ISSN:0148-6403    

DOI:10.1002/hed.2890040502

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

年代:1982

数据来源: WILEY

摘要:

AbstractReconstruction of the pharynx and cervical esophagus presents a formidable problem for the head and neck surgeon. The use of a free jejunal graft offers a reliable and effective means of performing this reconstruction. Experience with 17 cases forms the basis of this report, which emphasizes technique and complications.

ISSN:0148-6403    

DOI:10.1002/hed.2890040503

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

年代:1982

数据来源: WILEY

摘要:

AbstractA total of 44 patients with previously untreated Stage IV squamous cell carcinomas of the head and neck were treated with a combination of cis‐platinum (100 mg/sq m) and 96‐hour infusion of 5‐fluorouracil (5‐FU) (1,000 mg/sq m/day) in two courses or with cis‐platinum (100 mg/sq m) and 120‐hour infusion of 5‐FU (1,000 mg/sq m/day) in three courses. In the 26 patients receiving the two course regimen, the tumor response rate was 88.5%. In five of the 26 patients complete disappearance of the tumor was achieved; partial remission was obtained in 18 of 26 patients. The main side effects were nausea and vomiting (70%), leukopenia (27%), and mild‐to‐moderate renal toxicity (27%). In the 18 patients who received the three course regimen of 5‐FU and cis‐platinum, there were 11 (61%) complete responses, 6 (33%) partial responses, and 1 (6%) minimal response. The incidence of complete response was increased with each course given. No added toxicity was observed with su

ISSN:0148-6403    

DOI:10.1002/hed.2890040504

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

年代:1982

数据来源: WILEY

摘要:

AbstractA one‐stage operation is described for reconstruction of large defects of the columella nasi, the lower part of the nasal septum, and the vestibular floors. Nasolabial flaps are transposed on a cranial, de‐epithelialized pedicle, and passed deep to the nostrils into the vestibular cavity. The method is illustrated with four case repo

ISSN:0148-6403    

DOI:10.1002/hed.2890040505

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

年代:1982

数据来源: WILEY

摘要:

AbstractDuring the past seven years, a total of 1,713 patients underwent strumectomy for a variety of causes at the University of Düsseldorf. Unilateral palsies of the recurrent nerve developed in 147 patients. Both vocal cords were paralyzed in 22 patients. Of the 147 patients with unilateral palsies, 53 patients were available for follow‐up examination after one year. In 28 of these patients, complete paresis of the vocal cord remained. Twenty‐three patients showed complete recovery and normal function of the affected cord. In two patients, reduced but marked mobility of the previously completely paralyzed vocal cord was present. Of the 22 patients with bilateral recurrent nerve palsies, 10 were available for follow‐up examination one year later. In three of these patients vocal cord movement was still absent, in three others one vocal cord showed normal function, and in only one patient did both vocal cords reveal normal physiologic mobility. Three other patients demonstrated a reduced but marked mobility of one vocal cord. The results are discussed in relation to the clinical and histologi

ISSN:0148-6403    

DOI:10.1002/hed.2890040506

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

年代:1982

数据来源: WILEY

摘要:

AbstractAlteration in the appearance of the mucosa, fluid accumulations, and changes in the shape and texture of the sinus wall form the basis of the radiologic information that aids in the diagnosis of frontal sinus disease. Inflammatory disease of the frontal sinuses was discussed in Part 1A of this article; other disease processes of the frontal sinuses as they appear in the various roentgenographic modalities are described and illustrated here.

ISSN:0148-6403    

DOI:10.1002/hed.2890040507

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

年代:1982

数据来源: WILEY

ISSN:0148-6403    

DOI:10.1002/hed.2890040508

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

年代:1982

数据来源: WILEY

摘要:

AbstractPigmented lesions, including melanomas, of the mucous membranes of the head and neck are far outnumbered by their counterparts in the skin. This relative dearth is partially responsible for the fact that scientific inquiry into mucosal melanomas has not kept pace with the advances in knowledge of the pathogenesis of cutaneous melanomas and their diagnosis and treatment. Integral to these latter advances have been the refinements in clinical and histologic classification and clinicopathologic correlations withquantitativeevaluation of melanomas of skin—enhancements that up to now have been singularly lacking for mucosal melanomas. This report acknowledges this slowness in progress, presents recommendations for purifying the nomenclature of pigmented lesions of the mucosae, and at the same time, also notes the poorer prognosis for melanomas of the upper aerodigestive tracts, as a group, when compared with cutaneous melanomas. Only prospective studies will answer the question of whether the poor prognosis is intrinsic to these mucosal melanomas or whether delay in detection and removal are responsibl

ISSN:0148-6403    

DOI:10.1002/hed.2890040509

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

年代:1982

数据来源: WILEY

摘要:

AbstractThe natural history of extracranial cerebrovascular disease and available alternatives in its treatment are reviewed. An evaluation of the evidence suggests that carotid endarterectomy is the treatment of choice in patients with transient ischemic deficits, provided that an anatomically appropriate lesion can be identified. These patients have a 25‐38% chance of stroke if untreated, which can be reduced to 5‐10% by carotid endarterectomy. Patients with asymptomatic carotid stenosis who are good operative risks are also candidates for surgery, although this issue remains controversial. Patients with small asymptomatic ulcerated carotid plaques have a relatively benign prognosis and should not undergo preventive carotid surgery. Carotid surgery is occasionally indicated in patients with vertebral basilar insufficiency and carotid stenoses, fibromuscular dysplasia, or carotid kinks associated with symptoms of ischemia. Carotid endarterectomy may be performed with an overall mortality of 1‐2% and morbidity of 2‐5% if the patients are carefully selected and the surgical team is

ISSN:0148-6403    

DOI:10.1002/hed.2890040510

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

年代:1982

数据来源: WILEY

摘要:

AbstractA number of procedures in nuclear medicine are available to assist the surgeon in evaluating pathologic conditions of the head and neck. Gallium‐67 citrate scanning is occasionally useful in determining the extent of head and neck tumors but rarely can it detect an occult tumor and it cannot distinguish between an infection and a tumor. Technetium‐99m pertechnetate can be used to evaluate diseases of the salivary glands including parotitis, duct obstructions, and tumors. Iodine 123 and technetium‐99m pertechnetate are commonly used to obtain images of the thyroid, but some malignant thyroid nodules will accumulate technetium‐99m pertechnetate and the suspicious character of the nodule may be only appreciated by iodine scanning. The use of iodine 131 is generally limited to the detection of a substernal thyroid, therapeutic thyroid ablation, and the treatment of hyperthyroidism and thyroid cancer. Bone scanning has been used experimentally to evaluate the healing of mandibular bone grafts and to detect local extension of primary head and neck tumors to skull and facia

ISSN:0148-6403    

DOI:10.1002/hed.2890040511

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

年代:1982

数据来源: WILEY