ISSN:0148-6403    

DOI:10.1002/hed.2890090202

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

年代:1986

数据来源: WILEY

摘要:

AbstractWe determined the success of elective neck irradiation for 104 patients with carcinomas of the larynx and pyriform sinus whose only surgery was resection of the primary cancer. Tumor regrew in the neck of 22 patients (21%) and was twice as likely to recur in the neck when there was simultaneous regrowth of tumor in the laryngeal remnant or pharynx. The observed rate of neck recurrence did not vary appreciably from the expected rate as determined by the incidence of occult lymphatic metastases in dissected neck specimens. The rate of neck recurrence was less after high doses (>45 Gy) than low doses (⩽45 Gy) of irradiation, suggesting a benefit from higher doses of elective neck irradiatio

ISSN:0148-6403    

DOI:10.1002/hed.2890090203

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

年代:1986

数据来源: WILEY

摘要:

AbstractA group of 113 patients with malignant salivary gland tumors was retrospectively reviewed to analyze the association of clinical and histologic factors with survival. These factors were patient sex and age, tumor site, clinical stage, histologic diagnosis, tumor grade, and whether or not final surgical margins were clear. There were 57 parotid, 40 minor salivary, and 16 submandibular gland cancers. The histologic groups were mucoepidermoid carcinoma (49 patients), adenoid cystic carcinoma (31), adenocarcinoma not otherwise specified (18), acinic cell carcinoma (7), malignant mixed tumor (5), squamous cell carcinoma (2), and undifferentiated carcinoma (1). Univariate analysis of clinical factors showed that age and clinical stage significantly influenced survival. At 10 yr the predicted cumulative survival rates for Stage I, II, III, and IV tumors were 74%, 56%, 32%, and 10%, respectively. Tumor grade was the only significant histologic factor. This was most obviously reflected among patients with mucoepidermoid carcinomas. Cumulative survival at 5 yr was 94% for those with low‐grade tumors and 26% for high‐grade tumors. By multivariate analysis, clinical stage, age, and tumor grade remained highly significant. Analysis of patients with only Stage I and II disease demonstrated that the significant factors were patient age, tumor site, tumor grade, and whether or not surgical clearance was achieved. These results suggest that clinical stage should not be the exclusive determinant of the extent of surgery and that the selection of patients, for adjuvant therpay may be improved by an awareness of these prognostic fact

ISSN:0148-6403    

DOI:10.1002/hed.2890090204

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

年代:1986

数据来源: WILEY

摘要:

AbstractWe present an approach to the skull base that allows access to both the infratemporal fossa and the middle cranial fossa with minimal morbidity. This approach is different from most of the previously described approaches in that it uses a preauricular incision, preserves the facial nerve, and avoids the mastoid bone. It involves dividing the zygomatic arch and displacing it inferiorly, dividing the malar eminence (zygoma) and displacing it anteriorly, and cutting the coronoid process and retracting it superiorly with the attached temporalis muscle. Reconstruction is accomplished by using the temporalis muscle or a pericranial flap to cover the dura, a free fat graft to fill the space left by tumor excision, and by wiring the zygomatic arch and malar eminence into their original positions. Case reports of both benign and malignant lesions are presented.

ISSN:0148-6403    

DOI:10.1002/hed.2890090205

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

年代:1986

数据来源: WILEY

摘要:

AbstractA case‐control epidemiologic study was conducted to determine the relationship between quantities and types of tobacco and the risk of cancers of individual sites within the head and neck. Substantial variations were found to exist in the tobacco‐associated risk for each site. The use of cigarettes was associated with an increased risk of cancers of all sites, except the salivary glands. Cancers of the floor of the mouth and larynx exhibited the highest cigarette‐related risks. Cigar smokers experienced excess risks of cancers of the tongue, pharynx, and larynx. Pipe smokers experienced elevated risks of cancer of the tongue, mouth, pharynx, and larynx. Among users of smokeless tobacco, increased risks of cancer of the mouth and gum, pharynx, and salivary glands were obs

ISSN:0148-6403    

DOI:10.1002/hed.2890090206

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

年代:1986

数据来源: WILEY

摘要:

AbstractDetails of the course of the accessory nerve and the pattern of the cervical contributions to the nerve are essential for planning neck dissection. Based on a recent anatomic description, a technique was devised to preserve the distal accessory nerve; the theory advanced was that the trapezius was supplied by motor fibers from the cervical plexus, which join the accessory nerve in the posterior triangle. Dissections were performed on 23 cadavers to test such a theory. The course of the accessory nerve in the neck was mapped in each dissection, and landmarks for use during surgery determined. Cervical contributions to the nerve usually joined deep to the sternocleidomastoid, and not in the posterior triangle. Branches from the cervical plexus, independent of the accessory nerve, entered the trapezius in the posterior triangle. None of the bilateral dissections showed symmetry of the cervical contributions.

ISSN:0148-6403    

DOI:10.1002/hed.2890090207

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

年代:1986

数据来源: WILEY

摘要:

AbstractMediastinitis resulting from perforations of the hypopharynx is a life‐threatening complication associated with a high morbidity and mortality. In cases of perforation, which are not amenable to primary closure, transoral irrigation has been found to be an effective means of therapy. This technique rapidly controls sepsis, favoring the closure of perforations of the hypopharynx and cervical esophagus. Using this technique we have had no mortality attributed to mediastinitis in patients with mediastinitis due to perforation of the hypopharynx, cervical and thoracic esophagu

ISSN:0148-6403    

DOI:10.1002/hed.2890090208

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

年代:1986

数据来源: WILEY

ISSN:0148-6403    

DOI:10.1002/hed.2890090209

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

年代:1986

数据来源: WILEY

ISSN:0148-6403    

DOI:10.1002/hed.2890090210

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

年代:1986

数据来源: WILEY

ISSN:0148-6403    

DOI:10.1002/hed.2890090211

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

年代:1986

数据来源: WILEY