ISSN:1043-3074    

DOI:10.1002/hed.2880130302

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

年代:1991

数据来源: WILEY

摘要:

AbstractAn analysis of 508 patients (660 heminecks) with head and neck squamous cell carcinoma and clinically positive neck nodes who were treated with radiotherapy alone to the primary lesion (with or without a neck dissection) was conducted to determine if open neck‐node biopsy before definitive treatment adversely affected the probability of control of neck disease, the risk of distant metastasis, or the cause‐specific survival rate. The prognostic factors analyzed included biopsy status of the neck, N stage, neck treatment, node mobility, node location, T stage, primary site, and control of disease above the clavicles. Sixty‐six patients who had undergone an open neck‐node biopsy before definitive radiotherapy were compared with a control group of 442 patients who did not undergo a neck‐node biopsy; no detrimental effect of the biopsy on neck control, distant metastasis, or cause‐specific survival was demonstrated. We conclude that the potential adverse effect of violating the neck before definitive treatment cannot be demonstrated if radiotherapy is the next step in the patient's

ISSN:1043-3074    

DOI:10.1002/hed.2880130303

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

年代:1991

数据来源: WILEY

摘要:

AbstractSix consecutive patients with ectopic parathyroid lesions were studied by preoperative thallium‐technetium scintigraphy. Ectopic lesions were accurately localized in 5 of 6 patients. Four of five lesions deep in the superior mediastinum, and 1 in the superior carotid sheath, were correctly identified. Ectopic lesions in 4 of 5 patients, who had previously undergone unsuccessful exploration, were correctly localized. In 1 previously unoperated patient, a mediastinal lesion was identified by preoperative scintigraphy. In 2 patients, deep mediastinal exploration via manubriotomy was successfully conducted without confirmation by “invasive” intravascular procedures. There were no false‐positive studies. Lesions identified weighed from 185 mg to 9 g and were from 1.1 to 3.0 cm in size. Scintigraphy is particularly effective for demonstration of ectopic parathyroid tissue, because the absence of thyroid tissue in the mediastinum or superior cervical region permits appreciation of areas of abnormal thallium uptake unobscured by uptake in adjacent thyroid tissue. We conclude that ectopic parathyroid tissue may be accurately identified by thallium‐technetium scintigraphy without confirmation by invasive intravascula

ISSN:1043-3074    

DOI:10.1002/hed.2880130304

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

年代:1991

数据来源: WILEY

摘要:

AbstractExperience in over 65 cases of microvascular mandibular reconstruction has resulted in the development of reliable techniques for bone fixation and contouring to achieve the best functional results. Methods of graft contouring and the application of rigid internal fixation are described in detail. Unusual situations in which the tumor extends through the buccal cortex of the mandible, and when condylar replacement is necessary, are presented. The options for managing these situations are discussed.

ISSN:1043-3074    

DOI:10.1002/hed.2880130305

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

年代:1991

数据来源: WILEY

摘要:

AbstractA new approach to expose the nasopharynx and the parana sopharyngeal space is described. The maxilla, severed from its bony connections, is swung laterally to provide exposure of the nasopharynx. Tumors in the nasopharynx and the paranasopha ryngeal space can be adequately resected and tubings for after loading brachytherapy can be positioned accurately during surgery. The blood supply of the maxilla is from the attached cheek flap and masseter muscle. Three illustrative cases are presented. The wounds in all of them healed primarily with minimal morbidity. The only disadvantage is the development of mild trismus, which responded to conservative treatment.

