Raman spectroscopy in head and neck cancer.

In recent years there has been much interest in the use of optical diagnostics in cancer detection. Early diagnosis of cancer affords early intervention and greatest chance of cure. Raman spectroscopy is based on the interaction of photons with the target material producing a highly detailed biochemical 'fingerprint' of the sample. It can be appreciated that such a sensitive biochemical detection system could confer diagnostic benefit in a clinical setting. Raman has been used successfully in key health areas such as cardiovascular diseases, and dental care but there is a paucity of literature on Raman spectroscopy in Head and Neck cancer. Following the introduction of health care targets for cancer, and with an ever-aging population the need for rapid cancer detection has never been greater. Raman spectroscopy could confer great patient benefit with early, rapid and accurate diagnosis. This technique is almost labour free without the need for sample preparation. It could reduce the need for whole pathological specimen examination, in theatre it could help to determine margin status, and finally peripheral blood diagnosis may be an achievable target.

Throat swabs taken on the operating table prior to cleft palate repair and their relevance to outcome: a prospective study.

OBJECTIVE: The main objective of this study was to determine whether bacteria cultured from oral swabs taken at the time of surgery predicted postoperative fistula formation. DESIGN: The study was a prospective longitudinal audit. SETTING: The setting was a designated U.K. N.H.S. cleft center. PATIENTS: Subjects consisted of the patients of a single cleft surgeon who were undergoing surgery for cleft palate repair or cleft fistula repair. INTERVENTIONS: Oral microbiological swabs were taken from patients while they were on the operating table just before surgery. MAIN OUTCOME MEASURES: The results from microbiological culture of the swabs were recorded, as was the presence or absence of a fistula at 6 months postoperatively. Additional collected information was related to the severity of the cleft, whether the operating microscope was used during surgery, and whether the patient had developed a postoperative upper respiratory tract infection. RESULTS: Positive swab cultures were not significantly associated with fistula formation. Use of the operating microscope was not associated with an increase or decrease in the number of fistulas. A fistula developed in all patients who experienced a postoperative upper respiratory tract infection. CONCLUSIONS: The practice of performing routine preoperative mouth swabs should be abandoned because the presence of bacteria in the mouth does not increase the risk of fistula formation.