摘要:

AbstractThis study presents 19 patients who had mucosally inapparent carcinomas of the upper aerodigestive tract demonstrated by computed tomography (CT). This group contains subpopulations that were identified both retrospectively and prospectively. During the same period 40 nasopharyngeal, 20 oropharyngeal‐tongue base, and over 100 laryngeal and hypopharyngeal carcinomas were studied; all had clinically obvious mucosal components. Nine of our 19 patients had strictly submucosal tumors and a variety of clinical presentations; 5 patients had strictly submucosal recurrence of treated carcinomas and 5 had mucosal lesions which were not identified on examinations by more than one practicing head and neck surgeon. Sixteen of the 19 tumors were confirmed histologically; in 3 others confirmation was by a combination of CT and clinical course.CT can demonstrate the deep extent of aerodigestive tract carcinomas more accurately than physical examination and it can show mucosally inapparent disease. CT should be part of the staging work‐up in nearly all upper aerodigestive tract carcinomas and in patients suspected of harboring an unknown primary within this reg

ISSN:0023-852X    

DOI:10.1288/00005537-198302000-00001

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-198302000-00002

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractTwenty‐seven cancerous larynges were examined preoperatively by computed tomography and postoperatively by transaxial anatomic sections. Data from this correlative study provides a new radiographic classification based upon the relationship of the plane of maximal tumor size to the apex, body, or vocal process of the arytenoid. Unlike those tumors whose maximal size lies at or above the apex of the arytenoid, those below have a very high association with cartilage invasion (8% in former group, 86% in latter group). This is explained by our observation of sites of predilection of tumor invasion of the thyroid, cricoid, and arytenoid cartilages. At these sites collagen fibers have been observed to pass through the perichondrium and attach directly to cartilage. These same fibers may serve as a pathway to direct growth of tumor cells. There was no correlation between six histologic parameters and the presence of cartilage invasio

ISSN:0023-852X    

DOI:10.1288/00005537-198302000-00003

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractA group of 31 patients with inverted papilloma were treated at the Mount Sinai Medical Center. There were no multicentric cases, and one patient had an associated malignancy. A conservative procedure consisting of intranasal or transantral sphenoethmoidectomy was selectively performed in 8 patients with limited lesions. No recurrences were observed in this group after a mean follow‐up of 2 years. Lateral rhinotomy with medial maxillectomy anden blocresection of the ethmoid labyrinth was performed in 23 other patients. One recurrence appeared in this group, members of which were followed a mean of 3.8 years. Radiographic evaluation by multidirectional polytomography and CT scanning permits identification of a small group of patients who have limited lesions and may be candidates for conservative tumor excisio

ISSN:0023-852X    

DOI:10.1288/00005537-198302000-00004

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-198302000-00005

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractThirteen patients with chronic laryngeal stenosis were operated upon with total excision of stenotic scar tissue, enlargement of the lumen by sectioning the back and front wall of the larynx, and application of an indwelling Teflon® prosthesis for 4 months. The stenosis was in many cases caused by long‐standing recurrent paralysis complicated by attempted surgical correction of the stenosis. Following operation, the specific airway conductance increased in all patients (mean ± SD pre and postoperative values 0.51 ± 0.30 and 1.12 ± 0.51 kPa−1.s−1, respectively). The FIV1/FVC ratio was determined in 9 patients and an increase was postoperatively noted in all of them (mean ± SD pre and postoperative values 43 ± 17 and 76 ± 13%, respectively). The physiological findings confirmed the excellent clinical results of t

ISSN:0023-852X    

DOI:10.1288/00005537-198302000-00006

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractExcellent exposure of the cervical spine from C4 to T1 can be attained with the standard anterior approach which utilizes a longitudinal or transverse incision to gain access to the anterior border of the sternocleidomastoid which, along with the trachea, esophagus, and carotid sheath, is retracted. Blunt dissection anterior to the sheath exposes the prevertebral fascia and the anterior aspect of the spine from C4 to T1. Occasionally surgery in the lower cervical spine necessitates detachment of the sternal head of the sternocleidomastoid. Anterolateral approaches to the upper cervical spine and base of the skull often require partial release of the sternocleidomastoid from the mastoid process and retraction of the carotid sheath and hypoglossal and spinal accessory nerves. If these retropharyngeal approaches do not provide sufficient access to the base of the skull and C1 and C2, a transoral approach, possibly with mandible and tongue splitting, can be useful. Infection is a consideration in transoral surgery, however, and this approach is indicated only in special circumstances.

ISSN:0023-852X    

DOI:10.1288/00005537-198302000-00007

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractThe surgical complications associated with a cholesteatoma are predictable preoperatively depending upon the location of a cholesteatoma. If the patient has asattic cholesteatomathe surgeon can anticipate postoperatively a dry ear, minimal chance of persistent or recurrent cholesteatoma, satisfactory hearing restoration, and, although a mastoidectomy is usually necessary, the size of the mastoid cavity in an adult can be extremely small.If a patient has amiddle ear cholesteatomathe surgeon can anticipate postoperatively a relatively high incidence of moist ears, persistent or recurrent cholesteatoma, and an unsatisfactory hearing result. However, seldom will the creation of a mastoid cavity be necessary as rarely will mastoidectomy be required.Although most of the children before puberty in the study had middle ear cholesteatomas, all children — regardless of the location of cholesteatoma — had a higher incidence of surgical failure than did the adu

ISSN:0023-852X    

DOI:10.1288/00005537-198302000-00008

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractGastroesophageal reflux (GER) is a common condition with many manifestations which are of interest to the otolaryngologist. Factors predisposing to GER include anatomic abnormalities of the esophagus and pharynx, neurogenic disease and diet induced decreased lower esophageal sphincter pressure. Three interesting cases are reported, including subglottic stenosis which has not previously been thought to be a complication of GER. A literature review of otolaryngologic symptoms, the problems of diagnosis, and a suggested treatment plan are presented.

ISSN:0023-852X    

DOI:10.1288/00005537-198302000-00009

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractPhysiologic antrostomy, as presented in this paper, is a procedure developed by the author using both old and new techniques. Indications and contraindications for the use of the physiologic maxillary antrostomy are listed. The osteoplastic flap (trapdoor) is used to enter the antrum. The nature of the lesions which can be handled through this approach are covered. The methods for removal of the lesions without removing the mucous membrane lining are given. The indications for removing this membrane are also presented. The methods are presented for the placing of the ventilation tube in the natural ostium.A step by step description of the technique used to perform this type of surgery is presented. Using this method, surgery that is done in or through the maxillary sinus is simplified and the severe sequelae of the Caldwell‐Luc type of surgery are largely overcom

ISSN:0023-852X    

DOI:10.1288/00005537-198302000-00010

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY