ISSN:0148-6403    

DOI:10.1002/hed.2890100702

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

年代:1988

数据来源: WILEY

摘要:

AbstractForty‐three tissue transfers were performed in 41 patients for severe head and neck defects, no two of which were identical. Two thirds of the patients were in the pediatric age group (18 years or less), and 16 presented with severe radiation‐related defects. No bowel transfers are included in this group. The majority of the defects were complex, three‐dimensional defects in the cheek secondary to radiotherapy, surgery, or congenital defect. Free flaps were chosen to give the optimal aesthetic result and because they gave the best solution to the problem rather than the only solution. Total flap loss occurred in one patient, and partial loss occurred in two of the 43 flaps. No significant problems were encountered with either the radiotherapy or pediatric age group, although the complexity of the reconstruction was often greater. There were more flap‐related complications in the radiotherapy group, although these were al

ISSN:0148-6403    

DOI:10.1002/hed.2890100703

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

年代:1988

数据来源: WILEY

摘要:

AbstractTotal glossectomy for cancer is a very mutilating surgery. It is possible to preserve the larynx if it is not involved but reconstructive procedures are often insufficient. A complementary laryngectomy must often be performed. We present a new procedure using a gastroomental free flap for reconstruction after total glossectomy with conservation of the larynx. This flap gives excellent functional results and minimizes the problems of swallowing and aspirations. The suppleness of the flap allows free vertical movement of the larynx and constriction of the pharynx during swallowing. The omentum also provides excellent protection against fistula formation and vascular ruptures.

ISSN:0148-6403    

DOI:10.1002/hed.2890100704

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

年代:1988

数据来源: WILEY

摘要:

AbstractSubtotal laryngectomies with cricohyoidopexy allow the removal of the glottis in a single bloc in continuity with the paraglottic spaces and the thyroid cartilage (CHP type 1), or removal of the supraglottic larynx with the preepiglottic space in continuity with the glottis (CHP type 2). The operative technique is detailed. Eighty‐two CHPs have been performed as primary treatment for laryngeal cancer since 1978. Postoperative events, functional results, recurrence, and survival are described. Thirty‐seven CHPs have been followed‐up for at least 3 years. Within that group, only one (2.7%) had local recurrence. The single bloc excision of the primary tumor along with the potential spaces of extension involved in CHP may account for this very low rate. Indications and limitations are desc

ISSN:0148-6403    

DOI:10.1002/hed.2890100705

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

年代:1988

数据来源: WILEY

摘要:

AbstractThe application of craniofacial techniques has allowed the excision of lesions heretofore thought unresectable. Extensive exposure is gained through the use of bicoronal and face‐splitting incisions and by the performance of facial osteotomies. Dural defects are reconstructed with autogenous tissue, preferably with local flaps of dura or pericranium. The communication between the extradural space and the nasal cavity is similarly closed. Pericranial flaps based anteriorly on the supratrochlear and supraorbital vessels or laterally based flaps utilizing pericranium and temporalis muscle and fascia are well vascularized and can reach the defect. Osseous reconstruction of the anterior cranial floor, nasofrontal area, and other areas is most easily done at the time of resection using cranial bone and rigid mini‐plate fixation. A case illustrating these techniques is presen

ISSN:0148-6403    

DOI:10.1002/hed.2890100706

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

年代:1988

数据来源: WILEY

摘要:

AbstractDespite the remarkable progress made in the field of oral and reconstructive surgery, defects arising as a result of surgical removal of small and medium‐sized tumors of the retromolar trigone, palatoglossal arch, posterior part of the lateral floor of the mouth, gingivo‐glossal sulcus, and the adjoining areas, continue to present a challenge. Most methods of reconstruction presently in vogue, when used in such a situation, are associated with some morbidity and possible risks of complications. The use of a masseter crossover flap permits a reliable two‐layered primary closure without any significant complications and with early return of function. Experience with 24 cases to date is rep

ISSN:0148-6403    

DOI:10.1002/hed.2890100707

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

年代:1988

数据来源: WILEY

摘要:

AbstractA 45‐year‐old man with a history of nasopharyngeal carcinoma with metastasis to the right side of the neck, who was treated with radiotherapy for cure, developed spontaneous left internal jugular vein thrombosis. Within a few days, the patient showed signs of increasing intracranial pressure, and a diagnosis of pseudotumor cerebri secondary internal jugular vein thrombosis was made. A review of the literature revealed no other case of pseudotumor cerebri in association with spontaneous internal jugular vein thrombosis. The etiology, pathogenesis, clinical presentation, and treatment of pseudotumor cerebri is presen

ISSN:0148-6403    

DOI:10.1002/hed.2890100708

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

年代:1988

数据来源: WILEY

摘要:

AbstractIntraoperative brachytherapy with radioactive Iodine 125 seeds using a pectoralis major myocutaneous flap for carotid artery coverage and primary repair was used in 10 patients with advanced oral and oropharyngeal carcinoma. There were no major complications such as orocutaneous fistula, carotid artery blowout, or wound breakdown. Fifty percent of the patients are alive without evidence of disease. By introducing a nonirradiated blood supply with the myocutaneous flap, re‐irradiation by brachytherapy is possible without significant complications. It is recommended that the use of intraoperative brachytherapy with125I seeds be entertained when surgery is indicated for advanced or recurrent oral or oropharyngeal cance

ISSN:0148-6403    

DOI:10.1002/hed.2890100709

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

年代:1988

数据来源: WILEY

摘要:

AbstractPrevious studies on the carcinogenesis of radiotherapy for head and neck tumors have been conflicting. A series of 1,856 head and neck cancer patients was classified into three groups based on treatment: 1) surgery alone, 2) surgery with pre‐ or postoperative radiotherapy, or 3) radiotherapy alone. Patients who were followed‐up for longer than 5 years were used to compare the incidence of multiple primaries among the three groups. The overall incidence of multiple primary head and neck malignancies in this study was 9%. There was no significant difference in the incidence of multiple primaries in the groups treated by surgery alone versus the combined surgery and radiotherapy group. In this study, radiotherapy appeared neither to protect against nor induce multiple primaries within head and neck radiation port

ISSN:0148-6403    

DOI:10.1002/hed.2890100710

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

年代:1988

数据来源: WILEY

摘要:

AbstractThis is an analysis of 32 patients with chemodectomas arising in temporal bone structures who were evaluated and treated at the University of Florida between February 1964 and December 1984. The follow‐up ranged from 2 to 18 years, with 24 patients (75%) having greater than 5 years of follow‐up. The tumors were staged according to the presence or absence of bone or cranial nerve involvement. Twenty‐five patients were treated for de novo lesions as follows: 6 patients with early lesions were managed with surgery alone, 15 patients with radiotherapy alone, and 4 patients with surgery followed by postoperative radiotherapy. Seven patients were seen for the management of recurrent chemodectomas after initial surgery (4 patients) or initial surgery plus radiotherapy (3 patients) elsewhere. All patients managed with radiotherapy were treated with megavoltage equipment with doses ranging from 4,000 to 5,000 cGy at 170–180 cGy per fraction. The disease was controlled in all 25 patients who presented with de novo lesions. Local failure occurred in one of seven patients treated for recurrent chemodectomas; this patient was previously managed with surgery and radiotherapy el

ISSN:0148-6403    

DOI:10.1002/hed.2890100711

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

年代:1988

数据来源: WILEY