bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary carcinoma involving the petrous temporal bone
Authors: Liu Fei‐Fei , Keane Thomas J. , Davidson Jean 
Published: February 2007

AbstractBetween 1975 and 1985, 29 patients with the diagnosis of carcinoma of the petrous temporal bone were seen at the Princess Margaret Hospital. Twenty‐seven carcinomas were graded: 13 were well‐differentiated; the remaining 14 were either moderately or poorly differentiated tumors. Fifteen patients were managed with a combination of surgery and radiotherapy, 13 were treated with radiotherapy only, and one patient was treated by surgery alone. Median follow‐up time was 6.1 years, and the 5‐year actuarial local control and cause‐specific survival rates for the entire group were 40% and 50%, respectively. Age greater than 60 years, poor grade of tumor, and involvement of the facial nerve were three significant variables associated with poor outcome. A superior 5‐year actuarial local control was achieved with surgery plus postoperative radiotherapy (54%) compared to other treatment approaches. Based on the results from this review, we would continue to recommend a combined modality approach of surgery followed by postoperative radiotherapy in the management of this rare, but life‐threatening disease.
Relative roles of computed tomography and endoscopy for determining the inferior extent of pyriform sinus carcinoma: Correlative histopathologic study
Authors: Saleh Ezzat M. , Mancuso Anthony A. , Stringer Scott P. 
Published: February 2007

AbstractTen laryngopharyngectomy specimens were dissected to determine the relative accuracy of computed tomography (CT) and endoscopy under anesthesia for evaluating the inferior extent of pyriform sinus carcinoma. Endoscopic examination failed to detect involvement of the pyriform sinus apex in one patient, and considerably underestimated disease at this level in two others; CT accurately predicted the status of the apex in these three and all other patients. Endoscopy underestimated the inferior extent of tumor in six patients; CT revealed the inferior limit relative to the esophageal verge more accurately in all six of these submucosal extensions. Endoscopy revealed one case of mucosal spread to the esophageal verge not demonstrated by CT. Endoscopy and CT were both correct in revealing the esophageal verge to be involved (one case) and free of disease (two cases). This study also confirmed a common tendency of pyriform fossa cancer to spread through thyrohyoid membrane adjacent to the course of superior laryngeal neurovascular bundle (six cases). High‐resolution CT, in experienced hands, is a useful adjunct to endoscopy for detecting submucosal, inferior extension of pyriform sinus carcinoma. This information can influence the choice of the lower margin of resection and method of pharyngeal reconstruction.
Actinomycosis of the tongue: A diagnostic challenge
Authors: Ficarra Giuseppe , Di Lollo Simonetta , Pierleoni Felicita , Panzoni Enrico 
Published: February 2007

AbstractActinomycotic infections of the cervicofacial area are rare and frequently show a confusing clinical picture. We report a case of actinomycosis that mimicked a neoplasm of the tongue. The clinical and pathologic features and the differential diagnosis of this unusual oral infection are discussed.
Metastatic head and neck carcinoma in a percutaneous gastrostomy site
Authors: Meurer Michael F. , Kenady Daniel E. 
Published: February 2007

AbstractTwo unusual cases of metastatic head and neck carcinoma to the exit site of a percutaneous endoscopic gastrostomy (PEG) tube are reported. These patients presented with squamous cell carcinomas of the supraglottic larynx and oropharynx. In both patients, a PEG tube was inserted using the “pull” technique prior to any extirpative measures. Within 9 months after surgical treatment, each patient was diagnosed with metastatic squamous cell carcinoma at the PEG tube exit site. A review of the literature revealed three cases of metastatic head and neck neoplasms to a PEG site and a single case report of spread to the wound of an “open” gastrostomy. The hematogenous route is the probable mechanism of metastasis, but direct implantation cannot be dismissed. Until further data become available, the authors recommend that, when possible, PEG tube placement using the “pull” technique be deferred until after extirpation of head and neck tumors.
Reconstruction of extensive defects of the cranium using free‐tissue transfer
Authors: Potparić Zoran , Starović Borisa 
Published: February 2007

