摘要:

AbstractCancers of the cervix and buccal cavity share histologic, epidemiologic, and exposure characteristics. In particular, cigarette smoking and human papillomavirus (HPV) have been cited as etiologic cofactors of both malignancies. Using incidence data from the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute for the years 1973 through 1984, we evaluated the incidence of second cancers of the buccal cavity following an initial cervical cancer. Standardized incidence ratios (SIR) were uniformly elevated for both white (SIR = 2.0), and black (SIR = 3.5) women. There were also elevated risks for the development of cervical cancer following an initial buccal cavity cancer (SIRs = 3.3 and 2.5, respectively). A similar pattern was evident for laryngeal cancer among white women. HPV transmission could account in part for the paired occurrence of these two anatomically distinct cancer sites. Cigarette smoking could act as a synergistic cofactor in the malignant transformation of viral genome‐harboring tissue. © 1992 John Wiley&Sons, I

ISSN:1043-3074    

DOI:10.1002/hed.2880140502

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1992

数据来源: WILEY

摘要:

AbstractThe purpose of this preliminary investigation was to identify the location and length of the pharyngoesophageal (PE) segment during esophageal and tracheoesophageal (TE) speech among laryngectomees who were proficient in both methods of vocalization. Four patients who had undergone total laryngectomy and tracheoesophageal puncture served as subjects. Voice recordings were obtained and played to listeners of varying experience with laryngectomees. Videofluoroscopy was performed while the patients sustained “ah” in both modes of speech. Results of these analyses revealed that TE speech was rated as more effective than esophageal speech in all 4 subjects. However, only minimal differences were found in the length and the location of the PE segment during TE and esophageal speech when within subject comparisons were made. This study is the first to compare the physical characteristics of the PE segment during esophageal speech and TE speech as produced by the same speaker. © 1992 John Wiley&Sons,

ISSN:1043-3074    

DOI:10.1002/hed.2880140503

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1992

数据来源: WILEY

摘要:

AbstractThe need to treat the neck in patients with a small primary cancer in the tongue remains controversial. Twenty‐eight patients with stage I or II oral tongue squamous carcinomas were retrospectively reviewed. They had not received previous treatment. The tongue primary was excised via the transoral route and the neck was observed closely during follow‐up. Thirteen patients developed ipsilateral nodal metastases during follow‐up, three of whom also had simultaneous recurrence at the primary site. An additional patient had recurrence at the primary site alone. The incidence of occult neck metastasis was 42% (10 of 24). No tumor‐related death occurred in the group without nodal metastasis. The salvage rate after appearance of nodal metastasis was 30%. In oral tongue cancers, elective neck treatment should be considered regardless of a small primary and negative neck examination because of the high incidence of occult nodal metastasis and the poor outcome after salvage treatment. © 1992 John Wiley&S

ISSN:1043-3074    

DOI:10.1002/hed.2880140504

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1992

数据来源: WILEY

摘要:

AbstractAdvances in vascular radiology techniques for superselective arterial infusions and methods to overcome systemic toxicity from high‐dose cisplatin chemotherapy encouraged us to re‐evaluate the effects of rapid regional cisplatin infusion for patients with head and neck malignancies. Twenty patients (17 carcinomas, three sarcomas) received high‐dose cisplatin (100‐200 mg/m2) by this method. Fifteen of the 17 patients with upper aerodigestive tract carcinoma are part of an ongoing phase I dose escalation of cisplatin with sodium thiosulfate neutralization. Three additional patients with sarcomas were treated with intra‐arterial (IA) cisplatin and systemic Adriamycin. Fifty‐three IA infusions were performed without any complications. Only minimal toxicity related to the chemotherapy was observed. The overall response rate for previously untreated patients was nine of 10 (90%) [complete response (CR) 67%; partial response (PR) 33%]. The response rate for patients with recurrent disease was five of eight (63%) (CR 20%, PR 80%). The average length of follow‐up is 9.5 months and the actuarial survival rate is 56%. Superselective rapid infusion of high‐dose cisplatin for patients with advanced head and neck malignancies is feasible, relatively nontoxic, and may have important applications in multimodality therapy, particularly for patients with bulky primary disease. © 1992 John

ISSN:1043-3074    

DOI:10.1002/hed.2880140505

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1992

数据来源: WILEY

摘要:

AbstractVascular malformations of the mandible are uncommon, but often present with significant hemorrhage. Transarterial vessel occlusion has become a valuable primary or adjunctive treatment for such lesions, as well as for most other symptomatic congenital and acquired head and neck vascular anomalies. Permanent embolic obliteration of the malformation requires placement of occlusive material directly into the nidus (core) of the lesion. Prohibitively complex proximal vasculature may prevent successful catheter positioning and lead to failure of traditional embolotherapy. Even optimal placement of arterial embolic material may fail to fully obliterate the nidus, allowing eventual restoration of flow to the lesion due to arterial recanalization. Under such circumstances it may be possible to obliterate the malformation and control lesional hemorrhage by occlusion of the malformation or its venous drainage by direct percutaneous mandibular puncture. In our case, multiple transarterial embolizations failed to sufficiently manage a symptomatic vascular malformation. Successful embolotherapy was performed via direct puncture of the venous side of the malformation through the mandibular cortex. Venous thrombosis induced concomitant occlusion of abnormal arteriovenous shunts, resulting in long‐term control of life‐threatening oral hemorrhage. © 1992 John Wiley&Sons,

ISSN:1043-3074    

DOI:10.1002/hed.2880140506

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1992

数据来源: WILEY

摘要:

AbstractIatrogenic lesions of the external branch of the superior laryngeal nerve (EBSLN) during thyroidectomies are not infrequent due to the possibility of anatomic variations of the relationships of this nerve with the superior thyroid vessels. Therefore, based on an anatomic analysis of 30 superior thyroid poles from 15 fresh cadavers, a new classification of the EBSLN was proposed, considering the jeopardy during a thyroidectomy. Thirty‐seven percent of the nerves were type 2, ie, crossing the superior thyroid pedicle less than 1 cm above the superior thyroid pole. It is notable that 20% were type 2b, ie, crossing the vessels below the upper border of the pole, having been considered “high risk.” This incidence was comparable with other series, which found dangerous anatomic variations of the EBSLN in the range of 15% to 68%, confirming that a significant proportion of these nerves might be at risk during surgery on the superior thyroid pole. © 1992 John Wiley&Son

ISSN:1043-3074    

DOI:10.1002/hed.2880140507

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1992

数据来源: WILEY

摘要:

AbstractTwo patients presented with a presumptive diagnosis of hyper‐parathyroidism. Surgically excised “parathyroid glands” were found to be, in fact, large lymph nodes with sarcoid granulomata. In one patient, the preoperative localization of the “parathyroid adenoma” was based on scintigraphy (thallium‐technetium subtraction imaging) and sonography procedures. The differential diagnosis of hypercalcemia, and positive scintigraphy‐sonography studies, must include sarcoidosis in an isolated cervical lymph nodes. © 1992 John W

ISSN:1043-3074    

DOI:10.1002/hed.2880140508

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1992

数据来源: WILEY

摘要:

AbstractBasaloid‐squamous carcinoma was first recognized as a separate pathologic entity in 1986. It has been described in the hy‐popharynx, larynx, base of tongue, and nasal cavity. We report the first case of this rare tumor occurring in the buccal cavity and review the atypical squamous cell carcinomas that occurred in these sites. © 1992 John Wiley&Sons,

ISSN:1043-3074    

DOI:10.1002/hed.2880140509

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1992

数据来源: WILEY

摘要:

AbstractRhabdomyosarcoma (RMS) is a relatively frequent tumor in children. Judicious combinations have markedly improved treatment results in recent years. Orbital localizations are treated with chemotherapy and radiotherapy. It has been advocated that radiotherapy be limited to the original tumor bed. This case report illustrates the danger of shielding part of the orbit: in a clinically tumor‐free region before chemotherapy, which was shielded during radiotherapy, a local recurrence was seen while the original tumor bed remained controlled. Therefore, the whole content of the orbit should be irradiated in orbital RMS. © 1992 John Wiley&Sons, I

ISSN:1043-3074    

DOI:10.1002/hed.2880140510

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1992

数据来源: WILEY

摘要:

AbstractRhabdomyomas are usually found in the myocardium. Of the extracardiac sites, the head and neck is the most frequent region where this rare tumor arises. Multifocal head and neck lesions have only been described in 11 cases. We herein present two additional multifocal lesions. © 1992 John Wiley&Sons

ISSN:1043-3074    

DOI:10.1002/hed.2880140511

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1992

数据来源: WILEY