摘要:

AbstractTumors of the major salivary glands are reviewed according to classification, location, surgical procedure and end results. Our data of the incidence of benign and malignant tumors show that the most commonly involved area is the parotid gland and the most frequent is of the mixed variety.In the parotid region 80 percent are benign and 20 percent are malignant; whereas, in the submandibular gland, the malignant and benign tumors are equally distributed. The need for an extensive surgical attack and inclusion of contiguous structure is dictated by the nature of the malignant disease. The role of postoperative irradiation is discussed as is the indication for neck dissection.Management of the facial nerve, relative to malignant tumors of the parotid gland, is considered in detail.

ISSN:0023-852X    

DOI:10.1288/00005537-197706000-00001

出版商:John Wiley&Sons, Inc.    

年代:1977

数据来源: WILEY

摘要:

AbstractThe oncocyte is a peculiar cell found in the aging parotid gland. A precise definition of oncocytic tumors is now available using histochemical and electron microscopic techniques. Oncocytic carcinomas are very rare; only a handful have been cited in the literature. This is the first description of the electron microscope features of oncocytic carcinomas we can find in the literature.The cells of these carcinomas are characterized by mitochondrial hyperplasia, pleomorphism and atypism. The cells contained few other sub‐cellular organelles and no myofilaments or glycogen as previously described in benign oncocytomas. In additon to these electron microscopic features, the clinical presentation, treatment, and biologic course of these three cases of oncocytic carcinoma and two cases of benign oncocytoma will be presente

ISSN:0023-852X    

DOI:10.1288/00005537-197706000-00002

出版商:John Wiley&Sons, Inc.    

年代:1977

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-197706000-00003

出版商:John Wiley&Sons, Inc.    

年代:1977

数据来源: WILEY

摘要:

AbstractMost individuals are infected with Herpes Simplex in childhood usually suffering a mild febrile illness of no consequence. Later some individuals suffer recurrent infections which appear as cold sores on the lip while others intermittently shed virus in the oro‐pharygeal secretions. Adults uninfected in childhood may be exposed to viruses for example by kissing and develop an acute primary herpes with fever and gingivo‐stomatitis occasionally requiring hospital admission.Awareness of this condition is required for diagnosis after which the majority of patients seen in otolaryngological practice need only supportive therapy, explanation and reassurance. Recurrent cold sores are no more than a nuisance in most patients, but occasionally they are severe and in others the cold sore may precipitate oral erythema multiforme. Unfortunately the treatments available for recurrent cold sores are rather unsatisfact

ISSN:0023-852X    

DOI:10.1288/00005537-197706000-00004

出版商:John Wiley&Sons, Inc.    

年代:1977

数据来源: WILEY

摘要:

AbstractThe provocative title of this presentation has been chosen quite deliberately, knowing full well that the subject of management of patients with severe airway obstruction is a very controversial one. The views expressed do not necessarily represent those of all of the staff dealing with these problems at the Hospital for Sick Children.

ISSN:0023-852X    

DOI:10.1288/00005537-197706000-00005

出版商:John Wiley&Sons, Inc.    

年代:1977

数据来源: WILEY

摘要:

AbstractAs otolaryngologists become more involved with maxillofacial trauma, we are encountering an increasing number of athletic injuries. Ice hockey accounts for a large number of these facial injuries. The fast moving and random nature of the game, frequent body and equipment contact and lack of protective devices, predisposes the hockey player to facial injury. Because of the roughly tenfold increase in hockey participation over the last decade, the problem of facial injury prevention has become a significant public health problem in North America.Review of the medical literature shows a paucity of interest in the subject of facial injury prevention in hockey. Several articles have dealt with ocular injury, while other articles have dealt with the general subject of hockey injury with only scant attention paid to the facial area.A retrospective study was carried out to more clearly define the scope of the facial injury problem. Four levels of hockey play were examined. Individuals from the youngest and most inexperienced to seasoned professionals were studied. An individually completed questionnaire was received from players in each group. It is the purpose of this paper to indicate the rates of injury for the various types of facial trauma, present their mechanisms of occurrence and discuss means of preventing facial injury in hockey players.

ISSN:0023-852X    

DOI:10.1288/00005537-197706000-00006

出版商:John Wiley&Sons, Inc.    

年代:1977

数据来源: WILEY

摘要:

AbstractTo overcome some of the problems encountered in the repair of extensive composite defects of the head and neck, several means of transfering bone and soft tissue — while preserving the blood supply by means of a pedicle — have been clinically attempted.The superiority of pedicle osteocutaneous grafts compared to free grafts is demonstrated in a series of experiments in monkeys and dogs. Conventional and tetracycline labelled histological specimens, from animals sacrificed at intervals from two weeks to six months after grafting, illustrate the dynamic changes in the grafts. Pedicle supported grafts appeared superior to free grafts and participated actively in bone reconstruct

ISSN:0023-852X    

DOI:10.1288/00005537-197706000-00007

出版商:John Wiley&Sons, Inc.    