AbstractFourteen patients with large tissue deficits in the calvarium and orbits were reconstructed using microvascular free‐tissue transfer (15 flaps). The etiology of these defects was skin neoplasms (seven), osteomyelitis (four), burn (two), and trauma (one). The free flaps used were the latissimus dorsi muscle flap with a split‐thickness skin graft (seven), latissimus dorsi myocutaneous flap (two), rectus abdominis myocutaneous flap (three), radial forearm fasciocutaneous flap (two), and split‐iliac crest flap (one). There was one postoperative death, one flap failure, two recurrences of neoplasm, and one loss of bone grafts and flap from infection. The free flaps can offer good results in patients undergoing wide resection in the cranium and orbits providing immediate repair with acceptable cosmetic result, minimized morbidity, and short hospitalization. However, immediate reconstruction following tumor resection carries a danger of positive margins discovered on permanent histologic sections or the difficulty in detecting recurrence underneath a bulky free flap.
Predictors of neck node control in radically irradiated squamous cell carcinoma of the oropharynx and laryngopharynx
Authors: Varghese Cherian , Sankaranarayanan R. , Nair Balakrishnan , Nair M. Krishnan 
Published: February 2007

AbstractCases of squamous cell carcinoma (171) of the oropharynx and laryngopharynx with clinically positive neck nodes, treated primarily by radiotherapy, were used for a multivariate analysis of the factors related to the regional outcome. All patients were staged according to the UICC‐TNM (1982) classification. Lymph node size (P < 0.01), TNM nodal category (P < 0.05), and stage of the disease (P < 0.05) were significant in univariate analysis. Patient‐ and disease‐related factors (age, sex, and histology) and treatment related factors (radiation dose (5000–6000 rads), radiation schedule, and concurrent chemotherapy) did not reach statistical significance. The stepwise logistic regression resulted in a final model with node size as the most important predictor of neck node control (P < 0.01). Patients with neck nodes up to 1 cm can receive radical radiotherapeutic management for treating the primary as well as nodal disease.
Cisplatinum–epirubicin chemotherapy for advanced unresectable squamous cell carcinoma of the head and neck
Authors: Maipang Tanaphon , Watanaarepornchai Somchai , Panjapiyakul Chingyiam , Totemchokchyakarn Piya 
Published: February 2007

AbstractTwenty‐seven patients with locally advanced unresectable squamous cell carcinoma of the head and neck were offered three courses of cisplatinum and epirubicin. The purpose of this study was to evaluate the effectiveness of this chemotherapy regimen. Subsequent therapy included surgery when feasible and/or radiation therapy. Eighteen patients completed three courses of chemotherapy. Three had a complete response and 14 a partial response. Nine patients refused chemotherapy before treatment was completed. Overall response rate was 63%. Among responding patients, the initial favorable response to chemotherapy was apparent after the first course of chemotherapy. A moderate degree of nausea, vomiting, anorexia, and alopecia were the most common toxicities. Leukopenia grade 3 according to ECOG criteria (WBC 1,000–2,000/mm3) was found in 8(44%) of the 18 patients completing treatment. There was no cardiac toxicity. This regimen appears to be an effective induction chemotherapy for advanced unresectable head and neck cancer with acceptable side effects. Subsequent therapy with surgery and/or radiation can give long‐term local control of disease in some patients. In a selected group of patients with smaller tumors, this treatment should have a better response rate and a favorable effect on survival. Phase III studies using this regimen should be carried out.
Functional facial nerve weakness after surgery for benign parotid tumors: A multivariate statistical analysis
Authors: Mra Zan , Komisar Arnold , Blaugrund Stanley M. 
Published: February 2007

AbstractA retrospective study was done on 64 patients who underwent superficial or subtotal parotidectomy for a primary benign tumor of the parotid gland. Factors, such as age, sex, smoking, alcohol consumption, type of surgery, duration of surgery, pathology of lesion, and size of lesion, were reviewed in a multivariate statistical analysis to determine if any factors alone or in combination contributed to the development of functional facial nerve weakness postoperatively. Only the age of the patient was found to have a statistically significant causal relation using the Pearson chi‐square method (p = 0.015). The marginal mandibular branch was affected in nine of 10 cases. Different surgical approaches cited in the literature are discussed, along with the possible role of ischemic injury to the facial nerve during parotidectomy.
Surgical strategies for differentiated carcinoma of the thyroid isthmus
Authors: Sugenoya Akira , Shingu Kiyoshi , Kobayashi Shinya , Masuda Hiroyuki , Takahashi Shozo , Shimizu Tadahiro , Onuma Hiroshi , Asanuma Kazuhiko , Ito Nobuo , Iida Futoshi 
Published: February 2007

