摘要:

AbstractA Head and Neck Sarcoma Registry was established by the Society of Head and Neck Surgeons to review treatment results of a rare tumor by surgeons with special interest in this anatomic site. Two hundred fourteen patients were analyzed. There were 194 adult tumors and 20 pediatric tumors. The major sites included parotid and neck, 20%; face and forehead, 18%; maxilla and palate, 13%; scalp, 12%; mandible, 11%; paranasal sinuses, 7%; larynx, 2%; and oral cavity, 5%. Eighty‐four percent were resectable. The disease‐free survival was 56%; overall survival was 70% at 5 years. Major determinants of survival were adequacy of resection (margins free of tumor) and tumor type. Survival differed according to tumor cell type (tumor grade was not available). Patients with chondrosarcoma and dermat‐ofibrosarcoma had survival approaching 100%. Patients with malignant fibrous histiocytoma (MFH) and fibrosarcoma (FSA) had intermediate survival of 60% to 70%. The worst survival,<50% at 5 years, occurred in patients with osteosarcoma, an‐giosarcoma, and rhabdomyosarcoma in decreasing order. This suggests a rationale for identifying high‐risk patients for prospective adjuvant protocols. This sutdy emphasizes the value of recording uncommon tumors to provide relevant information for future study and possibl

ISSN:1043-3074    

DOI:10.1002/hed.2880140102

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

年代:1992

数据来源: WILEY

摘要:

AbstractThe degree of gene amplification for epidermal growth factor receptor (EGFR) and its expression levels were examined in 4 cases of tumor lesions and their cell lines of human squamous cell carcinoma (SCC) of the oral cavity. The amplification was detected in 1 case (ZA), but not significantly in 3 other cases (HOC605, HOC815, and HOC927) in which the amplification did not occur during the cell line establishment. In those 3 cases, levels of EGFR synthesis and human EGF (hEGF) binding capacity were varied: HOC605 and HOC815 had slightly increased levels of hEGF binding capacity and EGFR synthesis, respectively. While HOC927 had the lowest levels of both, the hEGF binding capacity was elevated in the tumor lesion when compared with the normal counterpart of the same patient. These results suggest that the increased capacity for EGF binding plays a more important role than does gene amplification on the tumorigenesis of SCC of the head and neck.

ISSN:1043-3074    

DOI:10.1002/hed.2880140103

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

年代:1992

数据来源: WILEY

摘要:

AbstractDuring the 5‐year period from July 1984 to 1988, 72 patients over the age of 50 underwent microvascular free tissue transfers for head and neck reconstruction. There were 22 patients aged 50‐59 years, 31 patients aged 60‐69 years, and 19 patients aged 70‐79 years. Seventy of these procedures (97%) were done at the time of ablative surgery utilizing a two‐team approach. There was 1 total flap loss for a flap viability rate of 99% (73/74). There were 46 complications in 40 patients: 21 surgical and 25 medical. Twelve of the surgical complications required reoperation for a major surgical complication rate of 16%. Major medical complications developed in 12 patients (16%). Medical complications more commonly were observed in patients aged 60‐69 years who had significant preoperative comorbidity and were classified as ASA class 3 or greater. There were 5 postoperative deaths for a mortality rate of 7%. Advanced chronologic age does not compromise the technical success of microsurgical free tissue transfer in the elderly patient with head and neck cancer. The risk of medical complications is significant and is directly related to concurrent illness of the individual patient rather than t

ISSN:1043-3074    

DOI:10.1002/hed.2880140104

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

年代:1992

数据来源: WILEY

摘要:

AbstractTwo hundred thirty‐two patients with nasopharyngeal carcinoma were evaluated for serous otitis media (SOM) at diagnosis. The diagnosis of SOM required the detection of effusion behind the tympanic membrane in association of air‐bone gap of 10 dB or more in pure tone audiogram. These patients were also evaluated by computed tomography for the degree of tumor extension. By stepwise logistic regression analysis, the degree of paranasopharyngeal extension of tumor, erosion of petrous temporal bone, and the obliteration of pharyngeal recess were significantly related to the development of SOM, but sex and age were not. The findings of computed tomography may influence the plan of management for SOM in patients with nasopharyngeal carcinoma at diagno

ISSN:1043-3074    

DOI:10.1002/hed.2880140105

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

年代:1992

数据来源: WILEY

摘要:

AbstractFlexible and rigid endoscopes allow good visualization of the nasopharynx using local anesthesia, and permit biopsies to be taken under direct vision. Little information is available on the accuracy of biopsies taken using local anesthesia, and general anesthesia is usually recommended for evaluation and biopsy of the nasopharynx to avoid missing small or submucosal lesions. We report the results from 260 patients biopsied using local anesthesia (188) and general anesthesia (72). All biopsies were taken using large nasal biopsy forceps under direct vision. The sensitivity of this technique in diagnosing nasopharyngeal carcinoma was 95.1% using local anesthesia and 95.6% using general anesthesia. We suggest that general anesthesia is rarely necessary for definitive biopsy of the nasopharynx. In the majority of patients, an accurate diagnosis can be obtained using large biopsy forceps under direct vision using local anesthesia.

