region and auto-transplantation in the clinical approaches andcould play an instructional role during early phases of bacterialchallenge.

Micro Fluidic Devices for Evaluating HNSCC Tumor

Biology

Deborah Sylvester, MBChB, MRCS, DOHNS(presenter); Samantha Hattersley, BSc; StephenHaswell, PhD; Nicholas Stafford, MB, ChB, FRCS;John Greenman, PhD

OBJECTIVE: 1) To utilize custom-made micro fluidic cham-bers to maintain pieces of head and neck tumor in a viablestate. 2) To quantify the effects of chemotherapy agents onthese tumor biopsies, with the aim of developing a personal-ized chemotherapy model.METHOD: Fresh pieces (5-10mg) of primary HNSCC ormetastatic lymph node were placed in micro fluidic devicesand subjected to continuous media perfusion under laminarflow conditions for up to four days. The effluent was evaluatedfor the concentration of lactate dehydrogenase (LDH); amarker of cell death. Tumor viability was assessed using thecell proliferation reagent WST-1 (both commercial assays,Roche Diagnostics). Architectural changes in the tissue follow-ing perfusion were studied by H�E stained cryostat sections.Following optimization of the approach (n�20), tissue wascontinuously subjected to a concentration of cisplatin and 5-FUequivalent to plasma doses, alone and in combination.RESULTS: LDH reproducibly showed a rapid decrease overthe first 12 hours of incubation to minimal detectable levels.Conversely, WST-1 levels increased over four days. The ad-dition of cell lysis buffer at any point resulted in an increase incell death and reduction in cell proliferation. Preliminary re-sults (n�4) for the addition of chemotherapy agents showedcell death when 5-FU or cisplatin were added, with a syner-gistic effect when given in combination.CONCLUSION: This study demonstrates a robust and repro-ducible system for the maintenance and interrogation of tumorbiopsies. The innovative model provides a new platform fortesting individual patient responses to chemotherapy, pavingthe way for a personalized treatment regimen.

MicroRNAs Expression Profile in Head and Neck

Cancer

Valentina Manciocco, PhD (presenter); FedericaGanci; Giulia Fontemaggi; Giovanni Blandino;Giuseppe Spriano

OBJECTIVE: Be able to characterize miRNAs signatureswith prognostic, predictive, or diagnostic power in HNSCCand at identifying possible correlations with TP53 status.METHOD: Patients with histologically proven HNSCC whounderwent surgical treatment without any previous chemo/

radio-therapeutic treatment were included in the study. Threebiopsies, from the tumor itself, peri-tumoral tissue, and normaltissue, were obtained for each patient and submitted to RNAand genomic DNA extraction.RESULTS: TP53 status was assessed in 55 patients, by directsequencing of exons 5 to 8, and 23 out of these 55 showedTP53 mutations. TP53 status was also evaluated in the peri-tumoral and normal counterparts and a wild-type TP53 se-quence was found in all cases. Additionally, cDNA cloningand subsequent sequencing from samples carrying double andtriple TP53 mutations showed the existence of different allelicpopulations, suggesting that these tumors are composed byTP53-heterogeneous cell types. MicroRNAs expression profil-ing was performed on 55 patients using the Agilent platform.Nineteen miRNAs are differentially regulated in the HNSCCsamples when compared with their normal tissue counterparts,while 18 miRNAs are significantly altered in their expressionwhen compared with their peri-tumoral tissue counterparts.CONCLUSION: The data obtained by TP53 cloning suggestthe presence of different clonal populations in the tumor. Mi-croarray analysis indicates that microRNAs are strongly mod-ulated between HNSCC tumor and non-tumor samples. Ongo-ing analyses are integrating microRNAs expression data withclinical information in order to evaluate the predictive/prog-nostic power of the modulated microRNAs.

Minimally Invasive Balloon Sialodochoplasty &

Sialolithotomy

Jonathan Boyd, MD (presenter); Sepehr Oliaei, MD;Marc Rubinstein, MD; Jason Kim, MD

OBJECTIVE: At the conclusion of the presentation of thisposter, the audience will be able to understand the minimally-invasive approach for the treatment of recurrent sialolithiasisand use it in select cases.METHOD: Retrospective review of one case of recurrentparotitis with documented presence of a salivary duct calculus.The study was conducted at a University-affiliated institution.A 46 year old male patient, presented to the emergency roomwith acute parotitis of several days duration. The patient re-ported a history of multiple similar episodes, treated withconservative measures (local heat, aggressive hydration sia-logogues, and antibiotics). A contrast enhanced computed to-mography scan revealed a 5 mm calculus in the parotid duct,with proximal dilatation, significant gland edema and inflam-mation, with likely phlegmon. The patient was admitted andtreated with IV antibiotics. The patient was taken to the ORafter failure to improve with conservative measures and con-cern for abscess.RESULTS: The duct was explored with a lacrimal probe anda moderate amount of pus was expressed from the gland. A 4Fr Fogarty catheter was then introduced into the duct andadvanced past the calculus. The catheter was slowly inflatedand withdrawn and the calculus was successfully retrieved

P166 Otolaryngology-Head and Neck Surgery, Vol 143, No 2S2, August 2010

from the duct. Copious amounts of pus were then drained fromthe gland. The patient was subsequently discharged after res-olution of the parotitis.CONCLUSION: Transoral, minimally-invasive, balloon sia-lodochoplasty with sialolithotomy is an effective, safe alterna-tive to surgical management of obstructive salivary disease thatfails to respond to conservative measures.

