title: A novel tool for the objective measurement of neck fibrosis: validation in clinical practice.
abstract: BACKGROUND
  Radiotherapy is commonly used to treat neoplasms of the head and neck, and fibrosis is a known side effect. The Cutometer is a device that quantifies properties of the skin. The goal of the study was to validate the Cutometer in normal neck tissues and then quantify fibrosis in radiated necks.
  
  
  METHODS
  We performed a prospective study of 251 patients. The elasticity and stiffness parameters were recorded. Control patients were compared to determine the correlation between their left and right sides. Next, the treatment groups were compared using a nonparametric test (Kruskal-Wallis).
  
  
  RESULTS
  We found a significant correlation between the left and right sides of the control patients' necks, supporting the view that the Cutometer provides reproducible measurements in the normal neck. Furthermore, the Cutometer demonstrated reduced elasticity in necks treated with radiation, surgery-radiation, and chemoradiation. No significant difference in stiffness was seen.
  
  
  CONCLUSIONS
  The Cutometer may serve as a valuable and valid tool for the measurement of neck skin elasticity. Radiated patients have a quantifiable decrease in their skin elasticity.
authors.affiliation: Department of Otolaryngology–Head and Neck Surgery, Western University, London, ON.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Chin
authors.forename: Jason H
authors.initials: JH
authors.lastname: Franklin
authors.forename: Benjamin
authors.initials: B
authors.lastname: Turner
authors.forename: Roger V
authors.initials: RV
authors.lastname: Moukarbel
authors.forename: Shamir
authors.initials: S
authors.lastname: Chandarana
authors.forename: Kevin
authors.initials: K
authors.lastname: Fung
authors.forename: John
authors.initials: J
authors.lastname: Yoo
authors.forename: Philip C
authors.initials: PC
authors.lastname: Doyle
mesh_terms: D004548:Elasticity; D005355:Fibrosis; D006245:Hardness Tests / Q000379:methods*; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D010173:Palpation; D011446:Prospective Studies; D012867:Skin / Q000473:pathology / Q000503:physiopathology*