摘要:

AbstractHypercalcemia is a well‐recognized phenomenon in squamous cell carcinoma of the head and neck, but the incidence of hypercalcemia in this group of patients is not clear. We have reviewed the records of 166 patients with squamous cell carcinoma of the head and neck presented at the Boston VA Medical Center over a 2‐year period (October 1981 to September 1983). Hypercalcemia (>11 mg/dl), for which a benign etiology could not be identified, occurred in the clinical course of seven patients (4.2%). Of the hypercalcemic patients, 5/7 (71.4%) had advanced stage IV disease and serum calcium levels ranging from 11.2 to 15 mg/dl at presentation. The incidence of hypercalcemia in this stage IV group was 5/78 (6.4%). On the basis of concomitant serum alkaline phosphatase, x‐ray films, and radionuclide bone scans in these patients, bone metastases or a humoral factor were felt to be the etiologic agent. Six of the seven patients died within 77 days of the onset of the hypercalcemia despite vigorous antihypercalcemic and chemotherapeutic measures, and the remaining patient is under chemotherapy at present. We conclude that hypercalcemia is a late manifestation of advanced squamous cell carcinoma of the head and neck and is an ominous prognostic sign. Hypercalcemia without bone metastases is presumably due to the production of ectopic parathormone (PTH)‐like substances from the tumor. To control this hypercalcemia, the underlying tumor must be treated vigorously in conjunction with symptomatic treatment. It should be noted that of 166 patients not all have been followed to the end stage of their disease and, thus, the true incidence of hypercalcemia may be slightly higher th

ISSN:0148-6403    

DOI:10.1002/hed.2890070202

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

年代:1984

数据来源: WILEY

摘要:

AbstractA technique designed to create a permanent, wide open, and stable tracheal stoma is based on two corresponding U‐shaped flaps: one from the anterior tracheal wall, the other from the skin in the suprasternal notch. The method described in this article has proved to be efficient, practical, well tolerated, and readily reversible. Its applications when indicated may reduce the side effects and complications associated with tracheostomy. Our clinical experience with this technique covers eight patients who tolerated the procedure well. The follow‐up period exceeds 2 ye

ISSN:0148-6403    

DOI:10.1002/hed.2890070203

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

年代:1984

数据来源: WILEY

摘要:

AbstractA retrospective analysis was carried out of 311 reconstructions of major defects following head and neck cancer treatment. Three hundred thirty‐one flaps were used; they included cutaneous flaps from 1972 to 1979 and myocutaneous flaps (MCF) after 1979. The aim of this study was to compare the healing patterns of the two types of flaps used in similar circumstances. Even though the use of myocutaneous flaps reduced necrotic complications, there was no significant improvement in overall healing. In this type of reconstruction, local conditions as well as more general factors have greater prognostic significance. Apart from considerations of reliability, other criteria have led to myocutaneous flaps being the treatment of choice in cervicofacial cancer repair. However, specific indications for the use of cutaneous flaps remai

ISSN:0148-6403    

DOI:10.1002/hed.2890070204

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

年代:1984

数据来源: WILEY

摘要:

AbstractComputed tomographic (CT) scanning of the face and sinuses has improved markedly with modern equipment and methods. Expertise in facial and sinus anatomy as seen by CT is invaluable to the clinician. A review of normal CT anatomy is presented as a basis for diagnosing, pathologic conditions.

ISSN:0148-6403    

DOI:10.1002/hed.2890070205

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

年代:1984

数据来源: WILEY

摘要:

AbstractBetween 1970 and 1980, we treated 107 previously untreated patients with biopsy‐proven carcinoma of the nasopharynx by megavoltage external radiation therapy to the primary site, base of the skull, and both sides of the neck. Eighty‐seven percent of the patients had stage IV disease (American Joint Committee 1980), 53% had T4 primaries, and 73% had palpable cervical metastases. The histology was anaplastic or poorly differentiated carcinoma in 81%. The observed 5‐year survival rate was 35% for the patients treated between 1970 and 1976, and increased to 72% for those treated between 1977 and 1980 (P<0.01). The two patient populations were similar except that the dose of irradiation (median and modal) to the primary site was 6,000 rad during 1970–1976 and 7,000 rad during 1977–1980. The survival rate was not significantly influenced by age, sex, birthplace, histology, or stage. These data suggest that a relatively high cure rate might be possible in carcinoma of the nasopharynx, even though most patients present with locally advanced disease. The patterns of relapse are

ISSN:0148-6403    

DOI:10.1002/hed.2890070206

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

年代:1984

数据来源: WILEY

摘要:

AbstractDefects resulting from bulky tumor resection of the head and neck region represent a reconstructive challenge. The trapezius musculocutaneous paddle flap based on the transverse cervical vessels is a useful tool for the reconstructive surgeon. Failure to recognize the variable anatomy is discussed in relation to other musculocutaneous flaps used for the purpose of head and neck reconstruction. The trapezius muscle has a variably located vasculature and diverse nomenclature. The knowledge of the variance of its anatomical vasculature is essential in the successful use of the trapezius musculocutaneous flap.

ISSN:0148-6403    

DOI:10.1002/hed.2890070207

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

年代:1984

数据来源: WILEY

摘要:

AbstractAn anatomical study of the blood supply of the nose and upper lip was done on 10 specimens. This demonstrated the blood supply of an inferiorly based nasal flap, which was successfully used to gain access for an en bloc resection of adenoid cystic carcinoma of the ethmoid sinuses, frontal sinuses, and nose. The “crossbow” incision and inferiorly based nasal flap facilitate the tridimensional excision of lesions in the anterior base of the skull, the midline portion of middle base of the skull, and the paranasal sinu

ISSN:0148-6403    

DOI:10.1002/hed.2890070208

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

年代:1984

数据来源: WILEY

摘要:

AbstractThe usual radiologic postoperative appearance of the bony nasal pyramid following a typical cosmetic rhinoplasty is demonstrated, and possible atypical sequelae are discussed. More specifically, the sites of the osteotomies performed as part of this surgical procedure are diagrammatically illustrated. It is believed that because of the increasing popularity of rhinoplastic operations, it is timely to acquaint radiologists with the postsurgical stigmata which, though minor, might be erroneously interpreted as resulting from accidental trauma or other pathologic processes. Beyond academic considerations, potential medicolegal implications also exist. A brief historical overview is included.

ISSN:0148-6403    

DOI:10.1002/hed.2890070209

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

年代:1984

数据来源: WILEY

摘要:

AbstractHigh resolution computed tomography (CT) has been of extraordinary value in all areas of the head and neck. Previous communications have indicated its effectiveness in the evaluation of the temporal bone and soft tissues of the neck. This current communication illustrates and discusses the anatomy and pathology of the salivary glands and oral cavity as seen on CT.

ISSN:0148-6403    

DOI:10.1002/hed.2890070210

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

年代:1984

数据来源: WILEY

摘要:

AbstractChondrosarcoma arising in the nasal septum has been previously described only 11 times. In this report, another case occurring in an 89‐year‐old man is discussed. The rarity of such a tumor arising in previously normal cartilage is emphasized. Prognostic factors and surgical treatment are discus

ISSN:0148-6403    

DOI:10.1002/hed.2890070211

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

年代:1984

数据来源: WILEY