Misrepresentation in Otolaryngology Residency

Applications

Daniel Beswick, BSc (presenter); Li-Xing Man, MSc,MD; Bruce Johnston, MLS; Jonas T Johnson, MD;Barry M. Schaitkin, MD

OBJECTIVE: 1) To assess the extent of research publicationmisrepresentation among 2010 otolaryngology residency ap-plicants. 2) To determine applicant attributes associated withmisrepresentation.METHOD: Electronic Residency Application Service appli-cations to the 2010 class of an otolaryngology residency pro-gram were prospectively reviewed for peer-reviewed journalpublications reported as provisionally accepted, accepted, or inprint. Publications were verified by searching PubMed, GoogleScholar, and electronic journals directly. Ulrichs InternationalPeriodicals Directory was consulted to facilitate inter-librarysearches. Applicants with remaining unverified publicationswere contacted via e-mail prior to announcing interviews.Misrepresented publications were defined as those that wereeither erroneously reported or unverifiable.RESULTS: Of the 325 applicants, 173 (53.2%) reported 432publications. Contacting applicants verified 26 publicationsand identified 10 errors. Seventeen applicants (9.8%) misrep-resented 22 publications (5.1%). Seven publications were in-appropriately reported as provisionally accepted, 3 publica-tions were not peer-reviewed, and applicants were erroneouslylisted as first author in 2 publications. Ten publications re-mained unverifiable. Applicants more likely to misrepresent apublication had four highly collinear attributes: Internationalmedical graduate (P�0.0001), older age (P�0.001), lowerUSMLE score (P�0.017), and two-or-more years betweenmedical school and planned residency (P�0.0001). All U.S.applicants with misrepresented publications were male(P�0.035) and were from a medical school not ranked in thetop 50 by U.S. News & World Report for research (P�0.002)or primary care (P�0.018).CONCLUSION: Misrepresentation of research experienceexists among otolaryngology residency applicants. The Elec-tronic Residency Application Service should develop standard-ized definitions and guidelines for provisional acceptance tohelp reduce this rate of misrepresentation.

MRI Findings in Castleman’s Disease of the Parotid

Mia E Miller, MD (presenter); John Moriarty, MD;Paul Kedeshian, MD

OBJECTIVE: 1) Analyze the clinical presentation and imag-ing features of Castleman’s disease of the parotid at a singleinstitution. 2) Compare these findings with other cases ofintraparotid Castleman’s disease through literature review.METHOD: A retrospective review of patients who underwentparotidectomy for Castleman’s disease at a tertiary care centerwas completed, as well as literature review.RESULTS: Castleman’s disease is a lymphoproliferative dis-order which very rarely involves the parotid. Two patients withthis disease were identified from a single institution. The firstwas evaluated for a right parotid mass, and preoperative MRIshowed a superficial T2-hypointense lesion. Parotidectomywas performed, and histopathology revealed lymphoid tissuewith multiple secondary lymphoid follicles in a background offibrous bands and interfollicular vascular proliferation withhyalinization, consistent with Castleman’s disease. The secondpatient underwent left parotidectomy, with similar histopathol-ogy. Preoperative MRI showed a T1-isointense, T2 intermedi-ate-signal intensity mass within the superficial lobe. There areonly 28 previous reports of Castleman’s disease of the parotidin the English language literature. Imaging findings in eachcase are reviewed. On CT, Castleman’s disease most often is awell-circumscribed homogeneous mass consistent with benigntumor. On MRI, Castleman’s disease of the parotid has vari-able T1 and T2 intensities with other documented features,including central fibrosis or calcification and surrounding vas-cular bundles.CONCLUSION: This is the first study to comprehensivelyreview imaging findings of Castleman’s disease in the parotid.Variable expression of Castleman’s disease on MRI may helpdistinguish it preoperatively from common benign parotid le-sions, such as pleomorphic adenoma.

Multiplanar CT Reconstruction to Diagnose

Lemierre Syndrome

Mona Shete, MD (presenter); Merry Sebelik, MD;Jorge Salazar, MD

OBJECTIVE: 1) Review presentation, diagnosis, and manage-ment of Lemierre syndrome (infectious jugular venous throm-bosis). 2) Discuss use of multiplanar reconstruction of contrastCT images to diagnose internal jugular vein (IJV) thrombosis.3) Learn the indications for obtaining alternative (non-axial)image views and discuss the need for more invasive diagnosticimaging studies such as angiography in detecting IJV throm-bosis.METHOD: This is a case report with a review of the literature.The patient presented in 2009 to the Veterans AdministrationMedical Center-Memphis and was evaluated as an inpatient bythe Otolaryngology Service. Reconstruction of initial CT im-ages provided confirmation of the diagnosis of Lemierre syn-drome. A literature search was undertaken to delineate the

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