摘要:

In operative treatment of extensive tumors of the lateral oropharyngeal region a combination of hemimandibulectomy and radical neck dissection (composite operation) is often necessary. The morphological and functional effects of hemimandibulectomy on the remaining temporo-mandibular joint are examined by clinical and radiological studies in 7 cases. Immediately after operation the patient will have problems with feeding, speech, adaptation of the prosthesis, occlusion and articulation. However, compensation will develop to a large extent. From our late results we conclude that these difficulties are so small that plastic reconstruction of the removed mandible does not appear urgent. Postoperative irradiation should always be undertaken, if the histology of the tumor proves to be radiosensitive, regardless of the complications for a later plastic reconstruction. The postoperative deviation of the mandible is reduced in edentulous patients with the help on an inclined plane. If the teeth are preserved, postoperative fixation with elastic ligatures is done as soon as possible in order to adjust slowly the position of the mandible to achieve central occlusion.

ISSN:0301-1569    

DOI:10.1159/000274966

出版商:S. Karger AG    

年代:1971

数据来源: Karger

摘要:

Reconstructive surgery of the esophagus with delto-pectoral flap. The use of the delto-pectoral flap in the reconstructive surgery of the esophagus is demonstrated. One flap was used for the one-stage reconstruction of the cervical esophagus. For large defects including the intrathoracal esophageal portion two flaps have been successfully employed. The delto-pectoral flap has shown an ideal vitality and reliability.

ISSN:0301-1569    

DOI:10.1159/000274967

出版商:S. Karger AG    

年代:1971

数据来源: Karger

摘要:

The diagnosis of primary malignant epithelial cervical nodes is applied to patients having epithelial metastatic ganglions where, despite complete and careful examinations of all systems, it was not possible to discover the primary cancerous focus. Many clinicians think that these tumors arise from epithelial degeneration of bronchial embryonic remnants in the latero-cervical region and group, without any anatomo-pathological proof, the total of these formations under the title of malignant branchioma. While some remnants may exceptionally degenerate, it still remains that the great majority of what one calls malignant branchioma, are nothing more than metastatic ganglions of the neck. This conception based on anatomo-pathological research is so close to reality that some practioners even doubt the existence of malignant branchiomas. During the last 15 years (1954–1969) 558 patients suffering from carcinoma of the oto-rhino-laryngological sphere have been hospitalized and regularly followed by the Geneva oto-rhino-laryngological clinic and polyclinic. Of this important material which we have studied with care, 12 cases (2.1%) of malignant cervical epithelial adenopathies, seemingly primary, were observed. The anatomopathological examination of these cervical tumors revealed in each case the picture of a metastatic invasion of the ganglion. In no case were we able to put in evidence kysts, or embryonic inclusions with or without degeneration. On the other hand, in studying the anatomo-pathological report of branchiogenic or thyreoglossal kysts operated in our clinic during the past 10 years, we found no trace of malignant transformation. Among our 12 patients, 3 (25%) died 8–12 months after the appearance of the first symptoms without having received any treatment. At the autopsy of 2 of them the primary tumor was found once at the level of the cavum, and once at the level of the parotid. The 3 other patients (25%) who received a partial treatment (removal of ganglions or cobalt therapy) died 6–16 months later, and at the autopsy we discovered in 2 cases the primary tumor (tonsil and parotid) while in the 3rd case all research remained in vain. Of the 6 other patients who received a complete treatment (surgery and radiotherapy over large areas), 4 (33%) are alive and present no further symptoms, 2 (17%) died, 1–3½ years after the first symptoms. The primary tumors in the 2 latter patients were found in the thyroid gland and in the bronches. The appearance of the primary tumor during the lifetime of the patienfs as well after the end of the treatment was observed in 2 of our patients. In 1 case it was found at the level of the piriform sinus 1½ years after the first symptoms, and in the other case at the level of the bronchi 3 years after their a

ISSN:0301-1569    

DOI:10.1159/000274968

出版商:S. Karger AG    

年代:1971

数据来源: Karger

摘要:

Although its pathogeny is still debated, the posterior cervical syndrome of Barré-Liéou is today well defined in the clinic. The illness has grown in importance these last years following the multiplication of cases of traumatic origin (whiplash injury). The vertiginous symptoms are, however, often hard to prove, the vestibular examination being often normal and seldom typical. GREINER et al. [1969] have recently described a very simple method to detect a cervical etiology by giddiness. It consists in investigation of the neck torsion nystagmus. The author has examined 50 cases by this method; in 27 cases there was no torsion nystagmus, 23 times it was clearly established and thus ensured and led to therapeutic treatment. The test seems to be most useful in the daily practic

ISSN:0301-1569    

DOI:10.1159/000274969

出版商:S. Karger AG    

年代:1971

数据来源: Karger

ISSN:0301-1569    

DOI:10.1159/000274970

出版商:S. Karger AG    

年代:1971

数据来源: Karger

ISSN:0301-1569    

DOI:10.1159/000274971

出版商:S. Karger AG    

年代:1971

数据来源: Karger

ISSN:0301-1569    

DOI:10.1159/000274972

出版商:S. Karger AG    

年代:1971

数据来源: Karger

ISSN:0301-1569    

DOI:10.1159/000274973

出版商:S. Karger AG    

年代:1971

数据来源: Karger