ISSN:1043-3074    

DOI:10.1002/hed.2880120402

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

年代:1990

数据来源: WILEY

摘要:

AbstractThis study was designed to evaluate the predictive value of quantitative bacteriology of intraoperative wound tissue in identifying the patient likely to develop wound infection, as well as its subsequent flora. Forty‐one patients undergoing contaminated cancer surgery of the head and neck were studied. Intraoperatively, a sample of wound tissue was cultured and anaerobic and aerobic bacterial isolates quantitated. The wound infection rate was 22% (9 of 41). There was no significant correlation between intraoperative tissue bacterial density and subsequent wound infection, or contaminating and infecting bacteri

ISSN:1043-3074    

DOI:10.1002/hed.2880120403

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

年代:1990

数据来源: WILEY

摘要:

AbstractA retrospective review of 57 patients, who had received frozensection diagnoses, was performed both to ascertain the accuracy of diagnosis and to evaluate its usefulness in assessing tumor surgery. Except for 2 cases, each with a parotid gland tumor, the frozen‐section diagnoses were consistent with the final diagnoses using permanent paraffin sections. Fifteen cases with either T1 or T2 squamous cell carcinoma of the oral cavity and 2 cases with malignant salivary gland tumor, showing tumor‐free surgical margins by frozen‐section examination, were followed. A local recurrence of the carcinoma was observed in 1 case during the follow‐up period. Prior to neck dissection, lymph node metastases were examined using frozen sections. Ten cases, which were diagnosed as negative for metastasis, showed no subsequent development of cervical node met

ISSN:1043-3074    

DOI:10.1002/hed.2880120404

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

年代:1990

数据来源: WILEY

摘要:

AbstractFor a presentation to the American College of Surgeons in November 1988, we reviewed the literature concerning primary management of glomus tympanicum and jugulare tumors. From the published series, we examined the local control and treatment‐related morbidity for three therapeutic approaches: surgery alone, radiation before or after surgery, and radiation alone. The local control rates were similar, 86%, 90%, and 93%, respectively. Among the surgical series reporting complications, new cranial nerve deficits were common, especially with advanced lesions. Serious sequelae from radiation therapy were rare (2% to 3%). We feel radiation therapy should be considered as primary treatment for glomus jugular

ISSN:1043-3074    

DOI:10.1002/hed.2880120405

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

年代:1990

数据来源: WILEY

摘要:

AbstractHigh‐resolution computed tomographic (CT) scanning and, more recently, magnetic resonance imaging (MRI) have provided more accurate evaluation of the extent of head and neck neoplasms. With increasing experience, better methodology is being developed to improve imaging accuracy. We present a series of patients with clinically proven neoplasms of the oropharynx and larynx, evaluated by MR using T1‐weighted, T2‐ weighted, and post‐gadolinium (Gd)‐DTPA T1‐weighted imaged. The concept behind the use of Gd‐DTPA was that it might permit the use of only pre‐ and postcontrast T1‐weighted sequences, reducing examination time and increasing the sensitivity of the examination. It was also anticipated that Gd‐DTPA could increase tumor conspicuity and edge definition. Imaging planes were chosen to best define the tumor extent and axial images were performed to evaluate adenopathy. The imaging results were compared with the clinical evaluation and with nonGd‐enhanced MRI. We present examples of the significantly improved soft tissue contrast with Gd‐DTPA T1‐weighted images and discuss the improved tumor margin definition with Gd‐ DTPA. Those cases in which it does not provide improved informa

ISSN:1043-3074    

DOI:10.1002/hed.2880120406

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

年代:1990

数据来源: WILEY

摘要:

AbstractWe reviewed 70 patients with lower lip mucoceles for patient characteristics, clinical features, and histopathologic findings. These cases represented approximately 75% of oral mucoceles seen in the Department of Otolaryngology, Takeda General Hospital, between February 1985 and July 1988. Patients were divided almost equally between males and females, with ages ranging from 2 to 63 years, with the highest incidence of lesions occurring in the second decade. Duration of the lesions varied greatly from a few days to 3 years, with no correlation to size. The most commonly affected site was opposite the upper lateral incisor, with the incidence divided almost equally between right and left side. Of 70 biopsies, 68 were mucous extravasation cysts and 2 were mucous retention cysts. Surgical excision was the treatment of choice, with recurrence of the lesion in only 2 cases.

