ISSN:8756-0437    

DOI:10.1002/ssu.2980070102

出版商:John Wiley&Sons, Inc.    

年代:1991

数据来源: WILEY

摘要:

AbstractLess than 5% of patients with metastatic cervical carcinoma will not have a detectable primary site despite a proper work‐up. Recent aids for these diagnostic problems include fine needle aspiration and immunohistochemical panels to differentiate undifferentiated carcinoma from melanoma and/or lymphoma. CT scanning can suggest areas in the upper aerodigestive tract for biopsy and can be helpful in suggesting the pathology of the enlarged lymph nodes. EBV titers are often elevated when a nasopharyngeal carcinoma is small. Aggressive treatment of the occult primary patient with metastatic melanoma, thyroid cancer, and metastatic cancer presumed to arise from the skin of the head and neck or the mucous membranes of the upper aerodigestive tract is indicated as long‐term survival is often achie

ISSN:8756-0437    

DOI:10.1002/ssu.2980070103

出版商:John Wiley&Sons, Inc.    

年代:1991

数据来源: WILEY

摘要:

AbstractThe various types of neck dissections are described. The indications for each type of neck dissection are discussed for patients with necks staged No, N +, for the patient with an unknown primary and for the patient whose neck dissection is in conjunction with radiation. The technical aspects of modified neck dissections are addressed but not in great detail. The indications for the use of postoperative radiation are emphasized. The nodal groups at risk for metastases from various primary sites are identified and a terminology for neck dissection is suggested.

ISSN:8756-0437    

DOI:10.1002/ssu.2980070104

出版商:John Wiley&Sons, Inc.    

年代:1991

数据来源: WILEY

摘要:

AbstractManagement of the clinically negative neck in patients with carcinoma of the oral tongue remains a complex and controversial subject. While statistical proof of the value of elective neck dissection in tongue cancer remains elusive, the high incidence of occult cervical metastases, even with small primary tumors, and the poor salvage rates and increased incidence of extracapsular spread in cases that have developed palpable adenopathy, provide a logical basis for treatment of the neck in a preclinical stage.

ISSN:8756-0437    

DOI:10.1002/ssu.2980070105

出版商:John Wiley&Sons, Inc.    

年代:1991

数据来源: WILEY

摘要:

AbstractAny swelling near the ear is best considered a parotid neoplasm until proved otherwise. The diagnosis is primarily based on the clinical examination. Imaging studies are best reserved for patients who present with palate or tonsil swellings, which must be distinguished from parapharyngeal or minor salivary gland tumors. Almost all benign, and most malignant parotid tumors can be resected with preservation of the facial nerve. Aspiration biopsy can add useful information, but is not essential for treatment planning as the extent of the surgical procedure is primarily determined by the extent of the tumor. Survival rates in patients with malignant tumors are most significantly influenced by tumor stage. Results seem to have improved in recent years, possibly because we are treating a larger proportion with favorable lesions. Another factor may relate to the enhancement of locoregional control now achieved with postoperative radiotherapy, particularly in patients with Stage III or IV tumors.

ISSN:8756-0437    

DOI:10.1002/ssu.2980070106

出版商:John Wiley&Sons, Inc.    

年代:1991

数据来源: WILEY

摘要:

AbstractWide exposure of the tumors of the base of the tongue and oropharynx can be easily obtained via mandibulotomy, which provides equally good exposure for tumors of the posterior oral cavity and oropharynx. Segmental mandibulectomy can be avoided in patients where the tumor does not invade the mandible or is not in close proximity of the mandible. Preoperative work‐up may include evaluation by means of the fiberoptic telescope to determine the extent of the tumor, examination under anesthesia, panoramic X‐ray of the mandible, CT scan and MRI, as well as dental evaluation. Tracheostomy provides airway during the operation and tracheobronchial access for clearance of pulmonary secretions postoperatively. The technique for median labiomandibuloglossotomy is described, as well as the mandibular swing approach and mandibulectomy. Cosmetic deformity after segmental mandibulectomy is minimal but mandible reconstruction should nonetheless be considered based on the extent of the tumor, tumor control, and the need for postoperative radiation ther

ISSN:8756-0437    

DOI:10.1002/ssu.2980070107

出版商:John Wiley&Sons, Inc.    

年代:1991

数据来源: WILEY

摘要:

AbstractPatients in whom the diagnosis of early carcinoma of the larynx is made and treated as outlined below have a good to excellent outlook (from 85 to 95% survival for glottic lesions). Metastases from lesions of the free edge of the vocal cord usually do not occur because of the paucity of lymphatics, whereas lesions of the supraglottis are more apt to metastasize to regional lymph nodes and local spread. The subglottic area on the other hand by in large has a more ominous prognosis. Carcinoma in situ is treated mainly by endoscopic surgery, whereas T1lesions of the glottis can either be treated by surgery or radiation with comparable results. This author prefers conservation surgery for the majority of T1lesions. Radiotherapy is utilized for selected patients with T1glottic lesions.

ISSN:8756-0437    

DOI:10.1002/ssu.2980070108

出版商:John Wiley&Sons, Inc.    

年代:1991

数据来源: WILEY

摘要:

AbstractRadiation therapy either as a single modality or as part of multimodality plans remains an integral part of curative treatment for cancers of the head and neck. This paper traces the modernization of radiation therapy regarding tumors of the head and neck using examples of sites of malignancy where radiation therapy is the sole modality or where radiation therapy can be combined with surgery and chemotherapy for optimal results. As local‐regional control rates have improved with the use of combined radiation therapy and surgery and aggressive hyperfractionation schemes for advanced primary tumors, distant metastases and second primary neoplasms are now accounting for a larger proportion of treatment failures. Until such time as more effective systemic therapy and cancer control mechanisms are developed to address these problems, radiation therapy will continue to play a major role in the overall management of patients with cancers of the head and nec

ISSN:8756-0437    

DOI:10.1002/ssu.2980070109

出版商:John Wiley&Sons, Inc.    

年代:1991

数据来源: WILEY

摘要:

AbstractToday's reconstruction of head and neck cancer related deformities is based on an in‐depth knowledge of soft and hard tissue repair coupled with the technical ability to transplant and reorient soft and hard tissues into a functional and cosmetic improvement for each patient. The recent advances of (1) the science of bone regeneration, (2) myocutaneous flaps, (3) hyperbaric oxygen, and (4) allogeneic bone cribs have resulted in reconstructions which are now predictable outcomes with few complications and minimal morbidity. This writing will discuss the contribution and mechanism of each of these four advances and how their application can be used to consistently reconstruct even large deformities with both hard and soft tissue loss, as well as in tissues which have been severely radiate

ISSN:8756-0437    

DOI:10.1002/ssu.2980070110

出版商:John Wiley&Sons, Inc.    

年代:1991

数据来源: WILEY

ISSN:8756-0437    

DOI:10.1002/ssu.2980070101

出版商:John Wiley&Sons, Inc.    

年代:1991

数据来源: WILEY