摘要:

AbstractIn a review of thyroid surgery during the past 12 years, total thyroidectomy was performed in 20% of the cases. Forty percent were done for malignant disease and 60% for benign disease. Our indications for using this operation in benign thyroid disease include bilateral nodular goiter, Graves' disease, chronic thyroiditis, and cases in which the rapid frozen diagnosis is equivocal for carcinoma.We feel that the risks of reoperation for recurrent thyroid disease are greater than the risks of a total thyroidectomy as the initial surgical procedure. With the increased use of total thyroidectomy the incidence of permanent hypoparathyroidism can be decreased. We reviewed our preoperative work‐up, indications for total thyroidectomy, surgical technique, diagnostic accuracy of needle biopsy, accuracy of rapid frozen section reports, and postoperative complication

ISSN:0023-852X    

DOI:10.1288/00005537-198708000-00001

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractA computer search of cancer patients enrolled in the Rocky Mountain Cancer Data System between 1973 to 1983 revealed 1, 362 patients with hypopharyngeal cancer, 1, 208 of whom could be staged by the American Joint Committee on cancer staging criteria. Stage I and II patients comprised 17.5% while 71% were either stages III or IV. The distant metastatic rate in advanced stage patients was 24%.Survivals for all treated patients were 65% at 1 year, 33.5% at 3 years, and 25% at 5 years. Three‐year survivals were 54.5% for the surgery only group, 41.6% for the combined therapy group, and 17.7% for the irradiation only group. Five‐year survivals for the surgery only group were 39.8%, combined therapy, 31.8%, and irradiation only 11.5%. These figures are actuarially corrected.Twenty‐two percent of combined therapy patients had preoperative irradiation versus 78% who had postoperative irradiation. There was no statistically significant difference seen between these two g

ISSN:0023-852X    

DOI:10.1288/00005537-198708000-00002

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractEleven cases of sinonasal undifferentiated carcinoma were treated between 1975 and 1986. This distinctive neoplasm involved the orbital cavity in 6 of 11 patients (55%) and the cranial cavity in 7 of 11 patients (64%) at the time of presentation. Of the eight patients (73%) who died of disease, six died within 13 months after the diagnosis. One patient has no evidence of disease 10 months after therapy, and two are alive with disease after 15 and 22 months.

ISSN:0023-852X    

DOI:10.1288/00005537-198708000-00003

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractThe Nevus Sebaceous of Jadassohn (SNJ) is a congenitally‐occurring, hamartomatous disorder of the skin and its adnexa of infrequent occurrence. This presentation of five cases emphasizes the smooth, waxy, yellow‐brown lesion's progression into a thickened sebaceous tumor of premalignant predilection. The incidence of neoplastic degeneration of these hamartomatous nevi may be as high as 30% with the capacity of metastasis occasionally reported. Because of malignancy risks as well as cosmetic considerations, early surgical removal is recommended.Previously unreported problems of dysphagia and malnutrition secondary to pulsion diverticulum at the esophageal inlet and cleft palate, obliterative aural stenosis with associated conductive hearing loss are documented. Regardless of SNJ's occurrence as either an isolated lesion or as the fully developed syndrome, including mental retardation and epilepsy, this congenital malformation of the skin, its hair, and sebaceous glands presents rare and histologically intriguing problems for the practitio

ISSN:0023-852X    

DOI:10.1288/00005537-198708000-00004

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractFrom January 1981 through December 1985, 9 patients underwent radical neck dissection with sacrifice of the spinal accessory nerve for removal of metastatic cancer to cervical nodes followed by reconstruction of the spinal accessory nerve utilizing a cable graft from the greater auricular nerve.Shoulder function on the operated side was assessed postoperatively using a subjective questionnaire, objective strength testing, and EMG recordings. The group that had cable grafts of the spinal accessory nerve were compared to a group who had modified radical neck dissection with preservation of the spinal accessory nerve, and to a third group that had classical radical neck dissection with sacrifice of the spinal accessory nerve and no cable graft reconstruction.The group with cable grafts scored in a position intermediate between the modified neck dissection group and the classical radical neck dissection group on subjective and objective testing. Most of the patients with cable grafts demonstrated voluntary motor potentials in the trapezius muscle on postoperative EMG testing.Cable grafting of the spinal accessory nerve sacrificed during radical neck dissection results in improved shoulder function in the postoperative period. Indications and contraindications for the use of this rehabilitative procedure are presented.

ISSN:0023-852X    

DOI:10.1288/00005537-198708000-00005

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractThe most morbid complication of laryngeal laser surgery is an endotracheal tube lire. The purposes of this study were to determine the efficiency of saline solution‐soaked cottonoid pledgets in protecting endotracheal tube cuffs from the laser beam and to evaluate the safety of four commonly used endotracheal tubes.The method involved measurement of perforation times of saline‐soaked cottonoid pledgets with controlled variables of air exposure times and laser energy. The second part evaluated the safety and ignition properties of the red rubber, silicone, polyvinyl chloride, and Xomed Laser‐Shield® tubes by studying their perforation times and ignition properties under controlled oxygen concentrations.The results revealed that saline‐soaked pledgets are very efficient in protecting endotracheal tube cuffs. The Laser‐Shield® tube was the safest one studied. It had the highest ignition threshold of the four t

ISSN:0023-852X    

DOI:10.1288/00005537-198708000-00006

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractA total of 2, 985 stapedectomies were done during the 25‐year period 1959 to 1984 in a busy urban otologic practice. One hundred twenty‐three of these cases were found to have obliterative otosclerosis which resulted in a drill‐out stapedectomy. Postoperatively, a minimum of 2 years follow‐up yielded 98 of the original 123 drill‐out cases constituting the study group. Several parameters will be evaluated:1.Initial hearing gain (measured 3 months after surgery),2.long‐term hearing results (measured 2 years and beyond),3.additional sensorineural hearing loss, and4.probability of bilateral obliterat

ISSN:0023-852X    

DOI:10.1288/00005537-198708000-00007

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractThe purpose of this study was to review mechanisms, etiologies, associated injuries, and treatment of maxillofacial trauma in children and to compare them to similar adult injuries. Thirty blunt injuries (1984‐1986) comprised the children's group, and 176 injuries, the adult group. Multiple associated injuries were more common in children, the most frequent being CNS and orthopedic injuries. Detailed anatomy of mandibular fractures required pleuridirectional tomography in 63% of the pediatric cases compared to 12% in adults. In the children's group, the mandibular fractures were favorable in 56% of cases compared to 15% in adults. Children required shorter periods of intermaxillary fixation with no child requiring reapplication of fixation. Based on these comparisons, a protocol for the management of pediatric maxillofacial injuries has been develope

ISSN:0023-852X    

DOI:10.1288/00005537-198708000-00008

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractExcessive projection of the nasal tip is a relatively uncommon deformity, often referred to as the “Pinocchio” nose. When this unaesthetic appearance is secondary to abnormally long medial and lateral crura of the lower lateral cartilages, and when tip rotation is undesirable, surgical correction can represent a challenging problem.A simple and reproducible method via the open septorhinoplasty approach is described for correction of this deformity. In this technique, preoperative photographs are analyzed to calculate the exact length of cartilage to be excised from the medial and lateral crura. The results of this procedure are critically analyzed in six consecutive patients followed for 7 to 19 months. Based on this experience, the operation is recommended as a reliable method for correction of the over‐projecting nasal tip when minimal or no rotation is desi

ISSN:0023-852X    

DOI:10.1288/00005537-198708000-00009

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractInvasive sinonasal aspergillosis is a severe and frequently fatal infection in immunosuppressed patients with hematologic malignancies.Seven patients with sinonasal aspergillosis who failed to respond to conventional amphotericin B (AmpB) were treated with liposomal AmpB (L‐AmpB). AmpB was incorporated into multilamellar vesicles consisting of dimyristoyl phosphatidylcholine and dimyristoyl phosphatidylglycerol in a 7:3 molar ratio. Five patients had underlying hematologic malignancies, one patient had aplastic anemia, and one patient had no underlying disease. All patients had biopsy‐proven invasive Aspergillus sinusitis, and had failed conventional antifungal therapy including AmpB. Five patients were cured and two did not respond to treatment. Fever and chills were infrequent and, when they occurred, mild, and responded well to conventional management. No severe renal or central nervous system toxicity was observed. L‐AmpB is effective and less toxic than conventional AmpB in the treatment of invasive Aspergillus sinu

ISSN:0023-852X    

DOI:10.1288/00005537-198708000-00010

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY