Henry T Hoffman

University of Iowa | UI · Department of Otolaryngology-Head and Neck Surgery

Objectives Present follow‐up data comparing transoral and transfacial parotid gland procedures for stone removal to offer insight addressing technical considerations and complications. Methods Retrospective study of a consecutive series of surgical treatments for parotid sialolithiasis from 2013 to 2018 at an academic institution by one surgeon pr...

Objectives: The presence of a catheter required for contrast infusion during sialography obscures imaging of the distal duct. Static imaging via cone beam computed tomography and magnetic resonance sialography fails to address changes that occur dynamically to the anatomy of the flexible salivary ductal system. We aim to identify dynamic changes to...

Immunoglobulin G4 (IgG4)-related disease is an immune-mediated disorder that commonly manifests in the salivary glands. As a recently described disorder, the description and classification of IgG4-related disease is an ongoing process. Diagnosis of IgG4-related disease requires integration of clinical history, histopathology, and radiographic findi...

Objectives The Salivary Gland Committee of the American Academy of Otolaryngology‐Head and Neck Surgery seeks to standardize terminology and technique for ultrasonograpy used in the evaluation and treatment of salivary gland disorders. Methods Development of expert opinion obtained through interaction with international practitioners representing...

Objectives To assess the adequacy of gadolinium in sialography as an alternative contrast agent for patients with iodine allergies. To directly compare images taken with gadolinium versus iodine‐based contrast agents using the Iowa Sialography Classification System. Methods Retrospective chart review was performed on patients undergoing sialograph...

The North American Airway Collaborative (NoAAC) previously published a 3‐year multi‐institutional prospective cohort study showing variation in treatment effectiveness between 3 primary surgical techniques for idiopathic subglottic stenosis (iSGS). In this report, we update these findings to include 5 years of data evaluating treatment effectivenes...

Our review of the literature shows anatomical variation of the submandibular gland is a rare entity, unlike the variation that can be seen in parotid glands. Specifically, bilateral submandibular abnormality has only been reported on one occasion with limited imaging in our review. We report a 78-year-old female with a history of sialadenitis and s...

Objectives: Serial intralesional steroid injection (SILSI) has been increasingly used to treat idiopathic subglottic stenosis (iSGS). Prior studies have shown effectiveness, but not in all patients. This multi-institutional study evaluates the effect of SILSI on time to recurrent operation, peak expiratory flow (PEF), and dyspnea. Methods: Post-...

Küttner tumor is an uncommon cause of salivary gland enlargement that most frequently affects the submandibular gland. More recently it has been considered a manifestation of IgG4-related disease (IgG4-RD) and synonymous with chronic sclerosing sialadenitis (CSS). We present a series of cases to emphasize this clinical entity as a disease pattern a...

Objectives To examine whether social determinants of health (SDH) factors are associated with time to diagnosis, treatment selection, and time to recurrent surgical intervention in idiopathic subglottic stenosis (iSGS) patients. Methods Adult patients with diagnosed iSGS were recruited prospectively (2015-2017) via clinical providers as part of th...

Objectives/Hypothesis To apply a novel sialography classification system to identify parotid and submandibular ductal findings following I‐131 therapy and to assess correlates to dose and duration of symptoms. Study Design Retrospective single‐center case series. Methods Patients who underwent sialography between February 2008 and February 2019 a...

Importance Surgical treatment comparisons in rare diseases are difficult secondary to the geographic distribution of patients. Fortunately, emerging technologies offer promise to reduce these barriers for research. Objective To prospectively compare the outcomes of the 3 most common surgical approaches for idiopathic subglottic stenosis (iSGS), a...

Objectives Tissue effects occurring with potassium‐titanyl phosphorous (KTP) laser treatment are difficult to quantify due to the multiple variables that affect not only the fluence (energy delivered) but also the laser–tissue interaction. This histopathologic analysis of recurrent respiratory papilloma (RRP) removed after treatment with KTP laser...

Background: Parotid swelling is rarely caused by pneumoparotitis from retrograde insufflation of air into Stensen's duct. Previous reports have identified occupational exposures, self-induced habits, exercise, spirometry, and short-term positive pressure airway ventilation as causes of salivary duct insufflation. Methods: We present 2 cases of p...

