, PhD, New Brunswick and Camden, N.J.
Prolonged edema or irritation from chronic infection, allergy, or acetylsalicylic intolerance can elicit a hypersensitivity response giving rise to polypoid nasal mucosa. We analyzed the changes in nuclear intensity, shape, size, and proliferative characteristics of nasal polyps and nondiseased controls through digital processing and morphometric analysis of histologically prepared tissue samples. It was hypothesized that polypoid respiratory epithelium should stain at lower digital intensity (greater numeric value) and size, reflecting the proliferative characteristics of the tissue. Tissue samples (n = 20) were obtained from patients requiring nasal polypectomies for nasal obstruction and nondiseased controls. Parameters measured included shape factor, compactness, average density, intensity (gray scale), number of pixels, and perimeter. Gray scale pixel intensity values were plotted on a frequency distribution. Digital image analysis demonstrated an increase in white pixel distribution for nuclei in polypoid mucosal tissue (106) compared with controls (56; p <0.001). Further analysis demonstrated an increase in shape factor and perimeter of nuclei in polypoid tissue as well. In conclusion, the histologic studies of nasal polyp epithelium demonstrated increased nuclear activity when compared with nasal mucosa without polypoid changes. Computerized digital image analysis afforded an excellent technique for quantitating nuclear changes and potential for polyp formation. Additionally, the frequency distributions were quite predictable,
Otolaryngology Head and Neck Surgery August 1996
Scientific Posters
the above findings to cultural values and belief with respect to attitudes about seeking medical care, as well as socioeconomic factors, are implicated. 61 Laser-Assisted Tonsillar Ablation: A Preliminary Report REGINA P. WALKER, MD, CHELLAM GOPALSAMI, PhD, and ABHAY M. VAIDYA; MD, Maywood, III.
Objective: Tonsillectomy has been the standard surgical procedure for the treatment of chronic cryptic tonsillitis and obstructive tonsillar hypertrophy. Recently laser-assisted tonsillar ablation (LATA) has been popularized as an alternative treatment for these conditions. The objective of this study is to review the surgical technique, outcome, and complications associated with this new procedure. Methods: Twenty-two patients were evaluated for LATA, and 14 patients underwent LATA for chronic tonsillitis and obstructive tonsillar hypertrophy. LATA was performed in the clinic with the patient under only local anesthesia. Results: Fourteen patients underwent between one and seven sessions to complete their treatment. All treatments were done in the clinic, no patients were admitted at any time, and there were no cases of postoperative hemorrhage. Conclusion: LATA is an alternative treatment for chronic cryptic tonsillitis or obstructive tonsillar hypertrophy. Because it is done in the clinic with the patient under local anesthesia, it may be a preferable method in patients who cannot tolerate or refuse a general anesthetic. 62 Mutations of P16, PRAD-I/CCNDI Polymorphlsm and Amplification of HST-I Are Related with Nodal Status in Head and Neck Squamous Cell Carcinoma JESUS GARCIA-FONCILLAS, MD, JUAN ALCALDE, MD, MARISOL GONZALEZ, MARIA-JESUS MARTINEZ, and MARIA GUZMAN, Pamplona, Spain
Objective: Abnormalities in chromosome 1 lql3 regions have been frequently found in head and neck squamous cell carconoma (HNSCC). The mechanisms by which genes located in this site promote tumorigenesis remains unclear but may play a role in regulation of the cell cycle. MTSI/ CDKN2/pl6 prevents the association of CDK4 with cyclin D and the subsequent substrates necessary for transit through the GI phase. Thus alterations in these genes could result in abnormal proliferation via defective cell cycle control. This study aims to analyze these oncogene abnormalities and the involvement of these alterations in the clinical behavior of the tumors. Methods: Forty-seven primary HNSCC and 29 metastatic lymph nodes were evaluated. Distribution of clinical staging was as follows: stage I, 12% (5 of 47); stage II, 18% (9 of 47); stage III, 39% (18 of 47); and stage IV, 41% (20 of 47). DNA was isolated from frozen tissue samples. Gene amplification was performed, and subsequent PCR products
were analyzed by direct sequencing. RFLP analysis of the PRAD-I/CCND1 polymorphism was used. Aneuploidy was assessed by flow cytometry. Results: Mutations of p16 were found in 1 (5%) of 18 of stage III and 2 (10%) of 20 of stage IV tumors. Node samples showed 5 (17%) of 29 p16 mutations. On the basis of the CCND1/PRAD-1 polymorphism, patients were subdivided into GG group versus AG and AA groups. The GO group was more frequent in stages I and II (8 of 14, 57%), and the AG/AA group was more frequent in stages III and IV (25 of 38, 65%; p = 0.02). Metastatic lymph nodes showed 21 (69%) of 29 samples with genotype AG/ AA (p = 0.04). Amplification of hst-I was detected in 3 (21%) of 14 of stages I-II and 22 (57%) of 38 of stages IIIIV (p = 0.04). Node samples showed 21 (69%) of 29 positive hst-1 amplifications. No statistical significance was found with histologic differentiation. DNA aneuploidy was more frequent with hst-I amplification and AG/AA CCND1/PRAD1 polymorphism. Conclusions: These data suggest that node involvement in HNSCC is associated with mutations of p16, AG/AA PRADl-polymorphism, and hst-I amplification.
63 Differential Dlgital Image Analysls of Nasal Epitheliumm Polypold Versus Nondiseased Mucosa DANNY HERNANDEZ, BA, HARRY CANTRELL, MD, FACS, and CHARLES W, HEWITr, PhD, New Brunswick and Camden, N.J.
Prolonged edema or irritation from chronic infection, allergy, or acetylsalicylic intolerance can elicit a hypersensitivity response giving rise to polypoid nasal mucosa. We analyzed the changes in nuclear intensity, shape, size, and proliferative characteristics of nasal polyps and nondiseased controls through digital processing and morphometric analysis of histologically prepared tissue samples. It was hypothesized that polypoid respiratory epithelium should stain at lower digital intensity (greater numeric value) and size, reflecting the proliferative characteristics of the tissue. Tissue samples (n = 20) were obtained from patients requiring nasal polypectomies for nasal obstruction and nondiseased controls. Parameters measured included shape factor, compactness, average density, intensity (gray scale), number of pixels, and perimeter. Gray scale pixel intensity values were plotted on a frequency distribution. Digital image analysis demonstrated an increase in white pixel distribution for nuclei in polypoid mucosal tissue (106) compared with controls (56; p <0.001). Further analysis demonstrated an increase in shape factor and perimeter of nuclei in polypoid tissue as well. In conclusion, the histologic studies of nasal polyp epithelium demonstrated increased nuclear activity when compared with nasal mucosa without polypoid changes. Computerized digital image analysis afforded an excellent technique for quantitating nuclear changes and potential for polyp formation. Additionally, the frequency distributions were quite predictable,