AbstractThe postoperative outcome (including clinicopathologic features) in 19 patients with differentiated thyroid cancer of the isthmus was investigated to develop more appropriate surgical strategies for these lesions. The extent of thyroidectomy, including neck dissection, tumor size, nodal involvement, and other clinical features were evaluated. The incidence of intraglandular dissemination was about 16% in all patients. Analysis of regional node metastatic distribution revealed no definite metastatic pattern. In addition, there was no apparent correlation between tumor size and nodal involvement. Two of the six patients who underwent total thyroidectomy suffered permanent postoperative hypoparathyroidism. It is thus recommended that isthmusectomy, including an adequate edge of surrounding normal thyroid tissues of each lobe and modified or limited neck dissection when cervical nodes are palpably enlarged is sufficient as an appropriate primary surgical procedure for differentiated carcinoma of the thyroid isthmus.
Retropharyngeal leiomyoma: Case report and review of the literature
Authors: Dharnidharka Vikas R. , Bahl N. K. , Kandoth Pravina W. , Kamath Jayashri R. , Vengsarkar Umesh S. 
Published: February 2007

AbstractAn 8‐year‐old girl was initially seen with dyspnea, drooling of secretions, and loss of weight. A large mass was seen protruding through the posterior pharyngeal wall, which was found to be a leiomyoma after excision. No previous case report exists of a retropharyngeal leiomyoma.
Primary and salvage surgery for cancer of the tonsillar region: A retrospective study of 120 patients
Authors: Gehanno Pierre , Depondt Joël , Guedon Charles , Kebaili Cheidli , Koka Venkata 
Published: February 2007

AbstractThe present series compares results in our head and neck department from primary and salvage surgery for tumors of the tonsillar region from 1978 to 1985. Of 120 consecutively admitted patients, 70 underwent primary surgery followed by irradiation, and 50 underwent salvage surgery after the failure of primary radiotherapy. Follow‐up has been continued for the past 6 years. Musculocutaneous flaps were employed in all patients requiring them after the introduction of this reconstructive technique in 1981. The actuarial survival rate after primary surgery was 58% at 3 years and 46% at 5 years. For salvage surgery the figures were 38% and 24%, respectively. This disappointing survival rate in salvage surgery resulted from a higher postoperative mortality (8% versus 1.4% in primary surgery) and from a higher local failure rate (36% versus 14%). The outcome was invariably unfavorable when tonsillar tumors extended into the base of the tongue.
Olfactory neuroblastoma: The results of modern treatment approaches at the University of Michigan
Authors: Zappia John J. , Carroll William R. , Wolf Gregory T. , Thornton Allan F. , Ho Laurence , Krause Charles J. 
Published: February 2007

AbstractA retrospective study was undertaken to review patterns of treatment and survival for patients with olfactory neuroblastomas at the University of Michigan since the introduction of craniofacial resection in the late 1970s. Recent results were compared to previous reports. Disease‐free and overall survival for patients with Kadish stage B tumors were unchanged from prior years. Improvement in both disease‐free intervals and overall survival was evident for patients with stage C tumors. Interestingly, in two patients with “unresectable” local disease, complete responses to induction chemotherapy followed by radiotherapy were noted.
Intravenous fluid administration and urine output during radical neck surgery
Authors: Priano Lawrence L. , Smith James D. , Cohen James I. , Everts Edwin E. 
Published: February 2007

