摘要:

AbstractOne hundred patients with a diagnosis of head and neck cancer were investigated carefully for a history of alcoholism.A majority of cases had a severe drinking problem; in fact, alcoholism was twice as common as initially anticipated. Patients were frequently able to hide the problem from their physician. Often the true diagnosis was obtained only by closely questioning relatives and friends.Most patients with cancer of the tongue, tonsil and oro‐pharynx were alcoholic. About one‐half of the patients with supraglottic carcinoma were alcoholic. In the nasopharynx and true vocal cords, there was no association with heavy drinking.The study is of epidemiological interest but also has implications in the management of the malignancy, depending upon the anatomic site invol

ISSN:0023-852X    

DOI:10.1288/00005537-197508000-00001

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-197508000-00002

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

摘要:

AbstractThe CO2surgical laser and microscope assembly have been used to excise carefully selected T1carcinomas of the membranous portions of the cord. Healing has been prompt and return of function satisfactory.General anesthesia and suspension laryngoscopy have provided excellent definitions of the lesions; the laser has provided a precise method of dissection.Initial results have been excellent and long term results will depend on the accuracy with which the margins of the tumor are defined and the presence or absence of the tendency of the larynx to produce multicentric disease.

ISSN:0023-852X    

DOI:10.1288/00005537-197508000-00003

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

摘要:

AbstractLaryngofissure and cordectomy is one of the first of the successful surgical procedures for the cure of cancer limited to the vocal cord. When the lesion is confined to the membranous cord and the motion of the cord is not impaired, cure rates ranging from 85 to 98 percent have been reported.Decline in the use of the procedure is due to the success of radiation therapy in achieving comparable cure rates while preserving normal voice quality. Hemilaryngectomy procedures are now done where laryngofissure and cordectomy had previously been indicated. The more extensive procedure gives greater security due to wider margins of resection and increase applicability, particularly when the lesion involves the anterior commissure.Although the indications for laryngofissure have diminished, the surgeon may use it when a simple, less extensive procedure is called for.

ISSN:0023-852X    

DOI:10.1288/00005537-197508000-00004

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-197508000-00005

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-197508000-00006

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

摘要:

AbstractSupraglottic cancer, because of the embryological development of the larynx, and of the arrangement of its lymphatic network, tends to remain limited within the vestibule of the larynx and the pre‐epiglottic space also in its advanced stages of evolution. The cancer spread may superiorly involve the epilarynx, the vallecula, the base of the tongue, and the pyriform fossa; however, inferiorly, the invasion of the glottis is quite exceptional (1 percent of cases); therefore, supraglottic laryngectomy is the operation of choice.The lower the location of cancer in the vestibule, the safer the indication. The higher location generally requires an extension of surgical excision toward the tongue, arytenoids and hypopharynx.In view of the high percentage of lymph node metastases, supraglottic laryngectomy should be associated with neck dissection, mainly bilateral, also in cases with no evidence of enlarged lymph nodes.Supraglottic laryngectomy has been performed in 240 cases in the course of the last 14 years and the five‐year cure rate has been 79 percent. Five postoperative deaths have been recorded.Rehabilitation time for the breathing and swallowing function has been three weeks as an average. Complications, such as fistula or infection have been exceedingly rare: uneventful recovery followed in all ca

ISSN:0023-852X    

DOI:10.1288/00005537-197508000-00007

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

摘要:

AbstractThe analysis of supraglottic subtotal laryngectomy with removal of the entire arytenoid cartilage is presented in 59 patients. The survival rate in the patients was 75 percent for primary surgery.

ISSN:0023-852X    

DOI:10.1288/00005537-197508000-00008

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

摘要:

AbstractCancer of the base of the tongue and the larynx is usually treated primarily with irradiation to 6,000 rads. Persistence of tumor after irradiation is common and requires a logical, thoughtful approach designed to augment all tissues removed. Careful preoperative planning and the use of the lateral approach to the base of the tongue, in conjunction with pharyngostome and laryngostome formation allows wide resection of the cancer.Preservation of the function of speech and swallowing, and preservation of the mandibular contour are important, and correlate closely with carotid artery protection.Five different methods of approach to the problem are analyzed and presented.

ISSN:0023-852X    

DOI:10.1288/00005537-197508000-00009

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

摘要:

AbstractRadical neck dissection has evolved into a standard surgical technique over the past century. It has been the most effective method of attempting to control suspected or gross metastasis to the cervical region. The technique embraces theen masseremoval of all tissue elements in the space between the subdermis and the fascia colli. The perimeters of the dissection extend from the midline anteriorly to the anterior border of the trapezius muscle posteriorly, and from the clavicle to the mandible. The essential portion of this large mass of tissue is the cervical lymph system with its lymph nodes and afferent and efferent connecting vessels. Controllability of the cancer process is in direct proportion to the number of nodes involved, their size and their position in the neck. Complications in the routine radical neck dissection are minimal. Cure rates are influenced by the type, size and site of the primary cancer, the possibilities for adjunctive treatment such as radiotherapy and chemotherapy, and the, as yet, little understood immunological factors. The radical neck dissection has proven itself to be an essential tool in the management of cancer in the head and neck.

ISSN:0023-852X    

DOI:10.1288/00005537-197508000-00010

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY