ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1982.tb01574.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

AbstractThis paper discusses the results of treatment of post‐cricoid carcinoma based on a personal series of 141 patients. The following conclusions can be drawn: small tumours with no clinical evidence of cervical lymph node metastasis should almost certainly be treated with radiotherapy, which gives a 5‐year survival of approximately 35%. Surgery for recurrent disease after radiotherapy is fraught with complications, and satisfactory salvage is seldom possible. Surgery for larger tumours and those associated with neck node metastases has a lower (20%) 5‐year survival with a high incidence of complications. The main problem after pharyngolaryngectomy is replacement of the pharynx. There is no evidence that any one of the methods in common use (skin flaps, transposition of the colon or stomach) is superior to any

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1982.tb01575.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

The protection of cochlear function following stapedectomy has emerged as the major problem in the surgical treatment of otosclerosis. Both immediate and delayed sensorineural losses continue to occur in spite of refinements of technique. The frequency and extent of these complications has been investigated by prospective and retrospective studies of the author's patients. It has been concluded that the size of the footplate fenestration plays a major role in the outcome, both immediately, and in the long term. Revision operations are necessary when initially good results rapidly deteriorate, both to resolve complications such as perilymphatic fistulae and also to restore function. Although second ear operations are usually worthwhile, they should be performed only when certain specific criteria have been met. The expected duration of unaided hearing gain, although often adequate when a standard large fenestra operation is performed, is considerably prolonged by restricting the size of the footplate to less than half its total area. For reasons unknown, bone conduction thresholds appear to be better, eventually, in operated as compared to unoperated ears.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1982.tb01576.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

The purpose of this study was to investigate the effect of pre‐operative radiotherapy on nerve grafting, using the rat sciatic nerve as an experiemental model. Two groups of 10 rats were used, one group irradiated, the other not. In each rat a 5 mm section of one sciatic nerve was excised then replaced and sutured into position. Nerve regeneration was investigated by expressing the area of the mass action potential in the regenerated nerve as a percentage of the mass action potential in the contralateral intact nerve. A significant difference (P<0.01) in nerve regeneration was found between the irradiated and non‐irradiated animals. In the irradiated group only two animals achieved more than 20% nerve fibre regeneration whilst in the non‐irradiated group all but two animals achieved greater than 20% regeneration. These results suggest that pre‐operative irradiation has an adverse effect on nerve regen

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1982.tb01577.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

A series of 76 cases of laryngeal carcinoma was examined in transverse slices using a motorized slicing machine. Eleven cases of ventriculosaccular carcinoma were detected by this method and the topography and gross appearances of the tumours in the larynges are described. Microscopy of the tumour indicates a keratinizing squamous cell carcinoma the mode of growth of which seems to be by concentric expansion through the whole margin rather than by invading tongues of tumour. In no case was there invasion of laryngeal cartilages or extension to the surgical cut surface of the specimen. The clinical, radiological and biopsy features in 10 of the 11 patients are described. In follow‐up studies, which were 12 years or longer in five patients, none had lymph node metastases or recurrences of the laryngeal carcinoma of any sort. The following features may suggest the diagnosis of ventriculosaccular carcinoma before laryngectomy: (1) a ventricular tumour, (2)a supraglottic bulge above it, (3)a paraglottic swelling on CT scan radiology covered by a smooth laryngeal lining and (4) biopsy appearances of a well differentiated ‘folded carcino

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1982.tb01578.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

In the treatment of glottic T3carcinoma there are four possible methods (1)primary radical surgery, (2)primary radical radiotherapy, (3)radical surgery with preoperative irradiation or (4)partial surgery. This study shows that patients treated primarily by surgery achieve worse results than those treated by radiotherapy.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1982.tb01579.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

After treatment of advanced malignant tumours of the head and neck by radiotherapy the clinician must determine the tumour regression and decide whether radiotherapy must continue or whether surgery is necessary. Only 9 patients out of 28 with histopathologically proven malignancies could be assessed after radiotherapy. Five scans confirmed a clinically proven tumour regression, two scans showed a false negative. We conclude that Ga‐67 scintigraphy is of limited value in assessing radiotherap

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1982.tb01580.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

A retrospective clinico‐pathological study has been carried out in a series of 405 patients with squamous cell carcinoma of the head and neck who underwent a total of 484 radical neck dissections. The recurrence rate in the neck in 327 patients who had histological positive nodes was 21.1%, Recurrence in the neck after a standard radical neck dissection almost invariably proved fatal. A statistical analysis has been carried out to evaluate the clinical and pathological factors which are of importance in regards to recurrence in the neck. Histological factors such as extra‐nodal spread and the number of histological positive nodes have been shown to be of much more prognostic importance than clinical parameters. When corrections are made for interdependencies between variables, histological extra‐nodal spread proved to be the most important single prognostic factor (P<

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1982.tb01581.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Fusion of cilia, the growth of clumps of fused cilia and giant cilium formation have been studied in the normal human organ of Corti using the scanning electron microscope. These unusual forms are found mainly in the apical portions of the cochlea and appear to precede the loss of normal apical cilia which increases and extends in a basal direction with age. These changes may be due to low frequency noise damage or be a phenomenom of ageing. The mechanism of their formation is discussed in the light of recent experimental work on cell fusion.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1982.tb01582.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

The use of a valve to restore functional speech following a total laryngectomy has been well described. We have encountered problems in both the formation of the tracheo‐oesophageal fistula and stenosis of the tracheostome if the valve is used by itself for long periods. A simple technique to establish the fistula is described, and a modification of the valve with a stoma button is suggeste

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1982.tb01583.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY