ISSN:0148-6403    

DOI:10.1002/hed.2890090102

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

年代:1986

数据来源: WILEY

摘要:

AbstractInvestigation of postlaryngectomy dysphagia is usually limited to the standard barium swallow. Manofluorography (mano, manometry;fluoro, videofluoroscopy;graphy, picture) is a new technique that permits analysis of simultaneous manometry and videofluoroscopy of deglutition. Manofluorography provides more detailed analysis of the swallowing dynamics during the pharyngeal stage of deglutition than either barium studies or manometry used alone. This study uses manofluorography to examine swallowing in two patient groups, total laryngectomees and total laryngectomees with tongue impairment, to analyze the role of various anatomic components in the swallowing process. Pharyngeal transit times were prolonged in both patient groups studied, with the tongue impairment group exhibiting the longest times. The postlaryngectomy pharynx offered greater resistance to bolus flow. The laryngectomy patients compensated by using increased lingual propulsion, whereas the patients with tongue impairment and total laryngectomy could not. This emphasizes the importance of the tongue in bolus propulsion in the pharynx. Other postoperative changes in swallowing are discussed.

ISSN:0148-6403    

DOI:10.1002/hed.2890090103

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

年代:1986

数据来源: WILEY

摘要:

AbstractNinety‐four squamous cell carcinomas of the oral cavity, treated on the author's service between 1969 and 1981, were evaluated. The series included squamous cell carcinomas of various intraoral sites excluding the lips and hard palate. Survical of 60 mo was 70% for stage I, 65% for stage II, 45% for stage III, and 27% for stage IV carcinoma. Twenty‐four of 34 patients with “early” cancer (stages I and II) were treated by operation alone. Too few patients with “early” cancer were treated by combined irradiation and surgery to draw conclusions regarding relative efficacy of combination therapy. Sixty patients had “advanced” cancer (stages III and IV). Five‐year survival was 37% for patients treated by operation alone, 18% after salvage surgery after failed irradiation, and 60% for patients treated by operation combined with planned perioperative irradiation. Combination therapy appeared to improve control of locoregional disease as well as survival in patients with

ISSN:0148-6403    

DOI:10.1002/hed.2890090104

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

年代:1986

数据来源: WILEY

摘要:

AbstractVerrucous carcinoma (Ackerman's tumor) is a low‐grade malignant lesion with distinct clinical and pathologic features, distinguishing it from other well‐differentiated squamous cell carcinomas. Much of the confusion surrounding its natural history, response to therapy, and anaplastic transformation may be ascribed to the failure of critically reviewing accepted diagnostic criteria. A series of 44 patients with verrucous carcinoma of the larynx is presented, 18 of these being updated results of previously reported patients. Ackerman's tumor, although not radi‐oresistant, seems less radiosensitive than ordinary squamous cell carcinoma. The tumor's rounded, pushing margins and inability to metastasize would seem to favor endoscopic removal, saving partial laryngectomy procedures for those lesions that cannot be managed endoscopically. Extensive lesions that would require total laryngectomy for complete removal of the tumor should be treated by primary radiotherapy. It is our belief that total laryngectomy should only be performed in large lesions that fail to respond to radiotherapy and whenever medical consideration spreclude partial laryngectomy proce

ISSN:0148-6403    

DOI:10.1002/hed.2890090105

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

年代:1986

数据来源: WILEY

摘要:

AbstractThis retrospective study concerns 105 patients treated between 1977 and 1981 who had resections of previously untreated squamous carcinomas that were localized to the oral tongue or the floor of the mouth. Almost 80% had simple peroral excisions. Elective lymphadenectomy was performed in about one‐third, all but one of whom had either T2 or T3 primaries or a surgical approach that involved entry into the neck. The determinate “cure” rate at 24 mo (median follow‐up 50 mo) was 86%. Ninety‐three percent and 78%, respectively, of those with T1 and T2 lesions remained alive and well after conservative operations, which yielded good functional results. Uncontrolled neck disease was evident in 10 of the 13 determinate patients who died as a result of their tumor. Although more of our patients with localized oral cancer now undergo elective lymphadenectomy when the primary is resected, T staging has not accurately predicted which patients are at greatest risk of metastasis. Preliminary data suggest that measurement of tumor depth may be a better way to select those patients who need elective nec

ISSN:0148-6403    

DOI:10.1002/hed.2890090106

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

年代:1986

数据来源: WILEY

摘要:

AbstractThe correction of contour defects of the frontal bone has been accomplished with a variety of autogenous and alloplastic materials. We report our experience in reconstructing 11 cases of congenital, traumatic, and postsurgical frontal defects with acrylic. The acrylic was cured intraoperatively within the defect in some patients, or prefabricated into a prosthesis and wired into position in others. The operative techniques for both methods of repair are detailed. The reconstruction was successful in all cases and there were no complications. The acrylic implant has been found to be well tolerated after 2–10 yr follow‐up. The value of the construction of a facial moulage is stressed, especially when restoration of the orbital rim is requi

ISSN:0148-6403    

DOI:10.1002/hed.2890090107

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

年代:1986

数据来源: WILEY

摘要:

AbstractWithin recent years differing approaches to the treatment of cold nodules of the thyroid gland have evolved. To assess these differences and to discover whether a general consensus exists, questionnaires were sent to professors of surgery and endocrinology and to chiefs of head and neck sections at various medical colleges and university hospitals throughout the country. Fifty‐three surgeons and 13 endocrinologists answered the questionnaires and their responses are analyzed and recorded her

ISSN:0148-6403    

DOI:10.1002/hed.2890090108

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

年代:1986

数据来源: WILEY

摘要:

AbstractRhabdomyosarcoma of the head and neck is a rare childhood neoplasm. Most occur in the orbit, which accounts for the scarcity of papers on modern techniques of treatment of soft palate rhab‐domyosarcomas. Only 30 cases of soft palate rhabdomyosar‐coma have been reported in recent years and none had long‐term follow‐up periods (>10 yr). This study reports three cases of pediatric soft palate rhabdomyosarcomas treated with surgery, radiotherapy (two of three), and chemotherapy. The complications that occurred in one patient are di

ISSN:0148-6403    

DOI:10.1002/hed.2890090109

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

年代:1986

数据来源: WILEY

摘要:

AbstractAn unusual form of squamous cell carcinoma of the tongue is reported, the “de novo” submucosal evolution of which is unique. Histologic definition of this malignancy and its distinction from clinically similar benign and malignant conditions are detailed through a brief review of the relevant differential diagnoses. The importance of circumspect diagnostic reassessment when the clinical behavior of a lesion contradicts apparent histologic benignancy is emphasized and treatment inferences are dr

ISSN:0148-6403    

DOI:10.1002/hed.2890090110

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.2890090111

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

年代:1986

数据来源: WILEY