ISSN:0023-852X    

DOI:10.1288/00005537-198306000-00001

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractWarthin's tumor is controversial. This controversy is multifaceted and relates to all aspects of the tumor from its historical beginnings to its pathogenesis, investigations, and treatments.In this paper, an in depth study of Warthin's tumor has been made to help clarify these controversies.

ISSN:0023-852X    

DOI:10.1288/00005537-198306000-00002

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractThe sensorineural component of a mixed hearing loss due to otosclerosis is generally accepted as due to the otosclerotic lesion. The existence of pure cochlear otosclerosis without stapes fixation has been questioned. However, we are documenting 7 such cases in a separate publication. Results of this study, which evaluates 46 temporal bones with clinical or cochlear otosclerosis, demonstrate that the degree of sensorineural loss is directly related to the amount of hyalinization of the spiral ligament. The hyalinization occurs adjacent to active otospongiotic lesions but not next to inactive otosclerotic lesions. Both types of lesions may involve the cochlear endosteum. Small channels through the endosteal bone from the lesion to the spiral ligament have been found. The hyalinization spreads laterally from these channels. The hyalinization is presumably a result of the passage of toxic substances (proteolytic enzymes) from the lesion to the ligament. Strial atrophy is most pronounced on ligaments with the greatest degree of hyalinization. Hyalinization in only one ear produces decreased hearing compared to the other ear.

ISSN:0023-852X    

DOI:10.1288/00005537-198306000-00003

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-198306000-00004

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractThree hundred thirty‐six patients with squamous cell carcinoma of the glottic larynx treated at the University of Virginia Medical Center from 1960 through 1977 were reviewed. Seventy patients with T2N0M0 disease, grouped according to the criteria of the American Joint Committee on Cancer, 1978, form the basis of this report. The 5‐year actuarial survivals, recurrences, salvages, and prognostic factors were examined. Treatment was radiation, surgery, or a combination of radiation and surgery.Impaired vocal cord mobility in Stage II glottic squamous cell carcinoma is the crucial significant prognostic factor in predicting response to therapy, survival, and response to salvage therapy for recurrences. The 90% 5‐year recurrence‐free rate with freely mobile cords is comparable to that achieved with Stage I lesions. Impaired mobility resulted in a 5‐year recurrence‐free rate of 73%, which is comparable to that of T3N0 lesions.We support the concept of reclassifying Stage II disease into Stage Ha (mobile cords) and Stage IIb (impaired mobility).Based on this review and those reported in the literature, we recommend radiation therapy for Stage IIa disease. Surgery results in fewer recurrences and in longer survival than irradiation when the vocal cords are not freely mobile

ISSN:0023-852X    

DOI:10.1288/00005537-198306000-00005

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractVertical hemilaryngectomy has been expanded aggressively in recent years so that, in some cases, the term subtotal laryngectomy would be more appropriate. Reconstruction after these extended resections is a problem. Intraluminal stenting has not been successful in cases where resection has been aggressive. The resulting lumen is inadequate. As a means of overcoming this problem, the epiglottic reconstruction procedure has been promoted.This paper presents experiences with 12 patients who underwent epiglottic reconstruction after subtotal laryngectomy. Indications, anatomic details, and overall results using this reconstructive technique are outlined. It is the conclusion of the author that epiglottic reconstruction is an effective procedure for preservation of function after subtotal laryngectomy.

ISSN:0023-852X    

DOI:10.1288/00005537-198306000-00006

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractIn the past laryngeal pseudosarcomas have been diagnosed asa. carcinosarcomas,b. pleomorphic or spindle cell carcinomas, orc. squamous cell carcinomas with pseudosarcomatous reactive stroma. Arguments have centered around the nature of the sarcomatous stroma. Because of this confusion there is disagreement as to the treatment and prognosis of these tumors.Seven pseudosarcomas were treated between 1969–1979, 4 were pedunculated and 3 exophytic. Treatment consisted of primary CO60irradiation in 2 patients, surgery in 3 cases and combined therapy in 2 cases with no recurrences. Three of the 7 have died, 1 of a poorly differentiated adenosquamous carcinoma of the right main stem bronchus and the other 2 of natural causes at ages 77 and 85.From a review of the literature as well as our experience, we have reached the following conclusions.1. Stromal cells are a malignant morphologic variant of the squamous cell and are best termed spindled cells.2. Neck metastasis at any time is a poor prognostic sign.3. The pattern of metastasis and survival seems to parallel laryngeal squamous cell carcinoma, and thus treatment should be similar for given stage

ISSN:0023-852X    

DOI:10.1288/00005537-198306000-00007

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractPlasmacytoma involving the larynx is very rare. To the best of our knowledge there are only 79 cases reported in the world literature. We are adding 3 more cases; 2 cases were associated with multiple myeloma and 1 was considered to be a solitary or extramedullar plasmacytoma. The clinical picture was hoarseness and upper airway obstruction. In plasmacytoma of the larynx multiple biopsies are often nondiagnostic, sometimes revealing only chronic inflammation and amyloid infiltration in the tissues. Most authors agree that the treatment of choice is conservative surgical excision and radiation therapy. Surgery may also be reserved to excise residual scar tissue and fibrosis after treatment mainly to improve the airway and eliminate the tracheostomy tube. To confirm the definitive diagnosis of solitary plasmacytoma of the larynx, long‐term follow‐up of many years is necessary in order to rule out multiple myel

ISSN:0023-852X    

DOI:10.1288/00005537-198306000-00008

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractIn early 1983 the authors presented an innovative procedure for the management of severe laryngeal stenosis. Because of the severity of the stenosis and the large surgical defect created by excision of the stenosis, multiple pieces of the hyoid bone were sewn together conjointly to bridge the surgical defect. The authors are now able to report follow‐up in 6 patients ranging from 11 to 60 months and discuss their favorable experience with this procedur

ISSN:0023-852X    

DOI:10.1288/00005537-198306000-00009

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractAngiodema can be frequently encountered in clinical practice, and usually represents transient areas of tissue edema and erythema. In general, lesions involve the deep dermis as well as subcutaneous or submucosal sites and can affect multiple organ systems, including the respiratory and gastrointestinal tracts. Although the underlying cause for the angioedema is frequently not known, it can result from atopy, specific antigen sensitivities, physical stimuli, as well as disorders that affect the complement cascade. These latter entities may be congenital or acquired. Pathogenesis for angioedema is generally thought to be activation of mast cells or basophils, with subsequent release of histamine and other mediator products which can induce inflammatory changes.In most patients with physical and allergic causes of angioedema, swelling can usually be treated with epinephrine, antihistamines and/or steroids. Management of the airway in such patients is usually symptomatic, although certain patients require hospitalization for supervised care. On the other hand, patients with hereditary angioedema do not often respond well to these agents. In such patients, we currently add infusions of epsilonaminocaproic acid as well as nembulized racemic epinephrine to our therapeutic regimen, but even this may not be satisfactory. At the National Institute of Allergy and Infectious Disease, endotracheal intubation is usually preferred to tracheostomy for securing a temporary airway, though certain patients may require placement of tracheostomies for better control of the airway. Patients with frequent recurrences of airway obstruction are rarely seen — even among those patients with known hereditary angioedema. However, such patients may require tracheal fenestrations to secure long‐term protection of the airway.The Institute's experiences in the management of patients with angioedema are reviewed, and therapies employed are descri

ISSN:0023-852X    

DOI:10.1288/00005537-198306000-00010

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY