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June 7, 1995

Otolaryngology—Head and Neck Surgery

Author Affiliations

The Johns Hopkins University School of Medicine, Baltimore, Md

JAMA. 1995;273(21):1705-1706. doi:10.1001/jama.1995.03520450075039

The recent otolaryngology literature documents advances in understanding several disorders of interest to all physicians. Approaches to head and neck cancer, vocal cord palsy, sinusitis, otitis media, and hearing impairment have been heavily scrutinized in recent publications. A survey of this literature reflects continued progress in further refining interventions and their indications and in assessing patient outcomes for these prevalent disorders.

Our molecular understanding of head and neck cancer continues to evolve and promises new directions in treating these lesions. Surgical oncologists have traditionally relied on light microscopic assessment of margins to ensure complete excision of a carcinoma. However, rare cancer cells at the margins of resection or in cervical lymph nodes may escape detection. With the use of molecular techniques, 13 of 25 patients with head and neck squamous cell carcinoma were found to have neoplastic cells in at least one tumor margin deemed to be negative by light

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