AbstractThis study examines perioperative urine output (UO) and hemodynamics in 24 patients who underwent radical head and neck surgery. The hypothesis tested was that “UO was not important in patients with normal renal function as long as hemodynamics were maintained.” Intraoperatively, a “wet” group (13 patients) had generous amounts of intravenous (IV) fluid administered during surgery receiving 1,018 ± 58 mL ± h−1. The other “dry” group (11 patients) had fluids restricted to 426 ± 23 ± h−1. The intraoperative UOs for the wet and dry groups were 1.33 ± 0.27 and 0.39 ± 0.10 mL ± kg−1 ± h−1, respectively (p < 0.05). Postoperatively, the UOs for the wet and dry groups were 1.9 ± 0.3 and 1.1 ± 0.1 mL ± kg−1 ± h−1, respectively (p < 0.05). Perioperatively, there were no statistically significant differences between groups in systemic or pulmonary hemodynamics. Postoperatively, ordinary indices of renal function remained normal in both groups. We conclude that intraoperative oliguria due to moderate fluid restriction is not detrimental to renal outcome as long as systemic hemodynamics are maintained. Furthermore, not only does this relatively “dry” status not compromise hemodynamics, it affords the patient other benefits.
Innervation of the trapezius muscle by the intra‐operative measurement of motor action potentials
Authors: Soo Khee‐Chee , Strong Elliot W. , Spiro Ronald H. , Shah Jatin P. , Nori Subhadra , Green Ronald F. 
Published: February 2007

AbstractAlthough the surgical anatomy of the spinal accessory nerve and the cervical plexus has been extensively described, the exact motor innervation of the trapezius has been controversial. Attempts to resolve this question have involved anatomic or electrophysiologic studies in human embryos and animals. Extrapolation of the results to adult humans may not be correct. Accurate identification of muscle innervation is obtainable by intra‐operative measurement of motor action potentials produced by direct stimulation of the accessory nerve and the cervical plexus. The study involved 14 patients undergoing supraomohyoid or modified neck dissections. Under direct vision, stimulating electrodes were placed on the identified nerves and motor action potentials, and latencies were recorded by surface electrodes placed over the three portions of the trapezius. In 13 patients, when the accessory nerve was stimulated, motor action potentials were obtained in 13 of 13 in the first portion, 11 of 13 in the second portion, and 10 of 13 in the third portion of the trapezius. In the last patient, the accessory nerve ended in the sternocleidomastoid muscle, and innervation of the trapezius was via C3 as demonstrated by motor action potentials. Responses when the roots of the cervical plexus were stimulated varied. Three patterns were seen: In the first group (seven patients), motor action potentials were distinct from those recorded when the accessory nerve was stimulated. Additionally, latencies were different from those of the accessory nerve. The second group (four patients) had motor action potentials that were similar to those obtained from stimulation of the accessory nerve, although their corresponding latencies were different. In two patients, no motor action potentials were recorded when the cervical plexus was stimulated. The results suggest that motor innervation of the trapezius is variable. The accessory nerve, when present, provides the most important input to the trapezius. Motor innervation from the cervical plexus is unpredictable, although it appears to be present in the majority of patient studies.
Tumor markers in the diagnosis and follow‐up of head and neck cancer: Role of CEA, CA 19‐9, SCC, TK, and dttpase
Authors: Walther Eberhard K. , Dahlmann Nicolaus , Gorgulla Harald T. 
Published: February 2007

AbstractThe clinical relevance of the carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19‐9, squamous cell carcinoma antigen (SCC), thymidine kinase (TK), and deoxythymidine‐5′‐triphosphatase (dTTPase) as tumor markers in the diagnosis and follow‐up treatment of 26 patients with head and neck cancer is evaluated. Serum levels prior to treatment were found elevated just above the upper limit of normal in 46% (SCC), 15% (CEA), 12% (CA 19‐9), 27% (TK), and 39% (dTTPase) of all patients. If all markers were taken into account, they were elevated in 73% of the untreated patients. However, only in a few cases were the tumor marker values elevated significantly (8%–12%). No significant correlation was detected between serum levels and tumor localization, staging, grading, or performance status for any of the markers. In the follow‐up none of the markers tested revealed any disease‐related information despite therapy variation. Patients with originally elevated marker levels showed decreasing and in some cases increasing values after primary therapy, although no tumor recurrence was detected. Even considering the results as preliminary due to the rather small sample size, they suggest that the routine assessment of CEA, CA 19‐9, SCC, TK, and dTTPase serum levels is of limited practical value.
Basic science reviews: Immunomodulation therapy for squamous cell carcinoma of the head and neck
Authors: Lee Norris K. , Cortesina Giorgio , De Stefani Antonella , Sacchi Manuela , Rosso Stefano , Galeazzi Emanuela 
Published: February 2007

