摘要:

AbstractBackground.Our purpose in performing this review is to analyze the relationship between the anatomic site of hypopharyngeal lesions and the pattern of recurrent disease, particularly cervical recurrence. This clinical information can subsequently be used to influence treatment options.Methods.The records of 169 patients with carcinoma of the hypopharynx treated between 1975 and 1986 were reviewed retrospectively. Patients were classified as having medial wall pyriform sinus disease (MP) lesions, lateral wall pyriform sinus (LP) lesions, posterior wall (PW), or postcricoid (PC) lesions. All patients were followed a minimum of 36 months. Patients with evidence of recurrent carcinoma were characterized according to the site of recurrence.Results.Recurrent carcinoma in the hypopharynx was noted in seven (4%) of 169 patients. Cervical metastases was the sole site of failure in 27 (16%) of 69 patients, whereas distant metastases developed in 25 (15%) of 169 patients. Failure in the contralateral unoperated neck occurred in 14% (10/71) of patients with MP lesions and, in contrast, 5% (4/76) LP patients. This difference was statistically significant (p= 0.04). Radiotherapy was not effective in preventing cervical recurrence in 20 (74%) of 27 overall neck failures and 11 (79%) of 14 contralateral NO neck failures.Conclusion.These data suggest that patients with carcinoma involving the MP are at greater risk for contralateral cervical metastases. We recommend bilateral neck dissection be offered to patients with MP lesions. © 1994 John Wiley&Sons, Inc

ISSN:1043-3074    

DOI:10.1002/hed.2880160502

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

年代:1994

数据来源: WILEY

摘要:

AbstractBackground.The long‐term survival of 81 patients with T3 squamous cell carcinoma of the glottic larynx treated with laryngectomy alone is presented and pathologic predictors for cancer recurrence above the clavicles and cancer death are identified.Methods.Clinical records, operative notes, and pathologic slides were reviewed. The major end points were failure above the clavicles, cause‐specific survival, and overall survival. All patients were followed until death or a minimum of 10.8 years.Results.The main pattern of treatment failure was within an undissected ipsilateral or contralateral neck. Subglottic extension and nodal metastases predicted failure above the clavicles and delayed metastasis within an undissected neck. The 5‐year rate of control of disease above the clavicles, cause‐specific survival, and overall survival were 74.1%, 73.7%, and 54.3%, respectively.Conclusions.Patients treated with laryngectomy for T3 glottic cancer who have pathologic evidence of subglottic extension or nodal metastasis are at higher risk for recurrence above the clavicles, particularly within an undissected neck. © 1994 John Wiley&S

ISSN:1043-3074    

DOI:10.1002/hed.2880160503

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

年代:1994

数据来源: WILEY

摘要:

AbstractBackground.Clinically, head and neck cancer patients with anterior resections have better postoperative outcomes than do patients with posterior resections.Methods.Videofluoroscopy was used to study the swallowing characteristics in postsurgery head and neck cancer patients and normal controls. Most patients received post‐operative radiotherapy and chemotherapy, and no cancer recurrence was noted at the time of study, 4‐8 months post‐treatment. Bolus types included: 3 mL and 10 mL liquid barium, barium paste, and barium‐coated cookie. Temporal measurements and a count of the number of swallows required to ingest each material were made from the video‐taped data. Statistical analysis using an unbalanced univariate repeated measures ANOVA was performed.Results.The major differences were found between bolus types, with few differences noted between surgical groups (anterior vs posterior resections) and normal controls. Patients took longer to ingest viscous material, accomplishing this by multiple piecemeal and clearing swallows. Coordination of mastication and swallowing of the cookie was different between normal and patient groups.Conclusions.Patients who are able to swallow reasonably well postoperatively maintain normal coordination and timing of swallowing activity and do not vary these parameters to compensate for structural inadequacy. Instead, repeated swallows are used. © 1994 John Wiley

ISSN:1043-3074    

DOI:10.1002/hed.2880160504

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

年代:1994

数据来源: WILEY

摘要:

AbstractBackground.Nucleolar organizer regions (NORs) are loops of ribosomal DNA that occur in nucleoli and that transcribe to ribosomal RNA. NORs have been identified by means of the Ag‐NOR technique in routinely processed tissues, and were found to be of discriminative value between some types of benign and malignant lesions.Methods.Follicular lesions of the thyroid (17 adenomas and 25 carcinomas) were examined. Ten normal thyroids served as the control group. All slides were stained by the Ag‐NOR technique and the number of Ag‐NOR dots were counted in 50 randomly selected cells. The mean number of Ag‐NORs was calculated for each case. Data were statistically analyzed by the Student's unpairedttest.Results.The mean Ag‐NOR counts were statistically higher in follicular carcinomas as compared to either follicular adenomas or the normal thyroid. Higher Ag‐NOR counts were found in the more aggressively behaving tumors.Conclusions.It is suggested that the Ag‐NOR technique could be of use as an adjunct to diagnostic histopathology and as an indicator of biologic behavior in follicular tumors of the thyroid. © 1994 John W

ISSN:1043-3074    

DOI:10.1002/hed.2880160505

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

年代:1994

数据来源: WILEY

摘要:

