摘要:

AbstractForty‐six patients in an emergency room (ER) setting and 159 people suspected of driving while intoxicated (DWI) had their blood alcohol concentrations estimated by the angle of onset of horizontal gaze nystagmus and confirmed by blood alcohol analysis or breathalcohol analysis (BAA) tests. In the ER group, 25/26 (96%) of legally intoxicated patients (blood alcohol concentration>.10% w/v) had an estimation consistent with intoxication. There were no cases in which the blood alcohol concentration (BAC) was incorrectly estimated to be>.10% w/v in the absence of other drugs. In DWI suspects there was a correlation of .878 between estimated BAC and BAA results. Three subjects were incorrectly classified as intoxicated. No subjects with estimated BAC<.10% w/v were legally intoxicated by BAA testing. Alcohol gaze nystagmus is presented as an effective tool for estimating the BAC in pure alcoholic intoxicatio

ISSN:0023-852X    

DOI:10.1288/00005537-198607000-00001

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractThe exact risk of multiple primary neoplasms in patients with salivary gland or thyroid gland malignancies is difficult to ascertain from the data available in the literature. This study examines, retrospectively, 198 patients with a first malignancy of the salivary gland and 186 patients with a first malignancy of the thyroid gland, treated over a 10‐year period. Fourteen cases of second tumors were found in the first group and 29 cases in the latter. Patients whose second neoplasm was a skin cancer or who had a previous neoplasm at a site other than those selected for study were excluded. The risk of a second tumor was compared to the expected number of second cancers from the Combined National Cancer Institute Registry Data, and the results indicated an increased risk in males with a first malignancy of the salivary gland and in both men and women with a first thyroid malignancy. The salivary glands, larynx, and colon were the most common sites of second tumors after a first salivary cancer. The adrenals, brain, lymphatic system, and breast were the most common site after a first thyroid cancer. The previously reported association of cancers of the thyroid and the breast in females is confirmed here in men and women. The excess of brain tumors and lymphomas has not been reported previousl

ISSN:0023-852X    

DOI:10.1288/00005537-198607000-00002

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractAdvanced anterior floor of mouth squamous cell carcinoma has been traditionally treated with wide excision in conjunction with mandibulectomy and radical neck dissection. This has resulted in significant mandibulofacial defects with functional and cosmetic significance. Efforts at primary reconstruction in the past using bone grafts, osteomyocutaneous flaps, and other methods have yielded unsatisfactory results. A history of prior irradiation has made this problem even more refractory.We present a series of 11 patients who underwent composite resection for advanced anterior floor of mouth carcinoma (T2‐T4), with primary reconstruction using a dynamic compression plating system in conjunction with local and regional tissue flaps. The clinical courses, complications, and surgical techniques are discussed.The issues of reconstruction at primary treatment, irradiation with a metal plate in the field, and the early restoration of oral function are addressed. Experience in this series shows that compression plates can be an effective method of primary reconstruction for advanced anterior floor of mouth lesion

ISSN:0023-852X    

DOI:10.1288/00005537-198607000-00003

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractLaryngeal framework surgery, using a Silastic®implant placed between the thyroid cartilage and inner thyroid perichondrium for vocal cord medialization, offers an exciting new surgical option to intracordal Teflon®injection for the relief of symptomatic unilateral vocal cord paralysis. A series of 11 patients who have undergone medialization laryngoplasty is presented. The advantages, technical details, and results of surgery are discusse

ISSN:0023-852X    

DOI:10.1288/00005537-198607000-00004

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractNeurofibromatosis is a neurocutaneous systemic disease that occurs in 1:2500 to 3300 live births. Prevalence figures have shown it to be as common as cystic fibrosis or Down's syndrome and more than twice as common as muscular dystrophy. In this study, our experience with 257 cases of neurofibromatosis seen since 1972 is reviewed. Intracranial, bony, and extracranial anomalies are described in the 223 patients (87%) who presented with, or ultimately developed, head and neck manifestations of the disease. The most common intracranial tumor was optic glioma, found in 35 patients (14%), 19 younger than 10 years of age. Acoustic neuromas were diagnosed in eight individuals (3%) and were bilateral in three. The most common skull anomaly was macrocephaly, noted 78 times (30%). Absence of the sphenoid wing occurred in 11 patients (4%) and 19 others (7%) had facial asymmetry due to other skull abnormalities. Extracranial manifestations included neurofibromas of the plexiform and nonplexiform type, Lisch nodules, and cafe‐au‐lait sp

ISSN:0023-852X    

DOI:10.1288/00005537-198607000-00005

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-198607000-00006

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractUvulopalatopharyngoplasty (UPPP) is an operation that is frequently performed for the treatment of obstructive sleep apnea (OSA). While UPPP usually eliminates or decreases snoring and often reduces excessive daytime sleepiness, the decrease in the number of episodes of apnea and hypopnea, and the improvement in oxygen saturation (SaO2) have been less predictable. We compared preoperative and postoperative polysomnography (PSG) in 27 patients with OSA and found that no single PSG parameter could accurately reflect the changes in respiration seen after UPPP. We suggest that a combination of indices including the apnea index, the apnea and hypopnea index, the frequency and severity of decreases in SaO2, and the lowest SaO2 be used to assess the effect of UPPP. Using this combination we determined that 30% of our patients were markedly improved, 33% were somewhat improved, and 37% were unimproved. To rely soley on the patient's subjective improvement often results in overestimating the therapeutic results of surgery, whereas to rely only on one PSG parameter may underestimate or overestimate the degree of improvement.

ISSN:0023-852X    

DOI:10.1288/00005537-198607000-00007

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractTwenty‐six cases of esthesioneuroblastoma were treated by the Department of Otolaryngology‐Head and Neck Surgery from 1960 to 1985. This period was divided into the precraniofacial period (1960 to 1975) and the craniofacial period (1976 to 1985) to denote the transition to a more aggressive combined therapeutic approach.Of the eight patients in the precraniofacial group (group I), only 37.5% are alive without disease. In group II (the craniofacial group), 82% of the patients are alive without disease with an average follow‐up of 4 years. This latter survival rate compares favorably with the survival rate of group I and the cure rate of 10% to 67% as stated in other st

ISSN:0023-852X    

DOI:10.1288/00005537-198607000-00008

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractMediastinitis occurring from a descending odontogenic infection occurs rarely. The diagnosis is sometimes difficult to make and is often delayed until the patient is in extremis. The physical examination is often nondiagnostic, but may include brawny edema of the neck and chest. CT scanning provides the most accurate diagnostic information. The treatment is always surgical, in combination with appropriate antibiotics. Five patients with mediastinitis secondary to odontogenic infections are presented, and the technique of transcervical drainage of the anterior and posterior mediastinum is reviewed.

ISSN:0023-852X    

DOI:10.1288/00005537-198607000-00009

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractExternal drainage is indicated when a neck abscess results from esophageal or hypopharyngeal perforation.Diagnosis, extent of disease, and timing of abscess drainage have traditionally challenged the surgeon in management of the perforated esophagus or hypopharynx. Diagnosis and management decisions are enhanced by use of computerized tomography (CT) as an adjunctive study.Five specific case presentations feature diagnosis and management.

ISSN:0023-852X    

DOI:10.1288/00005537-198607000-00010

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY