bluuebunny/crossref_metadata_2025_split huggingface dataset:
Central island myomucosal tongue flap
Authors: Harris Jeffrey P. , Fabian Richard L. 
Published: February 2007

AbstractResection of intermediate‐sized (T2 and T3) lesions of the anterior floor of the mouth is often associated with defects in speech, glutition, and cosmesis despite reconstructive efforts. This paper describes the use of the central island myomucosal tongue flap to reconstruct defects of this size. Since this flap possesses the same vascular characteristics as the myocutaneous flap it offers similar advantages. Experience with seven patients in whom this flap was used suggested that this is a dependable method of anterior floor of mouth reconstruction since there was no evidence of nonviability, delayed healing, or wound breakdown. The advantages of this flap are: (a) it is rapidly developed from easily accessible local tissue, (b) it offers the same reliability as myocutaneous flaps, (c) it causes less disability of articulation and deglutition than other tongue flaps, and (d) it results in no cosmetic deformity.
Squamous cell carcinoma of the maxillary sinus: Analysis of 66 cases
Authors: St.‐Pierre Sylvain , Baker Shan R. 
Published: February 2007

AbstractA retrospective review was performed of 66 patients with squamous cell carcinoma of the maxillary sinus. The majority of patients presented with tumors classified as T3 (31.8%) and T4 (54.5%). Seven (10.6%) patients presented initially with neck metastases and 13 (19.7%) patients subsequently developed regional disease. For the 66 patients studied, the observed 5 and 10 year actuarial survival rate was 27.3% and 20.7% respectively. The presence of cervical metastases, particularly when they developed subsequent to initial therapy, was associated with a poorer survival rate. Five year survival rate for patients without cervical metastases was 32.6% in contrast to 28.6% for patients initially presenting with nodal disease and 7.7% for patients who subsequently developed regional metastases. Overall, 5‐year survival rate for all patients with cervical metastases was 15.0%. A combined treatment regimen (surgery and radiation therapy) appeared to be superior to single modality therapy. A 58.0% observed 5‐year actuarial survival rate was achieved with combined therapy. Surgery or radiation therapy when used alone as a single modality resulted in a 5‐year survival rate of 20.0% and 15.7% respectively.
Postradiation dental extractions: A review of the literature and a report of 72 episodes
Authors: Beumer John , Harrison Richard , Sanders Bruce , Kurrasch Madeline 
Published: February 2007

AbstractThis report outlines our experiences involving 72 episodes of postradiation dental extraction over an 11‐year period. Bone exposures of 3 months or longer developed following 16 of the 72 postradiation extraction episodes (22%). The necrosis rate in the mandible was 29% (13 of 45) and in the maxilla was 11% (3 of 27). The risk of bone necrosis increased when the dose to bone exceeded 6,500 rad, and when 75% or more of the body of the mandible was within the radiation treatment volume. Five of the 13 mandibular bone necroses precipitated by postradiation extractions eventually required radical resection of the affected portion of the mandible. The remaining eight mandibular episodes healed with conservative measures. When possible, given the two above conditions, root canal therapy rather than dental extraction should be employed to resolve mandibular dental infection within the radiation field after radiotherapy.
Correction of cervical esophageal stricture using an axial island cheek flap
Authors: Sasaki Truman M. , Taylor Lloyd , Martin Lynn , Baker Harvey W. , McConnell Donald B. , Vetto R. Mark 
Published: February 2007

AbstractChronic strictures of the cervical esophagus after laryngectomy and radiation therapy pose a difficult problem in reconstructive surgery. Most conventional operations for cervical esophageal reconstruction are not well suited to the treatment of stricture because of lack of mucosal surface, or because of bulky tissues that awkwardly fit around the tracheal stoma. This report describes our experience with a new operation designed to correct this defect. We transposed an island full‐thickness cheek flap, which included an inner lining of mucosa and outer covering of skin. The flap was based on the facial artery and vein, and used as a patch to the stricture area. Normal swallowing and excellent cosmetic appearance were achieved. There has been minor numbness of the corner of the upper lip. This flap has excellent reach, and may have multiple applications to reconstruction problems in the head and neck.
Benign osteoblastoma of the maxillary sinus
Authors: Osguthorpe J. D. , Hungerford G. D. 
Published: February 2007

AbstractBenign osteoblastoma is an uncommon fibroosseous neoplasm with a predilection for the vertebrae and long bones, and a 2‐to‐1 male‐to‐female ratio of occurrence. Peak incidence occurs in the second decade, with 80% of all patients being under 30 years of age. The clinical, radiographic, and histologic presentation of a large maxillary sinus osteoblastoma is reviewed. Preoperative embolization of this vascular neoplasm is advocated.
The lower trapezius myocutaneous flap for head and neck reconstruction
Authors: Dinner Melvyn I. , Guyuron Bahman , Labandter Harold P. 
Published: February 2007

AbstractThe lower trapezius myocutaneous flap has proved to be another useful adjunct in the reconstructive armamentarium of the head and neck surgeon. The flap is based on the descending branch of the transverse cervical artery and vein. Providing these structures are protected during neck dissection, this flap may well become the first consideration of flaps for reconstruction of extensive defects of the head and neck. The flap is safe, reliable, and easy to raise, with constant vascular anatomy. The donor site functional deficit is minimal and the donor site may be closed by direct closure without the necessity of skin graft. Its cutaneous reach and arc of rotation make it a suitable source for skin and muscle replacement for the entire neck, face, and occipital region of the scalp and oral cavity.
Intraarterial chemotherapy for head and neck cancer, part 1: Theoretical considerations and drug delivery systems
Authors: Baker Shan R. , Wheeler Richard 
Published: February 2007

AbstractThe principal objective of regional chemotherapy is tumor cell kill. The rationale for regional delivery is based on the steep dose/response curve exhibited by most antineoplastic agents. Intraarterial (IA) chemotherapy has the potential advantage of increased drug concentration at the tumor site, decreased systemic drug levels, and continuous tumor cell exposure to an antineoplastic agent. Despite these advantages, the use of IA chemotherapy has not been universally accepted. This is in part due to the difficulties associated with establishing and maintaining arterial access. Considerable improvement in the techniques and efficacy of regional therapy for head and neck cancer will be necessary before there is widespread clinical acceptance. These improvements must be based on anatomic and pharmacologic factors that ensure success of regional therapy. In addition, the development of safe, reliable delivery systems will be necessary. Part 1 of this two‐part article will review these factors and discuss delivery systems.
Face lift, part 3: Plication of the superficial musculoaponeurotic system
Authors: Webster Richard C. , Smith Richard C. , Smith Karen F. 
Published: February 2007

AbstractIt is thought that plicating or folding the superficial musculoaponeurotic system (SMAS) upon itself near the ear with permanent sutures will improve and help maintain the results of cheek‐neck lifting of the skin layer alone. Getting proof of this conjecture with controlled studies is difficult in the existing medicolegal climate. However, many years ago, we did carry out a limited study in a few patients in whom plication was performed on one side only. We found that plication does have some relatively long‐lasting effects, particularly in improvement of platysma cording and in elevation and deepening of the cervical angle. Plication is not a substitute for adequate skin and/or fat resection. Because the early improvement in cases with platysma cording was so marked in contrast to the unplicated side, we had to limit the series stringently. As time went by, the differences on the two sides lessened.
Face lift, part 4: Use of superficial musculoaponeurotic system suspending sutures
Authors: Webster Richard C. , Smith Richard C. , Smith Karen F. 
Published: February 2007

AbstractWe describe nonabsorbable sutures running from one or more sites in the superficial musculoaponeurotic system (SMAS), to other sites at a distance, or to fixed sites beyond or deep to SMAS for the purpose of pulling on or suspending the distal selected SMAS sites or changing contours between the suture ends. Our reasons for abandoning some sutures and continuing with others are stated. In face lifting, we still often employ sutures running from the anterior part of the platysma and SMAS back to the sternocleidomastoid fascia. These sutures help prevent platysma “cording” and are useful in the restoration and preservation of a more youthful profile in the neck. Examples and controls are demonstrated. These sutures and the long‐term results of their use have never been shown before. Problems encountered in using suspending sutures are described.
The management of dural tear resulting from mid‐facial fracture
Authors: O'Brien Michael D. , Reade Peter C. 
Published: February 2007

AbstractThis study examines the relative risks and benefits of conservative and surgical management of dural tear secondary to middle third facial fracture and ascertains the type of skull and facial injury most often associated with the development of posttraumatic meningitis. Two projects were undertaken. First, the histories of 247 cases of major middle third facial fracture were reviewed with a recent follow‐up of those patients who also sustained a dural tear. Second, 280 cases of bacterial meningitis were reviewed and particular attention was given to cases of posttraumatic meningitis. Of the 247 cases of middle third facial fractures studied, 43% (107/247) had evidence of a dural tear; of this group, 76 patients were managed conservatively and 31 patients were managed surgically. In the former group, there were three instances of recurrent cerebrospinal fluid rhinorrhea (CFR). In the surgically managed group, 77% (24/31) sustained surgical complications including two cases of posttraumatic meningitis and 21 cases of neurological deficit. Of the 280 cases of bacterial meningitis, 48 patients had sustained dural tear following trauma. The prognosis for posttraumatic meningitis is considerably better than for other forms of meningitis. The preceding trauma involved the vault of the skull in 90% (43/48) of cases, and discrete middle third facial fracture in one case (2.1%). Posttraumatic meningitis followed a previous operative repair in 15% (7/48) of the patients. The results of this study indicate that dural tear subsequent to middle third facial fractures is a different proposition than dural tear subsequent to direct skull trauma. In the former, spontaneous repair most often occurs following reduction and immobilization of the fracture, and surgical repair with its attendant complications is thereby usually not warranted. Spontaneous repair is unlikely to occur where there is gross damage to the anterior cranial fossa, aerocele, significant frontal fracture separate from the facial injury, and in cases of definite persistent or recurrent CFR and late meningitis. In these cases surgical repair is indicated.
Face lift, part 5: Suspending sutures for platysma cording
Authors: Webster Richard C. , Smith Richard C. , Smith Karen F. 
Published: February 2007

AbstractWe describe the technical details used in applying nonabsorbable sutures running from the anterior platysma muscles and/or adjacent fascia back to the fascia just in front of or covering the sternocleidomastoid muscles. These sutures usually pass 1.5–2 cm below the angle of the mandible. Anteriorly, they cover or are attached to the platysma muscles at the level of the cervical concavity or angle. The sutures suspend or draw back the superficial musculoaponeurotic system (SMAS) at this level, preventing some of the anterior displacement of the platysma when it is contracted in normal use. We believe that the sutures have relatively long‐lasting effects and that they delay the early return of “platysma cording” after cheek‐neck lifting. Their application using Reverdin and Keith needles is demonstrated. Differences in technique when submental lipectomy is and is not performed with the lift are shown.
Treatment of tumors involving the anterior cranial fossa
Authors: Jackson Ian T. , Marsh W. Richard , Hide T. A. H. 
Published: February 2007

AbstractThe potential for a tumor of the upper face, either malignant or nonmalignant, to involve the anterior cranial base is often not appreciated. This leads to inadequate preoperative investigation and to surgery performed by the head and neck surgeon without the help of the neurosurgeon. In this way, complete tumor resection may be compromised or delayed. Neither of these situations is desirable. If the potential for anterior cranial fossa invasion is recognized, there should be prior consultation with the neurosurgeon and a combined operative procedure. Exposure of these lesions has considerably improved with experience in congenital craniofacial deformities: this will allow en bloc resection of most pathologies. Immediate reconstruction after resection of non‐malignant tumors is advocated, but in aggressive—particularly in recurrent—malignancies, delayed reconstruction is advised. Careful combined follow‐up with frequent blind biopsies should be carried out as indicated.
An unusual complication of the pectoralis major myocutaneous flap
Authors: Donegan J. Oliver , Gluckman Jack L. 
Published: February 2007

AbstractThe development of myocutaneous flaps has been a major advance in reconstructive surgery of the head and neck. The pectoralis major myocutaneous flap has proven to be the most reliable and versatile for use in this area. There have been several reports of its advantages with few complications noted. This article reports two patients who developed osteomyelitis of the rib in the donor area of the pectoralis major myocutaneous flap. The etiology of this potentially serious complication is discussed and the management is outlined.
Analysis of persistent disease on the ear following mohs surgery
Authors: Robins Perry , Nix Michael 
Published: February 2007

