ISSN:1043-3074    

DOI:10.1002/hed.2880110102

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

年代:1989

数据来源: WILEY

ISSN:1043-3074    

DOI:10.1002/hed.2880110103

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

年代:1989

数据来源: WILEY

摘要:

AbstractUltrastructural studies of pleomorphic adenoma have shown a coordinated differentiation of luminal epithelial and modified myoepithelial cells with the latter cells related to processes resulting in the myxochondroid stroma. Five examples of various histologic types of malignant mixed tumor of parotid origin were examined by electron microscopy to see if underlying patterns of tumor cell differentiation and organization matched those of pleomorphic adenoma. Whether they were intracapsular tumors (with or without identifiable pleomorphic adenoma), carcinomas ex pleomorphic adenoma, or a true malignant mixed tumor, all lesions had cell types and organizations either identical to those in pleomorphic adenoma or, as in less‐differentiated examples, displayed features suggesting origin from luminal cells, myoepithelial cells, or both. Even the chondroid cells in the true malignant mixed tumor expressed ultrastructural features indicating their epithelial derivation. On the basis of these findings, some alterations to the classification and terminology of the subtypes of malignant mixed tumor are suggeste

ISSN:1043-3074    

DOI:10.1002/hed.2880110104

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

年代:1989

数据来源: WILEY

摘要:

AbstractEthical dilemmas in head and neck cancer daily confront physicians, patients, families, and society at large. For every situation there are potential benefits and real burdens, as well as risks. There are no “right” answers for any given situation, but there are processes for assisting the primary decision makers involved in reaching meaningful and appropriate decisions. This paper asks some pertinent ethical questions and suggests some ways of responding to the iss

ISSN:1043-3074    

DOI:10.1002/hed.2880110105

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

年代:1989

数据来源: WILEY

摘要:

AbstractThe prevention of wound infection after major contaminated head and neck surgery is a critical issue for the head and neck surgeon. The proper interpretation of cultures taken from wounds is uncertain. Multiple organisms are invariably isolated from this nonsterile site including indigenous aerobic and anaerobic flora, aerobic gram‐negative rods, and fungi. We present evidence from controlled antibiotic trials that demonstrate the pathogenicity of oropharyngeal anaerobic flora. The presence of aerobic gram‐negative rods and fungi generally represent colonization and antibiotic coverage need not routinely be directed at these organisms. On the other hand, the antibacterial spectrum of an agent used for head and neck would prophylaxis should include coverage for pathogenic oral flora, namely the gram‐positive aerobic cocci (especially streptococci) and anaerobic bac

ISSN:1043-3074    

DOI:10.1002/hed.2880110106

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

年代:1989

数据来源: WILEY

摘要:

AbstractA myth persists that tumor involvement of bone and/or cartilage represents a clinical situation in which cure by radiotherapy would be considered unusual. There are sufficient data to the contrary. This essay reviews the radiotherapy results for (1) primary tumors of bone (benign and malignant), (2) primary malignant tumors of cartilage, and (3) benign and malignant tumors that secondarily involve bone and/or cartilage. It is hoped that the myth concerning radiocurability and bone and/or cartilage involvement will be replaced by an appreciation of the relative rates of cure depending on the clinical situation.

ISSN:1043-3074    

DOI:10.1002/hed.2880110107

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

年代:1989

数据来源: WILEY

摘要:

AbstractClinical staging of supraglottic carcinoma requires evaluation of the pre‐epiglottic space (PES). To explore the role of fine needle aspiration biopsy of the PES in the staging of epiglottic carcinoma, endoscopic transvallecular fine needle aspiration biopsies of the PES were performed in 16 patients with epiglottic carcinoma. The results of aspiration cytology were compared with CT scanning and postoperative histopathologic sections of the PES after total or supraglottic laryngectomy. This preliminary report shows that needle aspiration biopsy of the PES is a safe and sensitive technique, having a high correlation with histopathologic follow‐up. Needle biopsy, along with CT scan, is clinically useful in staging the PES, which cannot be examined direc

ISSN:1043-3074    

DOI:10.1002/hed.2880110108

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

年代:1989

数据来源: WILEY

摘要:

AbstractSuccessful management of frontal sinus fractures depends on correct identification of structural pathology, which may lead to inflammatory complications. Obstruction of the frontonasal duct is a significant factor predisposing to such complications and its evaluation is thus critical in the management of these fractures. Specific radiographic CT criteria and an intraoperative dye irrigation test are presented to determine the likelihood of frontonasal duct injury. Eighteen cases of frontal sinus fractures are reviewed, which have been treated based on these principles. A scheme is presented outlining the management of frontal sinus trauma using these methods.

ISSN:1043-3074    

DOI:10.1002/hed.2880110109

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

年代:1989

数据来源: WILEY

摘要:

AbstractPatients with bulbar amyotrophic lateral sclerosis (ALS) are often referred to the otolaryngologist/head and neck surgeon and speech pathologist for evaluation and management of dysphagia and dysarthria. These patients comprise an unusual group because of the progressive and multi‐system nature of their illness. The neuromuscular disabilities associated with bulbar ALS cause a myriad of related symptoms associated with swallowing, speech, and respiration. Although the rate of progression cannot be predicted, a general pattern of progression is noted. Bulbar disease accounts for the majority of the worst symptoms of ALS. The loss of the ability to swallow changes eating from a pleasurable task to a burden of survival. Loss of communication effectively imprisons the patient in a state of isolation. The progressive weakness of respiration, predominantly a spinal rather than bulbar manifestation, is the cause of death for nearly all ALS patients and is also discussed. The general patterns of progression of bulbar ALS are outlined in this paper. The development of symptoms are correlated with specific treatment recommendations to aid the clinician in devising an orderly plan of management for this progressive diseas

ISSN:1043-3074    

DOI:10.1002/hed.2880110110

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

年代:1989

数据来源: WILEY

摘要:

AbstractFrom 1970 to 1984, 32 patients were treated for tuberculous (TB) masses, which measured 1.2–5.5 cm. The posterior triangle was involved in 19 patients, anterior triangle in 7, and more than one triangle in 6 (3 bilateral). A superficial node was excised for diagnosis. Acid‐fast bacilli were identified on the smear of 18 patients. Caseation necrosis was present in 27 specimens, sarcoidosis in four, nonspecific lymphadenitis in one; all cultures grew Mycobacterium tuberculosis. A chest x‐ray showed no active TB. Chemotherapy was given for 9–18 months (9 months when only one node was diseased and 18 months with extensive nodal involvement). Follow‐up examinations in all patients (>3 years, mean 8.6 years) has revealed no recurrence. The need to excise all cervical TB nodes, chronically inflamed and often fused to important structures, was eliminated by adequate che

ISSN:1043-3074    

DOI:10.1002/hed.2880110111

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

年代:1989

数据来源: WILEY