ISSN:1043-3074    

DOI:10.1002/hed.2880120407

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

年代:1990

数据来源: WILEY

摘要:

AbstractThe reported incidence of postoperative hypoparathyroidism varies from 3% to 32%, and many surgeons are reluctant to perform a total thyroidectomy because of the risk of permanent damage to the parathyroid glands. We prospectively studied three groups of patients for evidence of acute parathyroid damage: group A consisted of 29 patients with total thyroidectomies; group B, 21 controls with partial thyroidectomies; and group C, 29 patients with total thyroidectomies that had been performed several months to years earlier. Functional status of the glands was measured by serum parathormone, calcium, and phosphorus levels. Although these levels fell postoperatively, they remained within normal limits. None of the long‐term follow‐up patients (group C) was found to have hypoparathyroidism, leading us to conclude that this risk may be overstated in the literat

ISSN:1043-3074    

DOI:10.1002/hed.2880120408

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

年代:1990

数据来源: WILEY

摘要:

AbstractA consecutive series of 28 patients treated by conservation surgery of the larynx for radiation‐failure, recurrent rT1and T2(postradiotherapy staging) glottic squamous cell carcinoma treated at Memorial Sloan‐Kettering Cancer Center from 1966 to 1983 is reviewed. The majority of patients were men with the age ranging from 46 to 76 years. The disease‐free interval ranged from 0 to 113 months (median, 8.5 months). The stage at presentation was rT1in 25 patients and rT2in 3 patients. Surgery consisted of cordectomy (7 patients), hemilaryngectomy (18), and extended hemilaryngectomy (3). There was no operative mortality. Local recurrence developed in 8 patients (28.5%), cervical metastasis in 2, and distant metastasis in 1. Only 3 patients were salvaged by further treatment. The rate of local control was influenced by positive surgical margins. Overall, voice preservation was achieved in 75% of patients. The ultimate local control was 82.1% during a follow‐up period that ranged from 1.3 to 16.7 years (median, 6.3 years). The actuarial survival at 5 and 10 years was 73% and 71% following conservation surgery of the

ISSN:1043-3074    

DOI:10.1002/hed.2880120409

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

年代:1990

数据来源: WILEY

摘要:

AbstractTwenty‐seven patients with recurrent pleomorphic adenomas of the parotid gland were seen. This study confirms that superficial parotidectomy with identification and dissection of the facial nerve greatly decreases the incidence of recurrent benign pleomorphic adenoma, and, in the small number that recur, are easier to cure. All lumps in the parotid area should be approached in the same manner, with the surgeon prepared to isolate the facial nerve and perform superficial parotidectomy. This technique is successful because it avoids dissection near the tumor capsule, which is the major cause of recurrence. The procedure recommended for treatment of patients to remove the first recurrent tumor is total parotidectomy and excision of the previous scar. This vigorous approach is dictated by the increasing difficulty of removing further recurrent tumors. Only 67% of patients with recurrent tumors ultimately achieve a tumor‐free status. Experienced surgeons can preserve the facial nerve even after multiple operati

ISSN:1043-3074    

DOI:10.1002/hed.2880120410

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

年代:1990

数据来源: WILEY

摘要:

AbstractCystic enlargement of the parotid gland is a newly described manifestation of infection with human immunodeficiency virus (HIV). A review of 15 such patients with respect to clinical presentation, natural history, and management is presented. Follow‐up ranges from 1 to 27 months, averaging 10 months. In 47% of the patients, parotid swelling was the chief complaint leading to the diagnosis of HIV infection. T‐cell analysis revealed the tendency for this lesion to occur in the early stages of immunodeficiency when T‐cell counts are high. Histologic examination revealed findings resembling benign lymphoepithelial lesion. It is felt that these lesions are a local manifestation of a systemic disease and treatment should be tailored with this in mind. Surgical excision may not be necessary. Fine‐needle aspiration (FNA) was found to be useful diagnostically and therapeutically. Recognition of this entity is essential for the head and neck specialist in providing an early diagnosis of HIV in

ISSN:1043-3074    

DOI:10.1002/hed.2880120411

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

年代:1990

数据来源: WILEY