AbstractThe role of the immune system in the pathogenesis and treatment of cancer is currently a popular area of research. An underlying fundamental concept of cancer immunology is the supposition that tumor cells express antigens differently than normal cells, both qualitatively and quantitatively. Understanding tumor–host interactions may suggest opportunities to modify these relationships to obtain antitumor effects. There is growing evidence that the immune system plays an important role in the pathogenesis of squamous cell carcinoma of the head and neck (SCCHN).1‐4 Based on this evidence, trials studying the therapeutic efficacy of biologic response modifiers (BRMs) have been undertaken. These trials have had variable success, but continued efforts incorporating newer cytokines are underway.
Carcinoma of the tonsillar region: A multivariate analysis of 243 patients treated with radical radiotherapy
Authors: Lee W. Robert , Mendenhall William M. , Parsons James T. , Million Rodney R. , Cassisi Nicholas J. , Stringer Scott P. 
Published: February 2007

AbstractBetween October 1964 and June 1990, 243 patients with squamous cell carcinoma of the tonsillar region were treated with continuous‐course radical radiotherapy at the University of Florida. All patients had a minimum 2‐year follow‐up. Patients were staged according to the AJCC system; stage IV was stratified into two subsets: favorable, IVA (T1‐T3 or N2A‐N3A); and unfavorable, IVB (T4 or N3B). The initial and ultimate local control rates (including surgical salvage) according to T stage were as follows: T1, 87% and 100%, T2, 79% and 92%; T3, 71% and 76%; and T4, 44% and 48%. Multivariate analysis demonstrated that anterior extension of the primary tumor (p = .0001) and T stage (p = .014) were the most significant parameters affecting local control after radiotherapy. For T4 lesions, twice‐daily irradiation significantly improved local control (p = .04). The 5‐year absolute and cause‐specific survival rates as a function of modified AJCC stage were as follows: 1, 37% and 100%; 11, 55% and 90%; 111, 55% and 85%; IVA, 35% and 60%; and IVB, 23% and 38%. The probability of a severe complication was 3% for the entire group of patients.
Pretreatment neck node biopsy, distant metastases, and survival in nasopharyngeal carcinom
Authors: Leung S. F. , Teo Peter M. L. , Foo William W. L. , Van Hasselt C. A. , Shiu Wesely C. T. , Ting C. L. , Lau Joseph T. F. 
Published: February 2007

AbstractPretreatment neck node biopsy had been performed on 50 of 422 patients who had cervical node metastases from nasopharyngeal carcinoma when initially seen. Multivariate analysis using the Cox proportional hazards model shows that pretreatment node biopsy is not a significant determinant of distant metastases, survival, or recurrence in the neck. Results of similar studies are reviewed and the role of pretreatment node biopsy in nasopharyngeal carcinoma discussed.
Base of tongue carcinoma: Patterns of failure and predictors of recurrence after surgery alone
Authors: Foote Robert L. , Olsen Kerry D. , Davis Dean L. , Buskirk Steven J. , Stanley Robert J. , Kunselman Susan J. , Schaid Daniel J. , Desanto Lawrence W. 
Published: February 2007

AbstractBetween January 1971 and December 1986, 55 patients with squamous cell carcinoma of the tongue base underwent complete surgical resection with curative intent. No preoperative or postoperative adjuvant therapy was administered. The study group consisted of 41 men and 14 women (median age 61 years). All patients were followed until death (39 patients) or for a median of 9.4 years. Local control at 5 years was 74%. No predictors of local recurrence were discovered. Control in the dissected neck at 5 years was 68%. Control of cancer above the clavicles at 5 years was 48%. Distant metastases developed in 14% of the patients by 5 years. Cause‐specific survival at 5 years was 65%. A Cox multivariate regression analysis revealed that pathologic N stage was the only significant independent predictor of recurrence in the dissected neck, recurrence above the clavicles, and cause‐specific survival. The 5‐year overall survival was 55%. Surgical mortality was 4%.