年代:1977

数据来源: WILEY

摘要:

AbstractCosmetic and functional restoration of the fractured mandible in the great majority of cases is thesine qua nonof therapeutic success. Not only must an acceptable low complication rate be obtained, but when present, their complex nature must be understood from the onset. Successful treatment of complications is a multifaceted problem requiring planned, interdisciplinary, often times staged reconstruction. The radiologist and dental prosthodontist make valuable contributions towards the surgeon's ultimate rehabilitation of the patient.A three year experience of 111 mandibular fractures treated on the UCSD Otolaryngology Service is characterized. Sixteen complications nine of which were seen after initial treatment elsewhere provide the focus of this report. Special emphasis is given to the pre‐treatment planning and surgical techniques necessary to correct malunion and nonunion. Particular advantages achieved by the use of osteogenic autogenous marrow, cellulose acetate filters and Vitalliumf (chrome cobalt) trays are detaile

ISSN:0023-852X    

DOI:10.1288/00005537-197706000-00008

出版商:John Wiley&Sons, Inc.    

年代:1977

数据来源: WILEY

摘要:

AbstractThe purpose of this paper is to review and update the subject of management of scars and lacerations. The surgeon who accepts responsibility for management of soft tissue injuries must be aware of fundamental surgical principles as well as detailed technique. Knowledge of basic anatomy and wound physiology is utilized and applied.Emphasis is placed on management of the total patient. The specialist must accept the role of team captain and establish an order of priority in management and in wound analysis. By having a basic knowledge of wound healing and the lines of favorable contracture, one is better able to prognosticate the eventual healing of the wound after proper management. By being able to predict wound contracture and scar maturation, the patient can be better informed as to what to expect during the period of healing. With lacerations immediate repair is carried out. With scars there is more time for planning and photographic analysis. The contracting forces will by this time have identified themselves and the degree of release of the contracture or camouflage can be determined.Specific wound management emphasizes meticulous closure in layers and the use of skin hooks with the interrupted subcuticular suture. Skin sutures with both the continuous subcuticular suture and interrupted sutures of monofilament nylon using the spring‐loop are described. Emphasis is placed on the preparation of the skin margins with slight beveling of the skin edges and undermining with precise even thickness of the skin especially at the wound margin. For scar revisions a minimum time of six months should elapse, and 12‐18 months is better.Complications include infection, hematoma, wound separation, and rejection of suture materials. Keloids are disciissed briefly, particularly regarding the use of intralesional injection of steroids.Broken line camouflage techniques are discussed with regard to breaking up contracture without lengthening. Lengthening either existing or anticipated contractures is accomplished with Z‐plasty. The multiple Z‐plasty, W‐plasty, and Zig‐Zag plasty are aimed towards creating a less conspicuous scar and creating some diffusion of the forces of contracture. A technique for a “practical Z‐plasty” is described.Both free grafts and skin flaps sometimes must be utilized to fill tissue defects and break up lines of contracture.The materials presented and conclusions drawn are based on 25 years of active emergency room coverage and long term follow‐up of treated patients. It is the responsibility of the physician to act within the first few hours and to take the time necessary for accurate approximation and realignment of both soft tissue and bone injuries. Minimal scarring depends on accurate approximation of skin margins without tension. The need for early meticulous repair, so that unsightly scars and disfigurements may be prevented, canno

ISSN:0023-852X    

DOI:10.1288/00005537-197706000-00009

出版商:John Wiley&Sons, Inc.    

年代:1977

数据来源: WILEY

摘要:

AbstractThe charts of 324 patients treated for 363 orbital floor fractures between 1965 and 1973 were reviewed retrospectively. Of these, 38 (11 percent) were isolated floor fractures, 27 (8 percent) were rim and floor fractures, 168 (46 percent) were trimalar fractures and 130 (35 percent) were associated with complex facial fractures.On initial examination, 31 percent of the patients were found to have diplopia and 4 percent enophthalmos. Orbital prolapse was suspected in 31 percent of the patients. Thirty‐seven percent of the patients had demonstrable ocular injury at the time of initial examination.Treatment was surgical in 336 of the fractures and non‐surgical in 29. Of the surgical patients 140 had no support placed, 120 had antral support only, 51 had both antral support and orbital implant, and 20 had an orbital implant only.Postpperatively the incidence of diplopia was 8 percent in all patients, and 7 percent had enophthalmos. A smaller group followed for more than five months were found to have diplopia in 17 percent and enophthalmos in 11 percent. Of the 29 patients treated non‐surgically, none had persistent dip

ISSN:0023-852X    

DOI:10.1288/00005537-197706000-00010

出版商:John Wiley&Sons, Inc.    

年代:1977

数据来源: WILEY