Fragmentation of flexible laser fiber tips has been reported to occur during therapeutic bronchoscopy and urologic stone treatment. We report fragmentation of 200-µm single-use silica-based fibers during sialendoscopy-controlled Holmium:YAG laser treatment of a parotid and a submandibular stone. The technique employed to successfully retrieve the f...

Basal cell adenomas and basal cell adenocarcinomas show marked histomorphologic similarity and are separated microscopically primarily by the invasive characteristics of the adenocarcinomas. We wished to explore potential differences in the expression of epithelial-mesenchymal transition associated proteins in these two tumor types. A tissue microa...

Background: Vocal tremor may be associated with cyclic oscillations in the pulmonary, laryngeal, velopharyngeal, or oral regions. Objectives: This study aimed to correlate the overall severity of vocal tremor with the distribution and severity of tremor in structures involved. Methods: Endoscopic and clinical examinations were completed on 20...

Objective: Cells, scaffold, and surgical approaches are important for regeneration of the lamina propria of the scarred vocal fold (VF). Microendoscopy of Reinke's space (MERS) is a surgical approach used to access the lamina propria. The present study evaluated MERS in the treatment of VF scarring as compared with standardized approaches for the...

The purpose of this study is to evaluate the efficacy of endoscopic fragmentation and removal of artificial calculi in a live porcine model employing intracorporeal pneumatic lithotripsy. In this experimental study, 7 submandibular ducts were accessed and artificial calculi placed. A salivary pneumatic lithotripter probe was inserted through an int...

Objective: To evaluate the endoscopic fragmentation and removal of human salivary stones by employing intracorporeal pneumatic lithotripsy in a clinical simulation model of the submandibular gland. Study design: Simulation model evaluating endoscopic management of human salivary stones. Setting: Laboratory. Subjects and methods: A flexible n...

Objective: To identify trends in treatment and survival for patients with stage I glottic cancer and glottic carcinoma in situ (CIS). Methods: The 18-registry SEER data were analyzed for CIS and stage I glottic cancer. Treatment variables and observed and relative survival were assessed separately for stage I and glottic CIS. Results: Among 14...

We present a case of duplication of the right internal jugular vein (IJV) in a patient who underwent neck dissection as part of the management of carcinoma of the larynx. The patient was a 63-year-old man who presented to the otolaryngology department with a 7-month history of hoarseness and a 3-week history of noisy breathing. Flexible endoscopy d...

Objectives/HypothesisTransillumination through laryngeal soft tissue may be used to direct percutaneous transcricothyroid membrane subepithelial needle placement in the larynx.Study DesignCadaver simulation (canine and human).Methods Lighted devices, including sialendoscopes and fiberoptic cables, were tested as transilluminating obturators in troc...

Recent guidelines recommend chest computed tomography (CT) for smokers based on studies of individuals aged 55 to 74 years with 30-pack year smoking to detect lung cancers. Some have postulated that a prior diagnosis of head and neck cancer (HNC) should also warrant lung cancer screening with CT, but no studies have demonstrated benefit in this pop...

The purposes of this preclinical study were to investigate histologic and rheologic outcomes of Microendoscopy of Reinke's space (MERS)-guided minithyrotomy and to assess its instrumentation. Human cadaveric and in vivo animal study. Three human cadaveric larynges were treated with MERS-guided placement of Radiesse VoiceGel and immediately evaluate...

Objectives/hypothesis: Fine-needle aspiration (FNA) biopsy and imaging are commonly used in the preoperative assessment of salivary gland mass lesions. The goal of this retrospective study was to clarify the role of FNA and imaging in the workup of salivary gland masses. Study design: Retrospective cohort study. Methods: A computer search iden...

Objective To compare incidence, stage, and survival of upper aerodigestive tract (UADT) cancers in patients with and without chronic lymphocytic leukemia (CLL). Design Inception cohort. Setting National database. Patients Individuals with CLL and UADT cancers included in the Surveillance, Epidemiology, and End Results (SEER) database. Main Outcome...

A 59-year-old woman presented with a 2-month history of daily pain and swelling in the left submandibular region. The swelling occurred with meals and would last 30 minutes before gradually resolving. Over the previous 3 weeks, the pain and swelling had steadily increased. The patient's history was remarkable for papillary thyroid carcinoma that ha...

