ISSN:0148-6403    

DOI:10.1002/hed.2890080602

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

年代:1986

数据来源: WILEY

摘要:

AbstractA group of 97 patients with clinical stage I and stage II squamous carcinoma of the oral tongue, treated by partial glossectomy alone, has been reviewed to define prognostic indicators. Sixty‐seven patients were staged T1NO and 30 were T2NO. Disease recurred in 28 patients (27%) and the most common site of failure was the ipsilateral neck (21%). The incidence of initial recurrence did not vary significantly with patient age, sex, T‐stage, or when tumor size was examined in other subdivisions. The presence of perineural invasion significantly increased recurrence rate (P= 0.003) and decreased survival (P= 0.002). Disease‐free survival at 5 yr was 73% for patients with T1 tumors, and 62% for T2 tumors. This difference was not significant. In this low‐risk patient population with early stage carcinoma of the oral tongue, partial glossectomy is adequate treatment in most cases. However, we recommend postoperative radiation therapy to the primary site and ipsilateral neck for patients with perineural invasion. No evidence could be found to support adjuvant local therapy or elective neck treatment in the remaining p

ISSN:0148-6403    

DOI:10.1002/hed.2890080603

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

年代:1986

数据来源: WILEY

摘要:

AbstractForty‐six cases of mucoepidermoid carcinoma (MEC) of the salivary glands were reviewed with an emphasis on the clinicopathologic aspects and prognosis of the tumors. MEC occurred in a wide age range, with few cases being diagnosed in childhood. Its peak of incidence was in the fifth decade and it involved major and minor salivary glands with equal frequency; the parotid gland was the gland most commonly affected. Presence of a mass was the most common complaint of all 46 patients. About 64% of the patients presented with stages 3 and 4 disease. Three distinct histologic grades were found after analyzing cellular pleomorphism, mitotic activity, and presence of necrosis. This study showed that clinical staging and histologic grading are the most important factors influencing survival and they seem to be independent of each other. Other variables found to be important in prognosis were age, sex, and the development of recurrent disease after surgery. Surgery with total resection of the tumor was the most effective treatment in our cases and adjuvant radiotherapy proved to be of little value in improving survival of MEC in our series of cases, considering that the patients in whom this type of treatment was used had unfavorable clinicopathologic factor

ISSN:0148-6403    

DOI:10.1002/hed.2890080604

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

年代:1986

数据来源: WILEY

摘要:

AbstractDuring the period between 1965 and 1983, 101 pharyngolaryngoesophagectomies with primary pharyngogastric anastomosis were carried out for primary hypopharyngeal cancer at The Royal National Throat, Nose and Ear Hospital, London, England. The Hospital mortality rate was 11%; postoperative complications such as pleural effusion and regurgitation of bile occurred in all patients. Successful swallowing occurred in all patients before they left the hospital‐usually within 2 wk of surgery. An actuarial survival rate of 58% was obtained for the entire grou

ISSN:0148-6403    

DOI:10.1002/hed.2890080605

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

年代:1986

数据来源: WILEY

摘要:

AbstractThe craniofacial approach for resection of tumors of the nose and paranasal sinuses is well established, as are its advantages over previous methods of treatment. The technique has been considerably modified, resulting in an operation that combines excellent access, a sound oncologic resection with excellent cosmesis, and low postoperative morbidity for conditions associated hitherto with an extremely poor prognosis. The 7‐yr experience of 60 patients is presented. Results suggest improved survival in a group of patients who are potentially curable by this procedure, while in those with extensive disease good palliation is achieved. In addition, large benign tumors that would previously have been considered inaccessible can be resected. Its many advantages recommend it as the treatment of choice for tumors of the nose and paranasal sinuse

ISSN:0148-6403    

DOI:10.1002/hed.2890080606

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

年代:1986

数据来源: WILEY

摘要:

AbstractThe scapular osteocutaneous free flap provides excellent tissue for reconstruction of massive lower facial defects. Five cases of full‐thickness cheek and lip defects associated with mandibular loss were successfully repaired with sandwiched osteocutaneous scapular flaps plus a parascapular or latissimus dorsi flap. In two instances the osteocutaneous scapular flap was harvested along with a parascapular skin paddle. The other three patients had latissimus dorsi myocutaneous units taken with the scapular osteocutaneous flap from the same subscapular pedicl

ISSN:0148-6403    

DOI:10.1002/hed.2890080607

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

年代:1986

数据来源: WILEY

摘要:

AbstractA retrospective review of 100 patients with major or minor salivary gland neoplasms was conducted to ascertain the accuracy and effect on therapy of frozen‐section diagnosis. Of these patients, 23% had malignant and 77% benign neoplasms. Twelve patients benefited by further surgery during the initial operation, and no treatment delay occurred as a result of frozen‐section diagnosis. There were four incorrect diagnoses of clinical significance, two false positives (benign tumor called malignant on frozen section) and two false negatives (malignant tumor called benign on frozen section). The accuracy of frozen section for specific pathologic diagnosis was 92%. No unnecessary radical surgery was performed. Frozen‐section diagnosis of salivary gland neoplasms in our institution was found to be accurate and u

ISSN:0148-6403    

DOI:10.1002/hed.2890080608

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

年代:1986

数据来源: WILEY

摘要:

AbstractFractures of the sphenoid bone occur following injury to the orbit and base of the skull. Such fractures are important since they can cause loss of vision and damage to various neural and muscular tissues. Ocular injury is also commonly associated. This paper reviews the hospital records of 112 consecutive patients with fractures of the base of the skull for the cause, frequency of signs and symptoms, and treatment of the sphenoid bone injury. Various deformities and dysfunctions are correlated with imaging data and classified to describe specific clinical syndromes. Several cases of sphenoid bone fracture serve as examples of diagnostic and treatment techniques.

ISSN:0148-6403    

DOI:10.1002/hed.2890080609

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

年代:1986

数据来源: WILEY

摘要:

AbstractHeterotopic cervical salivary gland tissue was found in a 4‐yr‐old girl with branchial and otologic abnormalities. Her mother and sister also had heterotopic cervical salivary tissue in association with anomalies that suggest the branchio‐otorenal (BOR) syndrome. Heterotopic cerivcal salivary gland tissue may result from abnormal branchial develo

ISSN:0148-6403    

DOI:10.1002/hed.2890080610

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

年代:1986

数据来源: WILEY

摘要:

AbstractGiant tracheoesophageal fistulas (TEF) present a significant management problem for the head and neck surgeon. Chronic aspiration and sepsis are associated complications that occur in these patients, who are frequently already debilitated from preexisting medical calamities. The combination results in prolonged morbidity and frequent mortality. Recently, we have managed two patients with this difficult problem. The first patient was managed using conventional methods well described in the literature with an unsuccessful outcome. The second was managed differently using a two‐stage approach. The esophageal stream was first excluded from the respiratory system via a surgical approach, which to the best of our knowledge has not been previously described in the literature. After a period of convalescence, the patient's alimentary tract is reconstituted with a gastric pull‐up, reversed gastric tube, or colon interposition. We propose this as an alternative method of management for

ISSN:0148-6403    

DOI:10.1002/hed.2890080611

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

年代:1986

数据来源: WILEY