摘要:

AbstractThe clinical features in 15 young adult patients with allergicAspergillussinusitis includes a history of asthma, recurrent nasal polyps, and radiographic evidence of pansinusitis. Multiple surgical procedures were performed on 12 patients.The histologic diagnosis is made on the mucinous material which contains eosinophils, fungal hyphae (Aspergillusspecies), and Charcot‐Leyden crystals. Mycetomas, direct mucosal and soft tissue invasion by fungi, were not observed.Immunologic findings include an immediate cutaneous reactivity toAspergillusin 60% of patients, total serum IgE elevation in 85%, and serum precipitins toAspergillusin 85%.A new therapeutic protocol was devised based on the current treatment of allergic bronchopulmonary aspergillosis. Therapy includes wide local debridement, adequate sinus aeration, and the postoperative use of systemic steroids. Seven patients placed on systemic corticosteroids are asymptomatic for a mean of 14 months.Diagnosis of allergicAspergillussinusitis requires a high index of suspicion, a confirmatory diagnosis from the inspissated mucus, and an immunologic evaluation prior to the institution of corticosteroid therap

ISSN:0023-852X    

DOI:10.1288/00005537-198703000-00001

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractComplication rates are lower using postoperative radiation therapy and cure rates at least compatible to preoperative radiation therapy. However, one of the concerns with postoperative radiation treatment is the possibility of delay in beginning the treatment because of an unhealed surgical wound. A delay of more than 6 weeks is detrimental.In order to study the effect of radiation therapy on incompletely healed wounds, a retrospective chart review of such cases during the period 1977 to 1984 was undertaken. One hundred and eighty‐five patients had planned postoperative radiation therapy, and 13 of these began radiation therapy with an unhealed wound or fistula. Six of 10 wounds closed spontaneously, 4 required surgical closure, and 3 failed to heal. Seven patients in this study died with cancer, 2 died of other causes, 3 are alive without disease, and 1 patient remains alive with disease.We conclude that giving radiation therapy to an open wound with appropriate precaution can be done without serious complication

ISSN:0023-852X    

DOI:10.1288/00005537-198703000-00002

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractThe dentition is a common source of infection in the head and neck and most odontogenic infections respond uneventfully to proper dental therapy. Some more fulminant odontogenic infections can produce complications including airway obstruction, necrotizing fasciitis, and extension of the infection to the orbits, intracranial structures, and thorax.Six such cases treated by the authors are presented and recommendations for management including aggressive antimicrobial, therapy‐based bacteriology and surgical drainage and debridement are mad

ISSN:0023-852X    

DOI:10.1288/00005537-198703000-00003

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractAirway obstruction associated with fractures of the midfacial skeleton can be life‐threatening if not recognized promptly and treated appropriately. One hundred seventeen patients with LeFort fractures were treated between 1978 and 1984. Of the 117 patients, 21 had a LeFort I fracture, 46 had a LeFort II fracture, 14 had a LeFort III fracture, and 36 had various combinations of the three types of LeFort fractures.Thirty‐one patients (26.5%) presented with airway obstruction, decreased respiration, or both, requiring either tracheotomy or endotracheal intubation. Of the 31 patients undergoing emergent tracheotomy or endotrachealintubation, 26 (83.9%) had loss of consciousness relating to their injuries. Thirty‐nine (33.3%) additional patients had an elective tracheotomy either at the time of surgical repair of their fractures or for prolonged endotracheal intubation.Age and sex of the patients played no role in the incidence of airway complications in patients with LeFort fractures. Patients with LeFort III fractures and those with associated injuries such as mandible fracture, laryngeal and pharyngeal injury, and chest or closed head injury are at greater risk for requiring emergent control of the a

ISSN:0023-852X    

DOI:10.1288/00005537-198703000-00004

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractHunter's disease is a genetically transmitted defect known to produce mucopolysaccharide infiltration of multiple organ systems. Upper airway obstruction is caused by an enlarged tongue, deformed pharynx, and short, thick neck. Its eventual lethal outcome by the second decade of life is known to result from an infiltrative cardiomyopathy leading to irreversible heart failure. Instead, our recent experience in the care of five patients with this disorder suggests the lethal event is related to progressive obstruction sequentially involving the upper, mid, and lower airway characterized by gradual deformation and collapse of the trachea. Autopsy and histopathologic whole organ sections demonstrate anteroposterior flattening of the trachea and bronchi with submucosal thickening producing structural alterations known only to this disease.

ISSN:0023-852X    

DOI:10.1288/00005537-198703000-00005

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractA new assay has been developed to predict the effectiveness of steroid‐hormone therapy in various tumors. The Biopsy Nuclear Binding assay measures the amount of biologically active receptor that binds both steroid hormone and acceptor sites in the nucleus. This assay does not measure the entire receptor population, only those that are biologically active; therefore, it should more accurately predict the response to steroid‐hormone therapy. We applied this assay effectively in breast and endometrial carcinoma. Preliminary studies have shown that 40% of patients with head and neck squamous‐cell carcinomas have biologically active (nuclear bound) progesterone receptors. If nuclear binding predicts a remission with hormonal therapy, then the quality of life of appropriately selected patients could greatly im

ISSN:0023-852X    

DOI:10.1288/00005537-198703000-00006

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractThe evaluation of a patient with a mass in the head and neck may require the consideration of lymphoma in the process of differential diagnosis. Non‐Hodgkin's lymphoma is a well‐described heterogeneous group of lymphoid malignancies characterized by a natural history ranging from indolent to aggressive growth. Little has been written, however, concerning the specific features of this disease in the head and neck.Between 1974 and 1984, 287 patients were treated for non‐Hodgkin's lymphoma presenting in the head and neck. A multivariant analysis of these cases forms the basis of this report. All case material was reviewed and classified according to the working formulation of the National Cancer Institute and the Ann Arbor Classification System for lymphomas. Sites of initial presentation, methods of diagnosis, choice of therapy and subsequent response to treatment were related to the manifestations of non‐Hodgkin's lymphoma in the head and neck. Of particular interest to the head and neck surgeon is the constellation of presenting signs and symptoms which point one to the possibility of non‐Hodgkin's

ISSN:0023-852X    

DOI:10.1288/00005537-198703000-00007

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractPatients with obstructive sleep apnea syndrome (OSAS) may have airway obstruction at various levels, including the uvula‐soft palate complex, base of tongue, and/or possibly other sites. For patients with tongue base and/or laryngeal obstruction, uvulopalatopharyngoplasty (UPPP, ppp) will not alleviate the obstruction. Prior authors have proposed that the hyoid bone position as determined by cephalometric x‐rays can predict which patients have obstruction at a lower site than the soft palate.In this study, patients with obstructive sleep apnea syndrome were evaluated with polysomnographic testing, fiberoptic endoscopy, and cine‐CT scans (Imatron Scanner with multiple level rapid sequence scans) in an attempt to determine precisely the site of airway obstruction. Measurements of airway size taken at the time of fiberoptic pharyngoscopy were compared with those determined by the cine‐CT studies.Initial results revealed that fiberoptic pharyngoscopy in the sitting and supine positions was helpful in confirming pharyngeal airway sites with smaller diameters in awake patients. However, the cine‐CT exam performed in both sleeping and awake states provided more direct data regarding the airway during sleep. We feel that with more clinical experience the cine‐CT technique will prove to be the most helpful study for identification of the obstructive airway site in obstructive sleep apn

ISSN:0023-852X    

DOI:10.1288/00005537-198703000-00008

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractThis report presents our experience with nasopharyngeal complications of UPPP in 85 patients undergoing the procedure from May, 1982 to January, 1985. Three patients developed nasopharyngeal stenosis and one patient developed permanent velopharyngeal insufficiency. Surgical management in two patients with nasopharyngeal stenosis resulted in adequate nasopharyngeal airway, while one patient still has a moderate stenosis following two surgical procedures. The patient with velopharyngeal insufficiency underwent Teflon® paste injection in the posterior pharyngeal wall. This resulted in complete alleviation of his nasal regurgitation

ISSN:0023-852X    

DOI:10.1288/00005537-198703000-00009

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractThe otocyst is the epithelial anlage of the membranous labyrinth that interacts with surrounding head mesenchyme tissue during formation of the otic capsule. In vitro studies were performed to gain a better understanding of the role that epithelial‐mesenchymal tissue interactions play in development of the otic capsule. Parallel series of otocyst/mesenchyme (O/M) and isolated periotic mesenchyme (M) explants provided morphological and biochemical data. The results indicate that epithelial‐mesenchymal tissue interactions control development of both the otic capsule and the perilymphatic spaces. The otocyst induces cartilage differentiation in periotic mesenchyme between embryonic days 11 to 13 and organizes otic capsule morphology between embryonic days 13 to 14 in the mouse embryo. The otocyst exerts a localized repression of chondrogenesis in nearby mesenchyme during perilymphatic space formation on embryonic days 12 to

ISSN:0023-852X    

DOI:10.1288/00005537-198703000-00010

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY