ISSN:0148-6403    

DOI:10.1002/hed.2890060502

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

年代:1984

数据来源: WILEY

ISSN:0148-6403    

DOI:10.1002/hed.2890060503

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

年代:1984

数据来源: WILEY

摘要:

AbstractThe potential for a tumor of the upper face, either malignant or nonmalignant, to involve the anterior cranial base is often not appreciated. This leads to inadequate preoperative investigation and to surgery performed by the head and neck surgeon without the help of the neurosurgeon. In this way, complete tumor resection may be compromised or delayed. Neither of these situations is desirable. If the potential for anterior cranial fossa invasion is recognized, there should be prior consultation with the neurosurgeon and a combined operative procedure. Exposure of these lesions has considerably improved with experience in congenital craniofacial deformities: this will allow en bloc resection of most pathologies. Immediate reconstruction after resection of non‐malignant tumors is advocated, but in aggressive—particularly in recurrent—malignancies, delayed reconstruction is advised. Careful combined follow‐up with frequent blind biopsies should be carried out as in

ISSN:0148-6403    

DOI:10.1002/hed.2890060504

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

年代:1984

数据来源: WILEY

摘要:

AbstractMohs surgery, as it has evolved since its inception by Mohs, is a technique for removing certain cancers using careful, precise microscopic marginal control. The contemporary technique using fresh tissue has enabled the application of Mohs surgery to the treatment of malignancies of the upper aerodigestive tract. Mohs surgery, once limited to large recurrent basal cell carcinomas, has expanded to include several cutaneous and noncutaneous neoplasms. With better understanding of the Mohs technique, its indications, applications, and advantages, an interdisciplinary approach to manage certain head and neck neoplasms is proposed.

ISSN:0148-6403    

DOI:10.1002/hed.2890060505

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

年代:1984

数据来源: WILEY

摘要:

AbstractHigh resolution computed tomography has completely replaced conventional multidirectional tomography in the evaluation of the temporal bone. Unprecedented detail is now available for evaluation of both middle ear and inner ear structures. A sampling of our experience in the evaluation of tubotympanic disease, otosclerosis, trauma, neoplastic disease, and congenital abnormalities is included in this publication. The state of the art in evaluation of sensorineural hearing loss is also illustrated.

ISSN:0148-6403    

DOI:10.1002/hed.2890060506

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

年代:1984

数据来源: WILEY

摘要:

AbstractNutritional status was evaluated in 50 consecutive patients with advanced squamous cell carcinoma of the head and neck. Using a linear equation developed by Busby, the prognostic nutritional index (PNI) was calculated from the serum albumin, triceps skin‐fold thickness, serum transferrin, and delayed hypersensitivity reaction. The treatment plan was determined by the patient's attending physician and complications were retrospectively evaluated. The patients were divided into three groups by the value of the PNI. The complication rate was not significantly higher in patients with moderate malnutrition (PNI between 20% and 39%). However, with severe malnutrition (PNI greater than 39%), the incidence of iatrogenic complications was prohibitive and 12 of 14 patients were dead within 6 months. We conclude that the PNI is a simple, objective measure of nutritional status that will identify patients at high risk for therapy‐related complications and early de

ISSN:0148-6403    

DOI:10.1002/hed.2890060507

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

年代:1984

数据来源: WILEY

摘要:

AbstractThe relationship between the mode of tumor invasion in the tumor‐host borderline and the frequency of regional lymph node metastasis was investigated in squamous cell carcinoma of the oral cavity. Cases with grades 1‐3 mode of invasion classified by modified Jacobsson criteria showed a low frequency of metastasis (10/72, 13.9%), while those cases with grade 4 mode of invasion, which consisted of grade 4C (cord‐like type) and grade 4D (diffuse type) showed a high frequency of metastasis (4C:11/18,61.1%;4D:9/12,75.0%; total 20/30,66.7%). Moreover, the number of metastatic nodes in each case of mode of invasion ranged from 1 to 3 in grades 1‐3, from 1 to 5 in grade 4C, and from 1 to 7 in grade 4D. The presence of metastasis indicated a poorer prognosis than did the absence of the mode of invasion in each grade, especially in grades 4C

ISSN:0148-6403    

DOI:10.1002/hed.2890060508

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

年代:1984

数据来源: WILEY

摘要:

AbstractA retrospective 10‐year review of thyroid function in 144 patients treated for cancer of the head and neck by radiation therapy, surgery, and combined surgery and radiation therapy was done. In five patients, hypothyroidism had been found in the posttreatment period. Two of them had developed a pharyngeal fistula resistant to intensive local care and surgical procedures, and a third patient had edema and necrosis of the skin flap. The five hypothyroid patients reported here have all been treated for laryngeal malignancy. In any other group of patients treated for head and neck malignancies studied within this article, we did not find clinical or chemical signs of thyroid hypofunction. Our report stresses the importance of periodic evaluation of thyroid function in patients who underwent irradiation of the neck or combined therapy for malignancy in the neck, even if they were clinically euthyroid. Hypofunction may be more frequent than generally recognized after multimodality treatment, and hormonal replacement therapy may be the keystone in curing rebellious pharyngeal fistula and shortening the disabled state of the patien

ISSN:0148-6403    

DOI:10.1002/hed.2890060509

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

年代:1984

数据来源: WILEY

摘要:

AbstractDuring the period 1972‐1982, 84 pharyngoesophageal reconstructions were performed on 82 patients (10 benign lesions and 72 malignant lesions) by the Department of Otolaryngology, Mount Sinai Medical Center, New York. The overall mortality for the series was 10%, with postoperative complications developing in the majority of patients and swallowing accomplished in 61%. The most successful method of reconstruction was stomach transposition (92%), followed by cervical flap repair (68%). The least successful methods were the use of the tubed deltopectoral and pectoralis major myocutaneous flaps, colon interposition, and jejunal autografts (40%‐50%). The pertinent literature is reviewed and the reported mortality, morbidity, indications, limitations, and success rates for each method of reconstruction are analyzed and compared with the present ser

ISSN:0148-6403    

DOI:10.1002/hed.2890060510

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

年代:1984

数据来源: WILEY

ISSN:0148-6403    

DOI:10.1002/hed.2890060511

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

年代:1984

数据来源: WILEY