摘要:

AbstractDiagnostic ultrasound has become firmly established as a key imaging modality in obstetrics and gynecology. Its role in abdominal and retroperitoneal disease is also well known and continues to expand. Although usage of ultrasound in the head and neck had its beginnings many years ago, the advent of newer high‐resolution transducers has allowed for further investigation of diseases in this area. Of particular interest are the thyroid gland and the extracranial carotid arteries. This review summarizes the current utility of gray‐scale and real‐time ultrasound in evaluating head and neck disease, and discusses potential future applications of the mod

ISSN:0148-6403    

DOI:10.1002/hed.2890010102

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

年代:1978

数据来源: WILEY

摘要:

AbstractAt present there is no single surgical approach that is ideally suited to rehabilitation of the paralyzed face. Dynamic reconstruction and neural reconstitution are usually preferred to static methods, except under special circumstances. Experience with over 150 autogenous facialnerve grafts using epineural suture technique has resulted in return of movement in 95% of properly selected patients. When grafting is not feasible, as in the obliterated central facial nerve, hypoglossal–facialnerve crossover is a simple and powerful source of reinnervation, usually resulting in minimal intraoral crippling and mild mass movement. A newer procedure, the cross‐face nerve graft, is an alternative to hypoglossal crossover, although it results in less axonal input and longer regenerative time. In cases of long‐standing facial paralysis with muscle atrophy, temporalis and masseter transfers are dependable and may sometimes be combined with a nerve

ISSN:0148-6403    

DOI:10.1002/hed.2890010103

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

年代:1978

数据来源: WILEY

摘要:

AbstractMucosal melanoma of the head and neck is a rare condition. This study presents a review of 26 patients with such tumors, followed up at a minimum of 5 years. The 5‐year survival rate in this group was 38%. Recurrences with a fatal outcome, however, have been encountered up to 12 years after initial diagnosis. Primary radical surgery offers the best chance for local control. Nasal‐cavity lesions seem to be associated with a better prognosis than oral‐cavity tumors. Analysis of pathologic features by microstage measurement showed that the majority of tumors were of considerable thickness. This factor may partially explain the poor prognosis associated with mucosal melanomas in comparison to their cutaneous counterparts. Local recurrences and distant metastases were the principal causes of treatment failure. A persistent treatment policy, however, may still substantially prolong survival in such cases. Regional lymph‐node metastasis did not pose a significant problem in the management of these tumors. Recognition of the nature and significance of the appearance of oral melanosis is s

ISSN:0148-6403    

DOI:10.1002/hed.2890010104

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

年代:1978

数据来源: WILEY

摘要:

AbstractAt the Roswell Park Memorial Institute, 111 patients were treated for squamous cell carcinoma of the pyriform sinus over a 15‐year period. Treatment modalities included surgery, radiation therapy, or a combination of both. A retrospective study was carried out to determine how these treatments, used singly or in combination, affected the cure rate. TNM clinical staging and recurrence patterns were studied, and a high tendency for distant metastases was documented. The five‐year survival figure in this study was 29% (28/

ISSN:0148-6403    

DOI:10.1002/hed.2890010105

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

年代:1978

数据来源: WILEY

摘要:

AbstractIn dealing with a child with a structural defect, an overall diagnosis must be formulated. Such a diagnosis makes it possible to provide genetic counseling for the parents and an accurate prediction relative to such a child's future development. Because there are a great many abnormalities involving the head and neck, it is hoped that the approach set forth in this article will allow for a systematic narrowing of the diagnostic possibilities. Nomenclature is established. Prenatal‐onset defects are described, including both single primary defects (malformations and deformations) and multiple malformation syndromes (chromosomal abnormalities, genetic disorders, defects resulting from teratogenic factors, and disorders of unknown etiology). Genetic and environmental factors of postnatal developmental problems are also discusse

ISSN:0148-6403    

DOI:10.1002/hed.2890010106

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

年代:1978

数据来源: WILEY

摘要:

AbstractThe use of quilted grafts in the treatment of minimally infiltrative carcinoma of the tongue is described. Results are assessed in terms of therapeutic effectiveness and functional adequacy. This single‐stage graft procedure is compared to multistage flap reconstruction as well as to direct suture. We conclude that, with careful selection of patients, the method is a satisfactory on