Determine the frequency of, the characteristics predictive of, and potential associated survival benefit from sentinel lymph node biopsy in a population of patients with desmoplastic melanoma of the head and neck. Analysis of a national database. The 17-registry Surveillance, Epidemiology, and End Results (SEER) database. Using the SEER database, t...

Recurrent infection from stones retained in Wharton's duct after submandibular gland resection warrants intraoperative attention to the duct remnant. Our hypothesis was that retrograde sialendoscopy would help ensure complete stone removal in submandibular gland removal for sialolithiasis. We reviewed 9 sequential cases of submandibular sialolithia...

Oromandibular dystonia (OMD) consists of prolonged spasms caused by contraction of the muscles of the mouth and mandible and involves the muscles of mastication, facial expression, tongue, and eye lids. A multidisciplinary treatment approach is presented including the fabrication of a dental prosthesis to reduce/eliminate the symptoms of OMD. Etiol...

Tracheocutaneous fistulas may persist after tracheostomy. Suture closure of the fistula may result in complications, including infection, wound dehiscence, and pneumomediastinum. We present a simplified and relatively safe technique to close persistent fistulas that may be performed under local anesthesia. A retrospective chart review was performed...

Commercial singers produce chestmix register by maintaining or increasing adduction of the vocal processes (VPs) and by engaging the thyroarytenoid (TA) muscle to a greater degree than they would to produce head register. Prospective cohort study. Simultaneous recordings of TA and cricothyroid (CT) muscle activity, videonasendoscopy, and audio were...

Viscoelastic properties of numerous vocal fold injectables have been reported but not at speaking frequencies. For materials intended for Reinke's space, ramifications of property values are of great concern because of their impact on ease of voice onset. Our objectives were: 1) to measure viscoelastic properties of a new nonresorbing carbomer and...

Objectives/hypothesis: Recurrent respiratory papillomatosis (RRP) is a benign disease characterized by recurrent lesions in the airway. The prevalence and degree of dysplasia that is present in the natural course of RRP is not well established. Adjuvant therapies, such as cidofovir, have been tried with the goal of decreasing the interval between...

Cowden syndrome is an autosomal dominant disorder characterized by benign and malignant hamartomatous lesions that can develop from all three germ cell derivatives. This disorder predisposes patients to develop malignant tumors of the breast, endometrium, and thyroid. We present a patient with clinically relevant manifestations of Cowden syndrome,...

P16 and p53 protein expression, and high-risk human papillomavirus (HPV-HR) types have been associated with survival in head and neck cancer (HNC). Evidence suggests that multiple molecular pathways need to be targeted to improve the poor prognosis of HNC. This study examined the individual and joint effects of tumor markers for differences in pred...

At our institution, the majority of buccal mucosal graft urethroplasties are performed using a two-team approach with an otolaryngologic surgeon. We report our two-surgeon experience with buccal mucosal grafting for reconstruction of all anterior urethral strictures. Twenty-four men underwent autologous buccal mucosal graft urethroplasty between Oc...

Adenoid cystic cancers (ACC) in the head and neck are rare yet present a clinical dilemma. Although 5-y survivals are excellent, they have a propensity for late recurrences. Most of these cancers are initially treated with surgery followed by radiation. When recurrences happen, treatment options are limited both by the morbidity and low efficacy of...

Swallowing is a complex, multistage event with oral, pharyngeal, and esophageal phases. A thorough clinical examination for swallowing complaints begins to differentiate whether the problem is due to anatomic, mechanical, or neurologic etiologies. Based on the clinical suspicion, additional tests may be beneficial, including fluoroscopic and direct...

This study retrospectively reviewed 183 cases of adenoid cystic carcinoma treated over 40 years. The local recurrence free survival rate was 68.2 per cent at five years and 40.8 per cent at 10 years. At 10 years, local recurrence free survival was significantly worse following radiotherapy alone (0 per cent), compared with surgery alone (41.8 per c...

Ultrasound-guided needle localization techniques have been used to direct the resection of targeted axillary lymph nodes in the management of breast cancer. To date, there has been only one other description of this technique as a localization method to direct cancer resection in the neck. We offer further support for the broader application of thi...

The Laryngeal Movement Disorder Clinic (LMDC) was started in 1990 in the Department of Otolaryngology at the University of Iowa. This specialized subset of the general Voice Clinic ( http://www.healthcare.uiowa.edu/otolaryngology/protocols/Parts/Part1/Part1C/P1C1.htm ) is scheduled twice a month for patients with laryngeal movement disorders such a...

Many papers have addressed the technical aspects of free tissue transfer in head and neck cancer patients. However, there has not been a critical assessment of the impact of free tissue transfer on resource utilization and patient morbidity compared with pedicle flap reconstructions. Two cohorts of patients derived from 245 consecutive reconstructi...

We sought to examine the current state of cancer care for head and neck tumors in the United States. We therefore performed a retrospective, longitudinal study of the approximately 822,000 head and neck cancer cases included in the National Cancer Data Base (NCDB) for 1990 through 2004, representing approximately 75% of the estimated incident diagn...

The reported effectiveness of single tumor markers (TMs) associated with squamous cell cancer of the head and neck ranges from 15% to 71%, with most studies reporting sensitivity no higher than 50%. An increased incidence of the syndrome of inappropriate secretion of antidiuretic hormone or arginine vasopressin (SIADH) in patients with head and nec...

Voice training exploits semiocclusives, which increase vocal tract interaction with the source. Modeling results suggest that vocal economy (maximum flow declination rate divided by maximum area declination rate, MADR) is improved by matching the glottal and vocal tract impedances. Changes in MADR may be correlated with thyroarytenoid (TA) muscle a...

To determine the accuracy and prognostic significance of post-treatment [(18)F]-fluorodeoxyglucose positron emission tomography (FDG-PET) in head-and-neck squamous cell carcinoma after radiotherapy (RT). This was a retrospective study of 188 patients with head-and-neck squamous cell carcinoma who had undergone FDG-PET within 12 months after complet...

To evaluate the impact of facial nerve sacrifice and postoperative radiotherapy on the outcome of adenoid cystic carcinoma of the parotid gland. Inception cohort. Retrospective review of Department of Pathology, SNOMED database, and Tumor Registry including health-related quality of life data for the subset enrolled in the longitudinal Outcomes Ass...

Contemporary surgical treatment of the superficial layer of the lamina propria or Reinke's space is most commonly performed through an incision in the overlying vocal fold epithelium. This approach may disrupt normal tissue, induce scarring, and allow extrusion of implanted materials. Previously reported external approaches to Reinke's space requir...

The vacuum-assisted closure (VAC) system is a topical negative pressure dressing that has been used extensively to manage a multitude of complicated wounds, including enterocutaneous fistula. We hypothesize that the VAC system may also facilitate the closure of orocutaneous and pharyngocutaneous fistulas. A retrospective chart review was performed....

Vocal outcomes after medialization laryngoplasty are variable and may change over time. A revision procedure via open approach or an injection laryngoplasty may be necessary to improve vocal outcomes. A retrospective chart review was performed. Twenty-nine subjects were identified and stratified into group 1A (n = 9) if the allograft was reposition...

When a fine needle aspiration biopsy of a thyroid nodule suggests follicular neoplasm, surgery is required for diagnosis. Establishing the diagnosis preoperatively would allow the patient to undergo the appropriate initial thyroidectomy. Preoperative [(18)F]-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging may be able to determine...

Injection laryngoplasty is a common operative technique used in the management of unilateral vocal fold paralysis. Cymetra is a micronized particulate injectable form of acellular human dermis that is commonly used for vocal cord medialization procedures. We report migration of an intracordal bolus of Cymetra into the medial wall of the pyriform si...

This study examined the reliability of two methods for documenting voice quality by clinicians and compared the methods for documenting patients' perceptions of voice quality. It involved a prospective reliability study and a retrospective chart review. Reliability of two clinician-based voice assessment protocols-Grade, Roughness, Breathiness, Ast...

The objective of this study was to determine regional control of local regional advanced head and neck squamous cell carcinoma (HNSCC) treated with intensity-modulated radiotherapy (IMRT), along with the role and selection criteria for neck dissection after IMRT. A total of 90 patients with stage N2A or greater HNSCC were treated with definitive IM...