AbstractBackground.A murine model of oral cavity carcinogenesis is needed to study the molecular aspects of malignant transformation. 4‐Nitroquinoline‐1‐oxide (4NQO), a water‐soluble carcinogen, produces squamous cell carcinoma in rodents. Protocols were designed to investigate the temporal aspects of neoplastic transformation.Methods.4NQO was applied topically to mouse palates for up to 16 weeks. Mice were observed and killed from 24 to 49 weeks.Results.A spectrum of lesions ranging from atypia to moderately differentiated invasive squamous cell carcinoma (SCC) was produced. The severity of the lesions corresponded to the duration of treatment and the length of observation. There was no gross or microscopic evidence of an inflammatory reaction to 4NQO. The lesions were focal and normal mucosa predominated in the treated mice.Conclusion.4NQO reliably produced preneoplastic and malignant oral cavity lesions, which morphologically and histologically mimic human head and neck cancer. Lesions develop long after 4NQO exposure and without an inflammatory response. Thus, the model should be useful for molecular analysis of neoplastic transformation. © 1994 John Wiley&S

ISSN:1043-3074    

DOI:10.1002/hed.2880160506

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

年代:1994

数据来源: WILEY

摘要:

AbstractBackground.This article reviews 12 cases of isolated sphenoid sinus disease: chronic inflammatory sinusitis (7), mucoceles (2), aspergillus lesions (2), and isolated polyp (1).Methods.Criteria for diagnosis were based on clinical symptoms, nasal endoscopic evaluation, and computed tomography (CT). Magnetic resonance imaging was used only in cases of bone erosion and when patients presented with vision problems. All patients were treated by functional endoscopic sphenoidotomy. Any postoperative complications were noted.Conclusion. The reported good results, on the basis of regression of functional symptoms and with nasal endoscopic and CT evaluation, suggest that intranasal sphenoidotomy under endoscopic control is a safe and effective method of treatment of nonmalignant isolated sphenoid disease. The mean follow‐up is 26 months. © 1994 John Wiley&Sons, I

ISSN:1043-3074    

DOI:10.1002/hed.2880160507

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

年代:1994

数据来源: WILEY

摘要:

AbstractBackground. The tendency of well‐differentiated thyroid carcinoma to remain localized and its slow progression have supported the belief that this disease behaves as a low‐grade malignancy. Consequently, a conservative approach in the management of the well‐differentiated thyroid carcinoma has existed during the years. Occult distant metastases of thyroid cancer is an occasional finding considered of ominous significance.Methods. In a retrospective study, we reviewed the records of 187 adult patients with well‐differentiated thyroid carcinoma treated by total thyroidectomy. These cases were found among 1,240 thyroidectomies performed in our department between 1982 and 1993. Occult distant skeletal and lung metastases disclosed by total body131I scans, after total thyroidectomy, were present at the time of initial treatment in 11 patients (11/187). This group included 9 women and 2 men ranging in age from 36 to 70 years, with a mean age of 47 years. Seven patients had papillary carcinoma, whereas follicular malignancy was found in four. Review of the surgical specimens showed total involvement of the gland in 5 cases, with extracapsular tumoral spread in 3 patients. Multicentric disease was present in 6 specimens. Patient follow‐up revealed a mortality rate of 64% (7/11) during the first 3 postoperative years.Conclusions. Analysis of this population confirms that well‐differentiated thyroid carcinoma with distant metastases is an aggressive disease with lethal consequence. Early detection and therapy of occult distant metastases present at the time of initial treatment is possible only after total thyroid ablation, because otherwise the radioactive iodine is trapped by the gland's remnants. © 1994 John Wil

ISSN:1043-3074    

DOI:10.1002/hed.2880160508

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

年代:1994

数据来源: WILEY

摘要:

AbstractMalignant clear cell hidradenoma is an uncommon tumor of eccrine sweat gland origin that has a predilection for the head and neck. It is characterized by an indolent growth pattern yet frequently recurs following surgical excision and has a high incidence of regional and distant metastases. A case of recurrent malignant clear cell hidradenoma of the upper lip is presented. The lesion was treated with surgical excision followed by radiotherapy. The literature on this rare lesion is reviewed and treatment strategies discussed.

ISSN:1043-3074    

DOI:10.1002/hed.2880160509

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

年代:1994

数据来源: WILEY

摘要:

AbstractA case with a fatal outcome caused by infection withFusobacteriumspecies was seen in a patient recently operated on for heavy snoring with uvulo‐palato‐pharyngoplasty (UPPP). The mechanism of infection is discussed. It is concluded that a febrile episode seen in patients less than 2 weeks postoperatively should be considered a serious symptom and be treated intensively after thorough examination. © 1994 John Wiley&Sons,

ISSN:1043-3074    

DOI:10.1002/hed.2880160510

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

年代:1994

数据来源: WILEY

摘要:

AbstractBackground. Primary adenocarcinoma of the larynx is a rare neoplasm. The incidence is reported as less than 1% of all laryngeal neoplasms in multiple series. Simultaneous primary adenocarcinoma and a solitary squamous cell carcinoma of the larynx is even rarer and only one case has been found on review of the literature.Methods. A case report of a 74‐year‐old man with a history of right‐sided throat pain, odynophagia, and progressive hoarseness is presented with a review of the literature pertaining to this unusual case.Results. The patient was found to have three distinctly separate laryngeal lesions on direct laryngoscopy. Histopathologic diagnosis of adenocarcinoma was made on one of the three biopsied sites with the other sites being squamous cell carcinoma. Following Combined radiotherapy and surgical treatment, the patient has remained free of disease.Conclusions. Adenocarcinoma of the larynx is an infrequent and lethal disease. This case report and a review of the literature demonstrate that aggressive surgical management is indicated, although still may not result in improved survival. © 1994 John Wiley&Son

ISSN:1043-3074    

DOI:10.1002/hed.2880160511

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

年代:1994

数据来源: WILEY