ISSN:0148-6403    

DOI:10.1002/hed.2890010107

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

年代:1978

数据来源: WILEY

摘要:

AbstractIn an effort to obtain quantitative and qualitative information regarding the extent of disability sustained following definitive treatment for head and neck cancer, 51 patients–28 who had had laryngectomy and 23 who had had other major surgery–were interviewed. Also examined were the types of rehabilitation measures taken. In all cases, the following areas in which disability could occur were identified and explored: physical appearance, speech, deglutition, mastication, salivation, sensory deficits, cranial motor‐nerve deficits, pain, nutrition, activities of daily living, psychosocial functioning, vocational status, environmental parameters, and delayed complications. Where appropriate, ratings and delineations of severity were compiled. Nine methods of rehabilitation were assessed with regard to frequency of utilization: surgical reconstruction, dental‐maxillofacial prosthetics, speech therapy, physical therapy, rehabilitation nursing, occupational therapy, vocational rehabilitation, rehabilitation counseling, and social service. Our conclusions were that half of the patients studied had sustained significant disability in three to four areas, while 43% had moderate or severe disability in five to nine areas. Additionally, the head and neck surgeon was found to have used surgical reconstructive and dental‐maxillofacial prosthetic measures, as well as the services of seven categories of allied health professionals, to provide rehab

ISSN:0148-6403    

DOI:10.1002/hed.2890010108

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

年代:1978

数据来源: WILEY

摘要:

AbstractThe surgical pathology of the head and neck is perhaps the most demanding of all subdivisions of pathology. It is demanding both for the pathologist and for the head and neck surgeon–who, as a team, must provide optimal patient care. Beginning with this issue of HEAD&NECK SURGERY, a series will be presented dealing with the clinicopathologic aspects of head and neck tumors. The authors have chosen to begin with the salivary glands, and in this report they present a concept of histogenesis and classification as well as an analysis of (1) salivarygland tumors in children, (2) the relationship between breast carcinoma and salivary‐gland carcinoma, (3) the status of radiation induction of salivary‐gland tumors, and (4) the clinicopathologic aspects of tumors of the salivary onc

ISSN:0148-6403    

DOI:10.1002/hed.2890010109

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

年代:1978

数据来源: WILEY

摘要:

AbstractNeurilemoma of the larynx is not common. Thus far, 86 cases have been described in the literature. In this study, another case, occurring in a 67‐year‐old woman, is discussed. The potential danger of the lesion is emphasized. The most common nerve of origin is thought to be the internal branch of the superior laryngeal nerve. Removal via a lateral pharyngotomy is advocated for larger tum

ISSN:0148-6403    

DOI:10.1002/hed.2890010110

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

年代:1978

数据来源: WILEY

摘要:

AbstractChemotherapy has traditionally been relegated to a late palliative role in the management of head and neck cancer. For advanced disease in patients previously treated with surgery or radiation therapy, methotrexate, which has a response rate of approximately 50%, is the best single agent available. Other orally or systemically administered single agents–such as bleomycin, adriamycin, hydroxyurea, and cis‐platinum–produce responses less frequently than methotrexate. Intraarterial chemotherapy with single‐agent methotrexate or with combinations– including methotrexate, vinblastine sulfate (Velban), cyclophosphamide (Cytoxan), and 5‐fluorouracil (5FU)–can match the response rate of systemic methotrexate, but all require inpatient treatment and significant technical expertise. Programs utilizing chemotherapeutic combinations have not produced remission rates or durations of remission greater than those achieved with methotrexate alone. Chemotherapy has also been used in combination with other modalities. In two studies, chemotherapy combined with irradiation produced improvement in median or overall survival in comparison to irradiation alone. Many similar studies have been negative. Recent trials of chemotherapy used preoperatively in the treatment of head and neck cancer have not yielded decreased recurrence rates or increased overall survival rates in comparison to surgery alone, but they do appear to have prolonged the diseasefree interval following defin

ISSN:0148-6403    

DOI:10.1002/hed.2890010111

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

年代:1978

数据来源: WILEY