Purpose: The purpose of this study was to determine whether curcumin would trigger cell death in the head and neck squamous cell carcinoma (HNSCC) cell lines CCL 23, CAL 27, and UM-SCC1 in a dose-dependent fashion. Experimental Design: HNSCC cells were treated with curcumin and assayed for in vitro growth suppression using 3-(4,5-dimethylthiozol-2-yl)-2,5-diphenyl tetrazolium bromide and fluorescence-activated cell sorting analyses. Expression of p16, cyclin D1, phospho-Inh, and nuclear factor-nh (NF-nh) were measured by Western blotting, gel shift, and immunofluorescence. Results: Addition of curcumin resulted in a dose-dependent growth inhibition of all three cell lines. Curcumin treatment resulted in reduced nuclear expression of NF-nh. This effect on NF-nh was further reflected in the decreased expression of phospho-Inh-a. Whereas the expression of cyclin D1, an NF-nh^activated protein, was also reduced, there was no difference in the expression of p16 at the initial times after curcumin treatment. In vivo growth studies were done using nude mice xenograft tumors. Curcumin was applied as a noninvasive topical paste to the tumors and inhibition of tumor growth was observed in xenografts from the CAL27 cell line. Conclusions: Curcumin treatment resulted in suppression of HNSCC growth both in vitro and in vivo. Our data support further investigation into the potential use for curcumin as an adjuvant or chemopreventive agent in head and neck cancer.

C.

Juvenile nasopharyngeal angiofibromas are vascular neoplasms, which originate characteristically in the posterior lateral wall of the nasopharynx. Although angiofibromas extend beyond the nasopharynx commonly, they rarely originate outside the nasopharynx. Reports of primary extranasopharyngeal angiofibromas have appeared sporadically in the literature. We present an unusual case of an angiofibroma arising from the middle turbinate. The clinical characteristics of extranasopharyngeal angiofibromas do not conform to that of nasopharyngeal angiofibromas. Therefore, they can present diagnostic challenges. A methodic evaluation and a high index of suspicion are essential in establishing the proper diagnosis and treatment.

To evaluate the effect of curcumin on production of interleukin 6 (IL-6) and 8 (IL-8) in head and neck squamous cell carcinoma (HNSCC) cell lines and to determine the mechanism by which these effects are modulated. Curcumin suppression of HNSCC is believed to be partly due to inhibition of the transcription factor nuclear factor-␤ (NF-␤). Interleukin 6 and IL-8 are cytokines induced by NF-␤ activation with elevated levels in the serum of patients with HNSCC.Design: We treated HNSCC cell lines CCL23, CAL27, UM-SCC1, and UM-SCC14A with increasing doses of curcumin and measured IL-6 and IL-8 levels using an enzyme-linked immunosorbent assay.Setting: Levels of NF-␤, I␤ kinase (IKK), and phosphorylated I␤ were analyzed by means of Western blot. The IKK activity was measured in UM-SCC14A cells using an IKK-specific I␤␣ substrate after treatment with curcumin.Main Outcome Measures: Reverse transcriptionpolymerase chain reaction was performed to determine the effect of curcumin on the expression of IL-6 and IL-8.Results: Curcumin treatment resulted in dose-dependent inhibition of IL-6 and IL-8 in all cell lines. All cell lines had similar NF-␤ levels; however, UM-SCC1 and UM-SCC14A had significantly higher I␤ kinase levels and required considerably higher doses of curcumin before inhibition of IL-6 and IL-8 occurred. Curcumin treatment resulted in inhibition of IKK activity and inhibition of IL-6 and IL-8 expression.Conclusions: Curcumin significantly reduces IL-6 and IL-8 levels in HNSCC cell lines. This mechanism appears to be mediated via inhibition of I␤-kinase activity in the NF-␤ pathway. Interleukins 6 and 8 have potential use as biomarkers to measure the efficacy of treatment with curcumin.

Minitrephination is a safe and effective adjunct in the management of complex frontal sinus disease, as it allows identification of the frontal recess and vigorous irrigation of the sinus contents.

In recent years endoscopically controlled laser-induced thermal therapy (LITT) has been increasingly accepted as a minimally invasive method for palliation of advanced or recurrent head and neck or gastrointestinal cancer. Previous studies have shown that adjuvant chemotherapy can potentiate endoscopic laser thermal ablation of obstructing tumors leading to improved palliation in advanced cancer patients. Eight patients with recurrent head and neck tumors volunteered to enroll as part of an ongoing phase II LITT clinical trial, and also elected to be treated with systemic chemotherapy (cisplatin, 80 mg/m2) followed 24 h later by palliative laser thermal ablation. Laser treatments were repeated in patients with residual disease or recurrence for a total of 27 LITT sessions. Four of the 8 patients treated with laser thermal chemotherapy remained alive after a median follow-up of 12 months. Of the 12 tumor sites treated, complete responses were located in the oral cavity (3), oropharynx (1), hypopharynx (1), maxillary sinus (1), and median survival for these patients was 9.5 months. This initial experience with cisplatinum-based laser chemotherapy indicates both safety and therapeutic potential for palliation of advanced head and neck cancer but this must be confirmed by longer follow-up in a larger cohort of patients.

We retrospectively reviewed the outcomes of 40 patients whohadundergone outpatientuvulopalatopharyngoplasty (UPPP) for the treatment of moderate to severe obstructive sleep apnea (OSA) in order to determine the safety of theprocedure in an outpatient setting. Postoperatively, 36 of the 40 patients (90%) were discharged home the day of surgery without morbidity; 3 otherpatientsstayed overnightfor nonmedical reasons, and 1 patient who was already an inpatient remained hospitalized for unrelated medical issues. No postoperative complications occurred, and all patients reported a resolution of OSA symptoms and improvement in sleep. Based on a combination of our data and those of previous studies, we conclude that patientswith significant OSA cansafely undergo UPPP as an outpatient procedure. We recommend that guidelines regarding the perioperative care of patients with OSA be adjusted to include consideration of treatment in an outpatient setting.

sustained head and neck trauma and adolescents who sustained trauma restricted to other body regions was investigated. METHODS: A total of 166 adolescents treated for trauma in two emergency departments were studied. Patients were categorized according to whether they sustained a head and neck trauma (nϭ57) or general trauma (nϭ109). A further 78 were evaluated with the Cognitive Appraisal of Risky Events (CARE), to determine the prevalence of risky behaviors. RESULTS: The head and neck trauma cases had a greater proportion of males (42%) than females (22%) (pϭ.01) and they were more likely to report drinking at the time of their injury (48%) compared to general trauma patients (27%) (pϭ.008). Stratifying by gender, more males with head and neck trauma were drinking at the time of their injury (56%) compared to males with general trauma who were drinking at the time of their injury (32%) (pϭ.02). The CARE revealed a statistical trend for adolescents with head and neck trauma to be more likely to get into a fight or argument (pϭ.10), and to participate in other forms of aggressive behavior compared to adolescents with general trauma. CONCLUSION: Male adolescents with head and neck trauma are more often drinking at the time of injury than male adolescents with general trauma. All adolescents with trauma should be screened for alcohol misuse. However, medical personnel should be aware that adolescent males with head and neck injuries have a higher rate of drinking at the time of injury and are more likely to participate in aggressive behaviors than adolescents with general trauma. SIGNIFICANCE: This study demonstrates that head and neck trauma patients are at particular risk for unhealthy alcohol use. SUPPORT: LIP (local initiated project, Univ. of Pittsburgh).