OBJECTIVES/HYPOTHESIS-Mortality for black males with head and neck squamous cell carcinoma (HNSCC) is twice that of white males or females. Human papillomavirus (HPV)-active HNSCC, defined by the concurrent presence of high-risk type HPV DNA and host cell p16 INK4a expression, is associated with decreased mortality. We hypothesized that prevalence of this HPVactive disease class would be lower in black HNSCC patients compared to white patients. RESULTS-There were 140 patients with HNSCC who met inclusion criteria. Self-reported ethnicity was white (115), black (25), and other (0). Amplifiable DNA was recovered from 102/140 patients. The presence of HPV DNA and the level of p16 INK4a expression were determined and the results were used to classify these patients as HPV-negative (44), HPVinactive (33) and . Patients with HPV-active HNSCC had improved overall 5-year survival (59.7%) compared to HPV-negative and HPV-inactive patients (16.9%) (P=0.003). Black patients were less likely to have HPV-active disease (0%) compared to white patients (21%), P=0.017. STUDY DESIGN-Multi-institutional retrospective cohort analysis. METHODS-Real-time CONCLUSIONS-The favorable HPV-active disease class is less common in black than in white patients with HNSCC, which appears to partially explain observed ethnic health disparities.

Objectives The purpose of this study is to report on long-term outcomes in a prospective study comparing the quality of life outcomes in smokers and non-smokers undergoing functional endoscopic sinus surgery. Study Design Prospective clinical trial. Methods A total of 235 patients were prospectively enrolled at a single tertiary academic center. Preoperative SNOT-20 scores and comprehensive demographic and smoking data were obtained. Preoperative SNOT-20 scores were compared to postoperative SNOT-20 scores. Results Long-term followup results were available in 111/185 nonsmokers (60%) and 26/50 smokers (52%). Non-smokers had a mean preoperative SNOT-20 score of 26.2, a short-term followup score of 10.1 (mean 3.1 months) and a long-term followup score of 11.4 (mean 44.2 months). Smokers had a mean preoperative SNOT-20 score of 27.8, a short-term followup score of 5.7 (mean 3.1 months) and a long-term followup score of 8.3 (mean 40.3 months). The mean improvement in SNOT-20 scores for smokers was significantly greater than non-smokers in short-term followup (p=.044), however no significant difference in improvement was seen between smokers and non-smokers at long-term followup. Conclusions Both smokers and non-smokers continue to maintain a highly significant improvement in SNOT-20 scores following endoscopic sinus surgery at long-term followup. While smoking remains a well documented cause of medical morbidity, smokers maintained an improvement in quality of life after long-term followup from endoscopic sinus surgery in this prospective study.

Removal of the bony pedicle resulted in excellent local control of skull base inverted papillomas. Our experience demonstrates that disease eradication with limited morbidity is attainable with this approach.

Objectives: Establish whether total thyroidectomy can be performed safely in the outpatient setting.Methods: This was a retrospective review of 410 total thyroidectomies performed by a single surgeon between 2009-2012. Of these, 241 were performed as an outpatient surgical procedure. Outcome measures included symptomatic hypocalcemia, readmission for hypocalcemia, true vocal cord paralysis/ paresis, hematoma, and overall readmission rate.Results: Of the total thyroidectomies performed by a singlesurgeon between 2009-2012, 241/410 (59%) were outpatient procedures. Symptomatic hypocalcemia occurred in 12/241 (4.9%) and readmission for hypocalcemia occurred in 4/241 (1.6%). True vocal cord paralysis was not observed, however 5/241 (2.1%) did have transient vocal cord weakness that resolved without further intervention. Hematoma requiring surgical intervention occurred in 2/241 (0.8%). Overall readmission rate was 5/241 (2.1%).Conclusions: Though traditionally an inpatient procedure; our experience indicates that outpatient thyroidectomy is a safe and reasonable option.

Thyroid surgeons will be faced more often with the prospect of elective thyroid surgery in patients of advanced age as an increasingly aged population emerges and the prevalence of thyroid nodules and thyroid cancer increases. Thyroid surgery in elderly patients is safe and no more dangerous than surgery in youthful patients. There is a slightly higher rate of readmission.