ISSN:1043-3074    

DOI:10.1002/hed.2880140106

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

年代:1992

数据来源: WILEY

摘要:

AbstractThe role of assistance in coordinating treatment and follow‐up on the effectiveness and reliability of long‐term care of head and neck cancer patients was evaluated. A comparison between the Department of Radiation Oncology, where a liaison team assists cancer patients, and the Department of Otolaryngology, where there were no such personnel, was made. Of 124 consecutive patients with head and neck squamous cell carcinoma, 31 were treated with surgery alone and 93 had radiation therapy alone or in combination with surgery. Patients were nearly equally divided among stages, although a higher percentage receiving surgery were stage I and those receiving radiation were stage IV. Nineteen radiation patients and 1 surgery patients have died; this is consistent with the differences in stage distribution. Thirteen of 31 surgery patients had unreliable follow‐up, with 7 lost to follow‐up. Only 8 of 93 radiation patients were unreliable, with 4 lost. The difference is statistically significant. The importance of nursing/social work liaisons in coordinating treatment and follow‐up of head and neck cancer patients is

ISSN:1043-3074    

DOI:10.1002/hed.2880140107

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

年代:1992

数据来源: WILEY

摘要:

AbstractEighty‐six injections in 49 patients with adult onset spasmodic torticollis were evaluated for efficacy with respect to single point per muscle versus multiple point per muscle injection techniques. Parameters of the syndrome assessed were pain, posture deformity, range of cervical motion, disfigurement, cervical muscle hypertrophy, activity limitation, and degree of involuntary movement. The multiple point per muscle injection strategy appeared superior to the single injection per muscle technique with respect to pain (p<0.002, chi‐square), posture deformity (p<0.001), range of motion (p<0.001), and improvement in activity endurance (p<0.001). No significant differences were noted with respect to cervical muscle hypertrophy or degree of involuntary movements, although the injections were considered beneficial in both groups to these syndrome compone

ISSN:1043-3074    

DOI:10.1002/hed.2880140108

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

年代:1992

数据来源: WILEY

摘要:

AbstractTo determine the optimal administration schedules of the newly synthesized, less nephrotoxic platinum analog NK121 and less pneumotoxic bleomycin analog NK313, the antitumor effects of 2 different injection schedules, (1) single injections on days 1, 5, and 9, (2) continuous infusion for 7 days, were compared in nude mice bearing human squamous cell carcinoma. Tumor growth delay was employed as the experimental endpoint of antitumor activity. Body weight and hematologic changes in the mice were also investigated as indications of drug toxicity after the combination treatment of NK121 and NK313. The antitumor effects of the 2 analogs indicated higher responses with the single injections of NK121 and continuous infusion of NK313. In combination chemotherapy with NK121 and NK313, the highest antitumor effect was observed when mice were given NK121 by single injections followed by NK313 by continuous infusion. This sequence was also less toxic than a simultaneous treatment schedule, which was of weak clinical significance because of its low antitumor activity, severe weight loss, slight myelosuppression, and renal toxicity.

ISSN:1043-3074    

DOI:10.1002/hed.2880140109

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

年代:1992

数据来源: WILEY

摘要:

AbstractPrimary synovial sarcoma is an unusual tumor of the head and neck. Fewer than 75 cases have been reported in the literature. We have treated 7 additional cases; 3 in the hypopharynx, 2 in the parapharyngeal space, 1 in the oral pharynx and 1 in the posterior triangle of the neck. An enlarging cervical mass, voice change, and dysphagia were among the presenting complaints. CT revealed solitary nonhomogenous tumors from 3 to 7 cm in diameter. Microscopically, all cases showed a biphasic cellular pattern verified by immunohistochemical staining. Multimodality treatment consisted of surgery and postoperative radiation therapy with 3 patients receiving chemotherapy. Although the original pathology report was incorrect in 3 cases, clinical suspicion for synovial sarcoma ensured proper diagnosis.

ISSN:1043-3074    

DOI:10.1002/hed.2880140110

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

年代:1992

数据来源: WILEY

摘要:

AbstractTumors arising in the parapharyngeal space are rare. Even more rare are those which originate from the pharyngeal and parapharyngeal musculature. Three examples of muscle tumors presenting as paraphyarngeal masses are reported, ie, a rhabdomyoma, rhabdomyosarcoma, and a leiomyosarcoma, and the literature pertaining to these tumors is reviewed. To the best of our knowledge, this represents the first case of a parapharyngeal leiomyosarcoma reported in the literature.

ISSN:1043-3074    

DOI:10.1002/hed.2880140111

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

年代:1992

数据来源: WILEY