ISSN:0148-6403    

DOI:10.1002/hed.2890090402

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

年代:1987

数据来源: WILEY

摘要:

AbstractSince most bony lesions of the midface will stop growing or regress, it is generally not appreciated when fibrous dysplasia and osteoma occasionally continue to grow, causing functional and cosmetic problems. To demonstrate the potential of the disease processes and management options available to the surgeon, a series of patients with massive fibrous dysplasia and osteoma of the midface is reviewed. Most of the patients show a facial deformity alone or in combination with telecanthus, epiphora, ex‐ophthalmos, or nasal obstruction. Several types of radical and conservative surgical procedures are described to remove or control the bony lesions, to restore facial contour, and to reconstruct the sinuses, nasal passageways, lacrimal collecting system, and medial wall of the orbi

ISSN:0148-6403    

DOI:10.1002/hed.2890090403

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

年代:1987

数据来源: WILEY

摘要:

AbstractThe pectoralis minor myocutaneous, osteomyocutaneous, and osteomuscular flaps were used in 14 patients. Thirteen cases had mandibular replacement, with bilateral flap application in three. The first eight flaps incorporated the fifth rib and the last eight flaps included the sixth rib. In the last four cases, the flap was transferred through a subclavicular tunnel. A mentum defect was present in 11 patients. There was one total flap necrosis due to venous thrombosis caused by surgical trauma. The flap provides rich vascularization and versatility, requires a small volume, and does not present serious sequelae to the donor site. It may be performed by a two‐team approach and is a valid option for head and neck reconstructio

ISSN:0148-6403    

DOI:10.1002/hed.2890090404

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

年代:1987

数据来源: WILEY

摘要:

AbstractFifteen patients with advanced upper aerodigestive carcinomas of squamous cell histology received the three‐agent cytotoxic regimen of VP‐16, bleomycin, and cis‐diamminedichloroplatinum (CDDP) administered as a continuous 120‐h infusion. The objective response rate was 40%. Median times to progression and survival were 3.2 months and 4.3 months, respectively. Hematologic and gastrointestinal toxicities were relatively transient and manageable. Our experience indicates that this three‐drug program does not offer a substantial therapeutic advantage compared with more conventional single agent cytotoxic approaches for advanced head and ne

ISSN:0148-6403    

DOI:10.1002/hed.2890090405

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

年代:1987

数据来源: WILEY

摘要:

AbstractPeriorbital cellulitis is a commonly occurring infectious process limited to the eyelids in the preseptal region. It occurs with greater frequency in the pediatric age group. It is important to distinguish this disease from orbital cellulitis, a potentially lethal infectious process involving the contents of the orbit. A retrospective study of clinical and laboratory data from 137 cases with orbital and periorbital cellulitis was performed. Periorbital cellulitis was documented in 98 cases (71%) in contrast to orbital cellulitis, which was noted in 39 (28%) patients. Sinusitis was the most frequently encountered predisposing factor for the development of periorbital cellulitis occurring in 29 patients. All patients with a diagnosis of periorbital cellulitis were hospitalized and received antibiotics, the majority (95%) receiving intravenous therapy. Hemophilus influenzae was the most frequently isolated pathogenic organism. It was necessary to operate on eight patients. Six patients underwent incision and drainage of an eyelid or periorbital abscess. A distinction between perioribital and orbital cellulitis is clarified. The separation of these entities on the basis of physical examination and radiographic studies is stressed.

ISSN:0148-6403    

DOI:10.1002/hed.2890090406

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

年代:1987

数据来源: WILEY

摘要:

AbstractA 30‐year retrospective analysis of 50 patients with squamous cell carcinoma of the salivary glands was conducted, including 42 patients with parotid tumors and eight with submandibular lesions. Clinical staging, performed for 48 patients in whom adequate data were available, yielded the following results: Stage I, 17%, Stage II, 12%, Stage III, 71%. Surgery was the primary therapy in 45 patients (86%). The determinate “cure” rate at 5 and 10 years was 24 and 18%, respectively, for patients with parotid lesions and 20% for those with submandibular tumors. As with other malignant salivary gland tumors, advanced stage and pain as a presenting symptom were ominous findings. Locoregional recurrence was the usual site of failure in both parotid (51%) and submandibular (67%) cases. Radical surgical extirpation, preserving the facial nerve when possible, remains our treatment of choice. It is anticipated that planned postoperative radiotherapy will reduce our high locoregional recurrence

ISSN:0148-6403    

DOI:10.1002/hed.2890090407

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

年代:1987

数据来源: WILEY

摘要:

AbstractSurgery of the floor of the mouth (FOM) using a scalpel or cautery has produced stenosis of Wharton's duct, necessitating further surgery because of painful enlargement to the gland or suspected metastasis. The laser has been proposed as an alternative method that might avoid this complication. A retrospective study comparing these excisional techniques was done at Walter Reed Army Medical Center between 1973 and 1983. Of a total of 58 lesions, 35 were T1NOMO and 23 were T2NOMO (two synchronous lesions being present). Of 35 lesions excised with a scalpel, 11 had an associated submandibular gland resection. Of the remaining 25, two developed secondary duct stenosis. Of 10 lesions excised with cautery, three had an associated excision of the submandibular gland. Of the remaining seven, two developed stenosis and one required subsequent excision of the gland. Of 12 lesions excised with laser, four developed stenosis and two required subsequent excision of the gland. Laser excision appears to be of no advantage in avoiding further surgery of the submandibular gland. A submandibular gland resection at the time of the original resection of T1NO or T2NO cancers of the FOM does not appear warranted.

ISSN:0148-6403    

DOI:10.1002/hed.2890090408

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

年代:1987

数据来源: WILEY

摘要:

AbstractBecause of the complex anatomic relations of the sphenoid, the surgical approach to this sinus was only introduced 100 years ago. There are three approaches to the sphenoid sinus: transethmoidal, transseptal, and transpalatal. We present a case report, and discuss surgical anatomy, with attention to the important anatomic relationship of the cavernous sinus and its contents. A variant of the classical, sublabial, transseptal approach is described as follows: a window is created in the face of the sphenoid. This approach is particularly applicable to the surgery of mucoceles and allows easy postoperative inspection of the sphenoid sinus.

ISSN:0148-6403    

DOI:10.1002/hed.2890090409

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

年代:1987

数据来源: WILEY

摘要:

AbstractGranular cell lesions in the oral cavity occur primarily on the tongue in adults (granular cell tumor) and exclusively on the alveolar ridge in newborns (congenital granular cell epulis). Because of the location, age of appearance, and certain clinical and histologic differences, these histologically similar lesions are considered separate clinical entities. This case report, however, describes the occurrence of a granular cell lesion on the tongue of a newborn. Although the etiopathogenesis of these lesions is unknown, the present case suggests a common etiologic relationship of these entities and tends to rule out an odontogenic origin for the congenital granular cell epulis.

ISSN:0148-6403    

DOI:10.1002/hed.2890090410

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

年代:1987

数据来源: WILEY

摘要:

AbstractA unilateral neck mass is an unusual clinical presentation for histoplasmosis. A patient with a large, unilateral neck mass caused byHistoplasmacapsulatum is presented to alert readers to such a possibility and to illustrate some of the difficulties in diagnosing and managing the disease.

ISSN:0148-6403    

DOI:10.1002/hed.2890090411

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

年代:1987

数据来源: WILEY