ISSN:1043-3074    

DOI:10.1002/hed.2880130306

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

年代:1991

数据来源: WILEY

摘要:

AbstractIsolated sphenoid sinus disease is an unusual entity that is encountered infrequently. With advances in antibiotic therapy and imaging techniques, the nature of isolated sphenoid sinus disease has significantly changed. More tumors and less inflamrnatory disorders are being encountered. We have retrospectively reviewed the medical records of patients who had undergone sublabial transseptal sphenoidotomy for isolated sphenoid sinus disease at Allegheny General Hospital for Pittsburgh between January 1985 and July 1989. Thirteen patients were identified with isolated sphenoid sinus disease who were successfully managed with sublabial transseptal sphenoidotomy. This approach allows maximal visualization and safety with minimal morbidity.

ISSN:1043-3074    

DOI:10.1002/hed.2880130307

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

年代:1991

数据来源: WILEY

摘要:

AbstractThe aim of this study was to analyze the effects of surgery, irradiation, and free tissue transfer in locally advanced head and neck cancer patients. Forty‐one patients with head and neck cancer were treated with surgery, irradiation, and free tissue transfer for reconstruction from 1977 to 1987. The age range was 38 to 78 years with a median age of 61. Patients were staged using the AJCC (1978) staging system. Eighty‐four percent of the patients were in stage III or IV. The common sites of primary tumors were the oral cavity (22) and oropharynx (10). Forty patients had squamous cell carcinoma and 1 patient had basal cell carcinoma. Six patients had preoperative irradiation, and the rest had postoperative irradiation. The most common surgical procedures were partial glossectomy and neck dissection (17 patients) and wide excision of the primary and neck dissection (17 patients). The most common types of free tissue transfer were dorsalis pedis (13 patients) and scapular flaps (6 patients). The primary site was controlled in 22 patients (54%) and the neck in 36 patients (88%). Three patients (7.3%) had flap failure which required further surgical management. Eighteen patients are living with no evidence of disease with a median follow‐up of 18 months (5‐101 months), 10 patients are living with disease with a median follow‐up of 9 months (3‐40 months), 9 patients are dead of disease with a median survival of 13 months (6‐54 months), and 4 patients are lost for follow‐up. This study shows that free tissue transfer before or after irradiation is of benefit with fe

ISSN:1043-3074    

DOI:10.1002/hed.2880130308

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

年代:1991

数据来源: WILEY

摘要:

AbstractThis study evaluated the toxicity resulting from combined therapy using carboplatin and radiotherapy in 22 patients with locally advanced (stage III and IV) head and neck cancer. Carboplatin was given after radiotherapy during the first 5 consecutive days of a 16‐fraction course of radiotherapy delivered in a total of 22 days. To find the acceptable toxic dose of carboplatin, the patients were treated in groups of 3 patients each. The first group received 50 mg/m2carboplatin and the dose was increased by 10 mg/m2in each subsequent group. Unacceptable toxicity (severe mucositis, nausea and vomiting, and/or myelo‐suppression) was encountered at a carboplatin dose of 80 mg/m2. A further 10 patients were then treated at a dose of 70 mg/m2. At this dose toxicity was acceptable. Although the group of 22 patients is too small for response and survival data to be meaningful, 10 complete responses were seen and median survival is in excess of 67 we

ISSN:1043-3074    

DOI:10.1002/hed.2880130309

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

年代:1991

数据来源: WILEY

ISSN:1043-3074    

DOI:10.1002/hed.2880130310

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

年代:1991

数据来源: WILEY

摘要:

AbstractOne hundred and forty‐eight (72%) of 205 allogenic bone marrow transplant recipients developed mucosal lesions in the oral cavity during the aplastic period after transplantation. Lesions were most frequent 8 to 9 days after transplantation. Factors that correlated with the development of mucosal lesions after univariate and multivariate analysis were a marrow cell dose of<3 × 108cells/kg body weight, (p<0.0001), prolonged aplastic period (white blood cell count<0.2 × 109) cell/l during more than 14 days (p<0.005), herpes simplex virus‐1 seropositivity of the recipient (p<0.01), and conditioning with total body irradiation (p<

ISSN:1043-3074    

DOI:10.1002/hed.2880130311

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

年代:1991

数据来源: WILEY