Retrospective comparison of split-thickness skin graft versus local full-thickness skin graft coverage of radial forearm free flap donor site.

The study aimed at comparing outcomes between split-thickness skin graft (STSG) and local ipsilateral full-thickness skin graft (FTSG) after radial forearm free flap defect closure. A comprehensive study protocol for objective and subjective assessment was established for this retrospective, single-center study. Clinical examinations were carried out, encompassing measuring wrist and finger range of movement and grip strength, testing skin sensitivity, and evaluating aesthetics using the Patient and Observer Scar Assessment Scale (POSAS). In addition, medical history, and questionnaire, including Cold Intolerance Severity Score (CISS) and 18 items, were used to assess satisfaction, functional limitations, and complaints. 44 patients were examined, and 40 patients included, who had received STSG (group 1; n = 19) respectively local FTSG from the ipsilateral forearm (group 2; n = 21) at least three months previously. Significantly lower values for parameters pigmentation, relief (p = 0.015), overall impression (p = 0.044), as well as mean POSAS observer scale total score (p = 0.046) and no complaints wearing a wristwatch (p = 0.012) were shown in group 2 (FTSG). Within the limitations of the study, it seems that FTSG harvested from the forearm should be preferred over STSG to cover RFFF donor site whenever appropriate, because of beneficial outcomes, while providing single intervention closure and avoiding secondary donor site.

Current concepts in cleft care: A multicenter analysis.

The current surgical techniques used in cleft repair are well established, but different centers use different approaches. To determine the best treatment for patients, a multi-center comparative study is required. In this study, we surveyed all craniofacial departments registered with the German Society of Maxillofacial Surgery to determine which cleft repair techniques are currently in use. Our findings revealed much variation in cleft repair between different centers. Although most centers did use a two-stage approach, the operative techniques and timing of lip and palate closure were different in every center. This shows that a retrospective comparative analysis of patient outcome between the participating centers is not possible and illustrates the need for prospective comparative studies to establish the optimal technique for reconstructive cleft surgery.

Influence of the volume of soft tissue herniation on clinical symptoms of patients with orbital floor fractures.

INTRODUCTION: One of the most important complications of orbital floor fractures is diplopia and restricted ocular movement. The role of the volume of soft tissue herniation on these clinical symptoms after orbital floor fractures is unclear and potentially may predict development of persistent clinical symptoms. Therefore the aim of this study was to assess pre- and postoperative complications associated to the volume of soft tissue herniation, with special interest to diplopia and bulbus motility impairment. MATERIAL AND METHODS: 204 untreated patients with orbital floor fractures from 2009 to 2011 were included in this retrospective study. Contingency tables and χ2-test were performed to analyze associations between two qualitative variables. p-Values p < 0.05 were considered as significant. Volume measurement was performed in a semiautomatic segmentation method with the software "ITK-Snap". RESULTS: The volume of soft tissue herniation correlated significantly with pre- and postoperative diplopia (p = 0.003; p = 0.002), persistent diplopia (p = 0.009) as well as pre- and postoperative bulbus motility impairment (both p < 0.001). Furthermore we found out significant associations between the volume of soft tissue herniation and pre- and postoperative complications depending on fracture type and reconstruction technique. CONCLUSIONS: Volume measurement of soft tissue herniation may help to predict postoperative complications, particularly bulbus motility restriction and persistent diplopia. The risk for these symptoms rises with increasing volume of soft tissue herniation after orbital floor fractures. Therefore we recommend for these patients within indication an early repair and/or closer observation.

Clinical and histopathological staging in oral squamous cell carcinoma - Comparison of the prognostic significance.

BACKGROUND: In oral cancer the prognostic significance of clinical staging (cTNM) is regarded inferior to histopathologic staging (pTNM) after surgery. This is mainly due to the point that the quality of the cTNM strongly depends on the clinical and radiological examination techniques applied and the physician's experience. The aim of this study was to evaluate the prognostic quality of cTNM and pTNM in a single center cohort. METHODS: This retrospective study included 392 patients with treatment-naive oral squamous cell carcinoma (OSCC). All patients received primary surgery including a neck dissection. According to tumor stage and histopathologic risk factors patients received adjuvant radiotherapy (RT) or radiochemotherapy (RCT). Prognostic factors were identified in univariate analysis by using the log rank test and in multivariate analysis through Cox regression. RESULTS: Clinical and histopathologic staging showed concordance in 62% for the primary tumor and 59% for cN- and pN-classification. In 58% of the cases of discordance the primary tumor was overstaged. In case of discordance of metastatic spread to the cervical lymph nodes, lymph node involvement showed overstaging in 78%. In univariate analysis cT-, cN-, cT- and pT-classification had a significant impact (p<0.05) on overall survival (OS). In multivariate analysis only pT- and pN-classification had a significant impact on OS. CONCLUSION: Despite advances and modern radiologic techniques, pTNM has a higher prognostic quality than cTNM. Discordance between clinical and histopathologic staging was observed in up to 40%. When discordance was observed overstaging for clinical T-stage and clinical N-stage was more likely than understaging.

Further evidence for deletions in 7p14.1 contributing to nonsyndromic cleft lip with or without cleft palate.

BACKGROUND: Nonsyndromic cleft with or without cleft palate (nsCL/P) is a common birth defect. Although genome-wide association studies (GWAS) have identified numerous risk variants, a considerable fraction of the genetic heritability remains unknown. The aim of the present study was to replicate a previous finding that de novo deletions in a 62 kb region of chromosome 7p14 are a risk factor for nsCL/P, using an independent cohort. METHODS: Data from a published case-control GWAS cohort of 399 patients and 1318 controls were used. Copy number variant (CNV) detection in the 62 kb candidate region of 7p14 was performed using QuantiSNP. Putative CNVs in probands were verified and validated by quantitative polymerase chain reaction. Segregation analyses were performed in family members for whom DNA was available. RESULTS: Within the 62 kb candidate region, a deletion of 7.4 kb showed association with nsCL/P (13/387 cases, 20/1300 controls, plowest = 0.024, odds ratio = 2.22). In all families with a sporadic case (n = 3), the deletion occurred de novo. In multiplex families, both incomplete segregation and incomplete penetrance were observed. CONCLUSION: The present data support the hypothesis that deletions at 7p14 are a common risk factor for nsCL/P. Genome-wide CNV analyses in nsCL/P cohorts are warranted to explore the functional relevance of these deletions and their contribution to nsCL/P, and to determine exact breakpoints. Birth Defects Research (Part A) 106:767-772, 2016. © 2016 Wiley Periodicals, Inc.

Moving the mandible in orthognathic surgery - A multicenter analysis.

Orthognathic surgery has always been a classical focus of maxillofacial surgery. Since more than 100 years, various surgical techniques for mandibular repositioning have been developed and clinically tested. Since the establishment of plate and screw osteosynthesis, orthognathic surgery became more stable and safe. Nowadays, different surgical methods for mobilising the mandible are existing. This international multicenter analysis (n = 51 hospitals) is providing first evidence based data for the current use of different surgical methods. The dominating techniques were Obwegeser/dal Pont (61%) followed by Hunsuck/Epker (37%) and Perthes/Schlössmann (29%). The main osteosynthesis materials were plates (82%), bicortical screws (23.5%), or a combination of both (5.9%). 47% of all centers reported to use several surgical methods at the same time, depending on the anatomical problem and the surgeon's preference. This shows that different surgical methods seem to work as comparable, safe, and reliable procedures in everydays clinical practise. On this basis, further prospective studies could evaluate possible advantages for our patients.

Autofluorescence imaging in recurrent oral squamous cell carcinoma.

The survival of patients with oral cancer is decreased by locoregional recurrence after an initial multimodal treatment. In order to identify lesions in the oral cavity for a possible recurrence, clinical evaluation as well as MRI or CT scanning is advised. The evaluation of mucosa lesions is hampered by changes related to radio- and chemotherapy as well as reconstruction with tissue flaps. Several techniques for easier identification of tissue abnormalities in the oral cavity have been advocated as adjuncts in order to facilitate identification. Especially methods using altered tissue fluorescence have gained much interest during the last decade. The aim of our prospective study was to evaluate fluorescence properties of undiagnosed mucosa lesions with the VELscope device in patients with multimodal treated oral cancer prior to histological confirmation. In total, 41 patients with a history of oral squamous cell carcinomas (OSCC) (19 females and 22 males) with undiagnosed mucosa lesions where included in the study. After clinical evaluation, examination and documentation using the VELscope® device were performed. Then, an incisional biopsy was performed. An autofluorescence loss indicating a malignant or dysplastic mucosa condition could be detected in six patients (14.6 %); however, only one OSCC and one SIN revealed a complete autofluorescence loss. In four patients, OSCC was present in lesions with retained autofluorescence. Sensitivity and specificity for the VELscope® examination to identify malignant oral lesions by autofluorescence were 33.3 and 88.6 %, respectively. The positive and negative predictive values were 33.3 and 88.6 %, respectively. No statistical correlation between gender and lesion appearance versus autofluorescence loss could be detected. In contrast to mucosa lesions in patients with no prior treatment, the autofluorescence evaluation with the VELscope reveals no additional information in our analysis. Accordingly, invasive biopsies as gold standard are still needed to get sufficient evidence regarding potential malignancy in patients after multimodal treatment for oral cancer.

The importance of early diagnosis in patients with maxillary sinus carcinoma.

There are two major challenges in the early diagnosis of maxillary sinus carcinoma: the maxillary sinus is not susceptible to direct inspection and palpation, and symptoms are uncharacteristic. The aim of this study was to assess the impact of the time interval between first symptoms noticed by the patient and the detection of the tumor on survival. 88 patients with maxillary sinus tumors were included in the retrospective study. Prognostic factors were identified through univariate analysis. Univariate analysis (p = 0.019) revealed a significant impact of the time interval from first symptom to diagnosis on overall survival. With increasing duration of the symptoms 5-year overall survival was reduced from 65 % for duration between 0 and 2 months to 24 % for duration of symptoms longer than 12 months. Furthermore, we found a significant association (p = 0.033) between local extension of the tumor and time interval from first symptom to diagnosis. Early diagnosis is often difficult because of uncharacteristic symptoms, which are identical with benign diseases of the maxillary sinus. The delay between the occurrence of the first symptom and diagnosis often makes a curative treatment impossible.

Effects of various chair-side surface treatment methods on dental restorative materials with respect to contact angles and surface roughness.

Available chair-side surface treatment methods may adversely affect prosthetic materials and promote plaque accumulation. This study investigated the effects of treatment procedures on three resin restorative materials, zirconium-dioxide and polyetheretherketone in terms of surface roughness and hydrophobicity. Treatments were grinding with silicon carbide paper or white Arkansas stone, blasting with prophylaxis powder and polishing with diamond paste. Surface roughness was assessed using confocal laser scanning. Hydrophobicity as measured by water contact angle was determined by computerized image analysis using the sessile drop technique. All of the specific surface treatments performed led to significant changes in contact angle values and surface roughness (Ra) values. Median contact angle values ranged from 51.6° to 114°. Ra values ranged from 0.008 µm to 2.917 µm. Air-polishing as well as other polishing procedures increased surface roughness values in all materials except zirconium dioxide. Polyetheretherketone displayed greatest change in contact angle values after air-polishing treatment.

Expression of ezrin in oral squamous cell carcinoma: Prognostic impact and clinicopathological correlations.

INTRODUCTION: There have been few investigations into the effects of ezrin expression in oral squamous cell carcinoma (OSCC). The aim of this study was to analyze the influence of ezrin expression on the prognosis of patients with OSCC. MATERIALS AND METHODS: Eighty patients were included in the retrospective study. Expression and localization of ezrin were evaluated using immunohistochemistry. Associations were identified using χ² tests. Prognostic factors were identified by univariate and multivariate analysis. RESULTS: Seventy-six (95%) patients showed ezrin expression. Ezrin expression had a significant impact on overall survival (OS) (p < 0.001). With increasing expression, the 5-year OS rate dropped from 100% for ezrin-negative patients to 47% for patients with high expression. Multivariate analysis confirmed the significant influence of ezrin expression on OS (p = 0.011). Cytoplasmic localization of ezrin led to a significantly lower survival rate in comparison with membranous expression. CONCLUSIONS: Ezrin may serve as a biomarker that predicts biologically aggressive behavior of OSCC and hence improves therapeutic techniques and the prognosis of patients affected with the disease.

Comparison of design and torque measurements of various manual wrenches.

PURPOSE: Accurate torque application and determination of the applied torque during surgical and prosthetic treatment is important to reduce complications. A study was performed to determine and compare the accuracy of manual wrenches, which are available in different designs with a large range of preset torques. MATERIALS AND METHODS: Thirteen different wrench systems with a variety of preset torques ranging from 10 to 75 Ncm were evaluated. Three different designs were available, with a spring-in-coil or toggle design as an active mechanism or a beam as a passive mechanism, to select the preset torque. To provide a clinically relevant analysis, a total of 1,170 torque measurements in the range of 10 to 45 Ncm were made in vitro using an electronic torque measurement device. RESULTS: The absolute deviations in Ncm and percent deviations across all wrenches were small, with a mean of -0.24 ± 2.15 Ncm and -0.84% ± 11.72% as a shortfall relative to the preset value. The greatest overage was 8.2 Ncm (82.5%), and the greatest shortfall was 8.47 Ncm (46%). However, extreme values were rare, with 95th-percentile values of -1.5% (lower value) and -0.16% (upper value). A comparison with respect to wrench design revealed significantly higher deviations for coil and toggle-style wrenches than for beam wrenches. CONCLUSION: Beam wrenches were associated with a lower risk of rare extreme values thanks to their passive mechanism of achieving the selected preset torque, which minimizes the risk of harming screw connections.

Implant-based rehabilitation in oncology patients can be performed with high long-term success.

PURPOSE: Radiotherapy and compromised vital bone and/or surrounding soft tissue can be a challenge to the successful osseointegration of dental implants. We evaluated the long-term results of dental implants in patients with oral cancer. MATERIALS AND METHODS: To address the research purpose, we designed and implemented a retrospective cohort study that included patients with oral cancer who had received dental implants from 2003 to 2011. The data were collected from a clinical oncology database. The predictor variables included a set of heterogeneous variables grouped into logical sets of demographics, surgical treatment, dental rehabilitation, radiotherapy type, and tumor entity. The primary outcome variable was implant survival; the secondary outcome variable was peri-implantitis. The descriptive statistics, survival time analysis, Kaplan-Meier implant survival curves, and Cox hazard proportional modeling were computed. RESULTS: The study sample included 59 patients with oral cancer (20 women [33.9%], 39 men [66.1%]; mean age at tumor diagnosis, 55 years), who had had 272 implants placed during the study period. The mean follow-up period was 30.9 months (range 3 to 82). Of the 272 implants, 269 (98.9%) and 264 (97.1%) had survived for 2 and 5 years, respectively. During the observation period, 10 implants were lost (3.7%). Of the implant failures, 82% occurred in transplanted bone (4 fibula flaps, 4 iliac crests, and 2 native mandibles). We observed peri-implantitis caused by insufficiently attached gingiva and bone loss in 182 of the implants (67%). The factors associated with implant failure were peri-implantitis, insufficient soft and hard tissue, muscle dysfunction, and xerostomia. CONCLUSIONS: Implant-based rehabilitation in oncology patients can achieve a high long-term success rate, although risk factors such as impaired muscle function and a high frequency of peri-implantitis can affect healing.

Change of walking distance in intermittent claudication: impact on inflammation, oxidative stress and mononuclear cells: a pilot study.

BACKGROUND: Atherosclerosis is a chronic inflammatory process involving the immune system and formation of reactive oxygen species (ROS). We investigated changes of mononuclear blood cells and ROS production in relation to the walking distance of patients with intermittent claudication during home-based exercise training. METHODS: Forty patients with intermittent claudication were asked to perform a home-based exercise training for a mean time of 12 months. ROS formation was measured using the luminol analogue L-012. Peripheral blood leucocytes [monocytes, polymorphonuclear neutrophils (PMN) and dendritic cells (DC)] were analysed by flow cytometry and analysed for the expression of major inflammatory surface molecules. RESULTS: At follow-up, patients showed an increased walking distance and reduced ROS production upon stimulation with a phorbol ester derivative (PDBu) (p < 0.01). Monocytes changed their inflammatory phenotype towards an increased anti-inflammatory CD14(++)CD16(-) subpopulation (p < 0.0001). Adhesion molecules CD11b, CD11c and TREM-1 on monocytes and PMN decreased (all p < 0.01). On DC expression of HLA-DR, CD86 or CD40 decreased at follow-up. Inflammatory markers like fibrinogen, C-reactive protein or soluble TREM-1 (sTREM-1) decreased over the observation period. Finally, we found a close relation of sTREM-1 with the walking distance, fibrinogen and ROS production. CONCLUSIONS: We observed an amelioration of the proinflammatory phenotype on monocytes, DC and PMN, as well as a reduced ROS production in PAD patients under home-based exercise, paralleled by an increased walking distance. Our data suggest that a reduced inflammatory state might be achieved by regular walking exercise, possibly in a dimension proportionately to changes in walking distance.

Prognostic quality of the Union Internationale Contre le Cancer/American Joint Committee on Cancer TNM classification, 7th edition, for cancer of the maxillary sinus.

BACKGROUND: Carcinomas of the maxillary sinus are classified according to the Union Internationale Contre le Cancer (UICC)/American Joint Committee on Cancer (AJCC) TNM classification. The purpose of this study was to assess the prognostic significance of the UICC/AJCC TNM classification seventh edition, which was introduced in 2010. METHODS: One hundred thirteen patients with malignant tumors of the maxillary sinus were included in this study. The prognostic impact of the TNM classification and the UICC/AJCC seventh edition's stage grouping were analyzed in univariate and multivariate analysis. RESULTS: The UICC/AJCC stage grouping, the T classification, and the N classification had a significant impact on overall survival (OS) in univariate analysis (p < .05). No significant differences were observed between the groups T4a and T4b (p = .109). In multivariate analysis, the UICC/AJCC stage grouping (p = .031), the N classification (p = .014), and age (p < .001) had a significant impact on OS. CONCLUSION: Although UICC/AJCC stage grouping and the N classification provided a significant prediction of OS in univariate and multivariate analysis, T classification only influenced OS in univariate analysis.

Comparative analysis of sialendoscopy, sonography, and CBCT in the detection of sialolithiasis.

OBJECTIVES/HYPOTHESIS: The diagnosis of sialolithiasis is, along with clinical presentation, based on different imaging techniques and more invasive procedures such as sialendoscopy. The aim of the study was to analyze the potential of cone beam computed tomography (CBCT) for the diagnosis of sialolithiasis and to compare the results with those of sonography and sialendoscopy. STUDY DESIGN: Retrospective analysis. METHODS: The data of 43 patients with suspected sialolithiasis were evaluated retrospectively. All patients had CBCT and sonographic imaging and received sialendoscopy to confirm and possibly treat sialolithiasis. RESULTS: Sonography, CBCT, and sialendoscopy together indicated sialolithiasis in 33 patients. The mean maximum diameter of the extracted sialoliths did not significantly differ between the three diagnostics. Each diagnostic tool showed an excellent specificity and positive predictive value. Sensitivity and negative predictive value were best in sialendoscopy (94% resp. 83%), followed by CBCT (79% resp. 56%) and then sonography (70% resp. 47%). CONCLUSION: The results revealed that CBCT is capable of diagnosing sialoliths in general and tended to be more sensitive than sonography. However, in view of the radiation exposure, the use of CBCT must be critically weighed and should not be used as a primary option. LEVEL OF EVIDENCE: 4.

Comparison of TNM-based stage grouping versus UICC/AJCC stage grouping (7th edition) in malignant parotid gland tumors.

BACKGROUND: Although the UICC/AJCC's TNM staging of the 7th edition was improved in 2002, there are still shortcomings concerning the prognostic quality. Alternative TNM-based stage-groupings such as the T and N Integer Score (TANIS) where shown to have a better prognostic quality for various kinds of head and neck tumors in the past. The aim of the study was to compare the prognostic value of the 7th edition of the UICC/AJCC TNM-classification for carcinoma of the parotid gland with different TNM-based stage groupings. METHODS: The retrospective analysis included 180 patients with carcinoma of the parotid gland diagnosed between 1986 and 2007. The stage grouping system of the 7th edition of the UICC/AJCC and TNM-based stage-groupings (TANIS-3, TANIS-8, Snyderman, Berg and Hart) were tested for their prognostic significance. Overall survival (OS) was plotted by Kaplan-Meier analysis. Prognostic factors were identified through univariate and multivariate analysis. RESULTS: In univariate analysis all stage-groupings had a highly significant impact on overall survival (p<0.05), however in multivariate analysis, only the TANIS-8 scheme (p=0.008) and Snyderman scheme (p=0.047) predicted OS, while the UICC/AJCC-classification did not predict OS significantly (p=0.381). CONCLUSION: In comparison to other TNM-based stage groupings the UICC/AJCC-classification did not provide significant prediction of OS, while alternative stage-groupings such as the TANIS-8 had a higher prognostic value.

Critical limb ischaemia is characterised by an increased production of whole blood reactive oxygen species and expression of TREM-1 on neutrophils.

BACKGROUND: Atherosclerosis is a chronic inflammatory process involving polymorphonuclear neutrophils (PMN) and formation of reactive oxygen species (ROS). The aim of the present study was to investigate the phenotype of inflammatory cells in regard to the expression of triggering receptor expressed on myeloid cells (TREM)-1 and its soluble form (sTREM-1) as well as its relationship with oxidative stress in peripheral artery disease (PAD) patients. METHODS: In total 90 patients with PAD (N = 30 intermittent claudication (IC) > 300 m absolute walking distance, N = 30 IC < 300 m absolute walking distance, N = 30 critical limb ischaemia (CLI)) and 30 control persons were included. ROS formation was measured at basal or stimulated conditions using the luminol analogue L-012 chemiluminescence. Peripheral blood leucocytes were analysed from whole blood by flow cytometry using different gating strategies to identify PMN and monocytes and analyse TREM-1 expression. RESULTS: CLI patients showed a significant higher ROS production at basal levels (p < 0.05) and upon stimulation with PDBu (p < 0.0001), LPS (p < 0.05) and zymosan A (p < 0.0001). TREM-1 was expressed significantly more on PMN of CLI patients (p < 0.01) in comparison to all other groups, whereas monocytic expression of TREM-1 was similar between all 4 groups. The serum concentration of its soluble form sTREM-1 however was increased in CLI and IC < 300 m patients (p < 0.0001). sTREM-1 concentrations correlated with basal ROS levels as wells with ROS production upon stimulation. Furthermore, we found the walking distance of IC patients to inversely correlate with sTREM-1 (rs = - 0.29; p = 0.03). CONCLUSIONS: We found an increased oxidative stress as well as an increased expression of TREM-1 and serum levels of sTREM-1 in patients with CLI. IC < 300 m patients showed a similar patter in regard to oxidative stress, TREM-1 expression and sTREM-1 concentration. Thus, sTREM-1 might represent a potential inflammatory biomarker to evaluate the severity of PAD. Whether this implies the potential for therapeutic recommendations, i.e. conservative vs. interventional/operative treatment, or a possibility to monitor the efficacy of interventions, requires further studies.

The role of clinical versus histopathological staging in patients with advanced oral squamous cell carcinoma treated with neoadjuvant radiochemotherapy followed by radical surgery.

INTRODUCTION: Several studies have questioned the prognostic accuracy of the TNM system for oral cancer since neither patient's comorbidity, specific tumor related factors nor multimodal treatment regimens such as preoperative radiochemotherapy (RCT) are incorporated. The present study was performed in order to evaluate the prognostic impact of cTNM and ypTNM in oral cancer patients treated with preoperative RCT and resection. METHODS: In this retrospective analysis a total of 139 patients (103 male, 36 female, average age 56.8 years) with oral squamous cell carcinoma (UICC II-IVb) were included. Treatment consisted of concomitant RCT with 39.6 Gy radiations and Carboplatin (cumulative dose 300 mg/m(2)) during the first week of radiation, as well as surgical tumor resection and neck dissection. RESULTS: During the mean follow up of 88.9 months 86 patients (61.9%) died. Locoregional recurrences occurred in 41 patients (29.5%). The 5 years overall survival rate was 45.5%. In univariate analysis margin status, ypT, ypN and ypUICC as well as complete pathological response revealed statistical significance on overall survival. In multivariate analysis ypT, ypN and margin status showed independent prognostic impact in our cohort. Neither cT nor cN provided statistical association with overall survival. CONCLUSION: Results indicate that the clinical staging status of advanced oral cancer prior to preoperative RCT and resection should be interpreted with caution in terms of prognosis.

Stage grouping in tumors of the ethmoid sinuses and the nasal cavity using the sixth edition of the UICC classification of malignant tumors.

BACKGROUND: The purpose of this study was to evaluate the prognostic impact of the sixth edition of the Union Internationale Contre le Cancer (UICC) classification and different TNM-based stage groupings for malignant tumors of the ethmoid sinuses and the nasal cavity. METHODS: We conducted a retrospective analysis of 98 patients with malignant tumors of the ethmoid sinuses and the nasal cavity between 1967 and 2003. The UICC classification of the sixth edition and the T and N Integer Score (TANIS) and Hart were tested for their prognostic significance. RESULTS: In univariate analysis, all stage groupings revealed discriminatory power for overall survival (OS; p < .05), however, in multivariate analysis only the UICC-stage grouping (p = .033) and the TANIS-8 scheme (p = .044) predicted OS. The TANIS did not have a better prognostic quality than the sixth edition of the UICC classification. CONCLUSION: The UICC-stage grouping of the sixth edition is a good prognostic index for malignant tumors of the ethmoid sinuses and the nasal cavity.