This study determines if postradiotherapy [18F]fluorodeoxyglucose positron emission tomography (FDG PET) can predict the pathology status of residual cervical lymph nodes in patients undergoing definitive radiotherapy for head and neck squamous cell carcinoma (HNSCC). Patients with stage N2 or higher HNSCC underwent PET and CT imaging after definit...

The acoustic properties of giggle, a mild form of laughter, were studied. The purpose was to determine if there is some uniqueness to the frequency and number of vocalization bursts in giggle. The underlying hypothesis was that a neuromechanical oscillator serves as an activator for rhythmic vocalizations, as in vibrato, with a pair of agonist-anta...

Survival statistics for patients with head and neck squamous cell carcinomas (HNSCC) are commonly calculated from the time of diagnosis. The less commonly employed conditional survival (CS) analyzes survival for patients who have survived a period of time after diagnosis. Useful prognostic information for cancer survivors is provided by CS analysis...

Review the University of Iowa experience with intensity modulated radiation treatment (IMRT) in oropharyngeal squamous cell carcinoma. From January 2000 to July 2004, 66 patients with oropharyngeal cancer were treated with IMRT, 62 with definitive IMRT and 4 postoperative IMRT. Three target volumes (CTV1, CTV2, and CTV3) were defined. The prescribe...

Aspergillus infections in an immunocompetent host seldom occur, and primary laryngeal aspergillus infections are encountered even less frequently. We report a case of a primary noninvasive aspergillus infection of a vocal fold cyst in an immunocompetent host, with resemblance to aspergilloma. © 2006 American Academy of Otolaryngology-Head and Neck...

Survival has decreased among patients with laryngeal cancer during the past 2 decades in the United States. During this same period, there has been an increase in the nonsurgical treatment of laryngeal cancer. The objectives of this study were to identify trends in the demographics, management, and outcome of laryngeal cancer in the United States a...

Objective To determine the regional control of locoregional advanced head and neck squamous cell carcinoma (HNSCC) treated with intensity-modulated radiotherapy (IMRT). Design Retrospective study. Setting Academic center. Patients From December 1999 to July 2005, 100 patients with stage N2A or higher HNSCC were treated with definitive IMRT. Five...

Objective Fine-needle aspiration of a thyroid nodule may result in a diagnosis of a follicular neoplasm. Establishing a definitive diagnosis would allow the patient to undergo the appropriate initial thyroidectomy. This study evaluated the ability of positron emission tomography (PET) to assess the malignant potential of a follicular neoplasm. Met...

Fragile histidine triad (FHIT) gene is thought to be a tumor suppressor; abnormalities in expression have been reported in a variety of neoplasms. To determine whether abnormalities of FHIT protein expression or loss of heterozygosity in the FHIT gene were correlated with survival or other clinical parameters in patients with oral cavity squamous c...

Context.—Fragile histidine triad (FHIT) gene is thought to be a tumor suppressor; abnormalities in expression have been reported in a variety of neoplasms. Objective.—To determine whether abnormalities of FHIT protein expression or loss of heterozygosity in the FHIT gene were correlated with survival or other clinical parameters in patients with or...

In 1965, Bakamjian described the deltopectoral (DP) flap as a reconstructive option in head and neck surgery. It served as the premier flap for reconstructing complex head and neck defects until the late 1970s. Today, the DP flap is often overlooked; although its role has diminished, its use is still warranted in certain select clinical situations....

We wished to correlate the expression of E-cadherin and beta-catenin in squamous carcinomas of the head and neck to outcome and other clinicopathologic variables. This retrospective study was carried out in a tertiary care setting. The tumors of 45 patients who had their head and neck squamous carcinoma primarily treated by resection were evaluated...

The practice of injection laryngoplasty under local anesthesia has become more common as both the indications for the procedure and the number of injectable substances increased. Modifications to the injection techniques used for vocal fold augmentation have been described over the last decade that reflect changes in the established percutaneous an...

This study provides the largest contemporary overview of presentation, care, and outcome for base of tongue squamous cell carcinoma (SCC). We extracted 16,188 cases from the National Cancer Data Base (NCDB). Chi-square analyses were performed on selected cross-tabulations. Observed and disease-specific survival were used to analyze outcome. Three-q...