AbstractA retrospective study of 338 patients with malignant lesions of the auricle is presented. The results of treatment using Mohs microscopically controlled surgery and conventional surgical excision are compared and the high incidence of recurrence is stressed. The incidence, etiology, pathology, and subclinical extension of auricular tumors are discussed. The treatment of choice is Mohs microscopically controlled surgery and a plea is made for a more radical therapeutic approach to these often casually treated neoplasms.
A phase II study of cis‐diamminedichloroplatinum and 5‐fluorouracil in advanced upper aerodigestive neoplasms
Authors: Creagan Edward T. , Ingle James N. , Schutt Allan J. , O'Fallon Judith R. 
Published: February 2007

AbstractThirty patients with advanced head and neck cancer of diverse histologies received the combination of cis‐diamminedichloroplatinum (CDDP) (100 mg/m2) and 5‐fluorouracil (5‐FU) (1,000 mg/m2/24 hours × 4 days) at 3–4‐week intervals. Among all study participants, the median time to progression was 3.9 months and the median survival was 7.2 months. Among 20 patients with squamous cell carcinoma, we observed five objective regressions (25%). None of the responders had prior chemotherapy; four had extensive prior radiation therapy. Among 10 patients with non‐squamous cell carcinoma neoplasms, we detected three objective responses (30%). Histopathology of the responding patients included poorly differentiated sarcoma, anaplastic carcinoma, and malignant mixed parotid tumor. Significant gastrointestinal toxicities included moderate‐to‐severe nausea (60%), vomiting (43%), and stomatitis (57%). Leukopenia (< 4,000 cells/mm3) and thrombocytopenia (< 130,000 cells/mm3) affected 78% and 41% of patients, respectively, without sepsis or hemorrhage.
Tracheotomy and inhalation injury
Authors: Sataloff Dahlia M. , Sataloff Robert T. 
Published: February 2007

AbstractIndications for tracheotomy in patients with respiratory burns have been unclear. Much of the literature is inconclusive or misleading. A thorough understanding of the pathogenesis, diagnosis, and therapy of inhalation injury is necessary to understand the role of tracheotomy. A critical review reveals relatively clearcut indications for the use of tracheotomy in inhalation injury, but many unanswered questions. Increased participation by otolaryngologists in burn management is recommended.
Assessment and treatment of neurogenic and non‐neurogenic tumors of the parapharyngeal space
Authors: Ferlito Alfio , Pesavento Gastone , Recher Gianfranco , Nicolai Piero , Narne Surendra , Polidoro Franco 
Published: February 2007

AbstractThe clinical and pathologic findings in eleven cases of parapharyngeal space tumors are described. The anatomy of this area and diagnostic procedures are discussed. Investigations should include a few basic examinations such as sialogram‐computed tomographic (CT) scan, carotid angiogram, and echography. Several surgical approaches are considered in relation to the site and the size of the neoplasm. Prognosis depends on the histologic type of the tumor.
Clinical evaluation and surgical treatment of hemangiomata
Authors: Pitanguy Ivo , Caldeira Alberto M. L. , Calixto Carlos Alberto , Alexandrino Adelson 
Published: February 2007

AbstractWe report on the histologic and anatomopathologic aspects of cutaneous hemangiomas, stressing the involutive and noninvolutive aspects of these malformations. We analyze its clinical evolution, approaching the propedeutic and therapeutic methods, and present a detailed commentary on the conservative methodology of a series of 473 consecutive patients, encompassing a follow‐up of 1 to 18 years.
Late sequelae of superficial irradiation
Authors: Hood Ian C. , Young J. Edward M. 
Published: February 2007

AbstractSuperficial irradiation results in well recognized late sequelae including not only sclerosis and atrophy of skin and subcutaneous tissue, but also the development of benign and malignant tumors of skin and adjacent structures. The long latency between irradiation and its late effects allowed the early uncontrolled use of radiation treatment for benign conditions. The subsequent recognition of the causal relationship between tumors and previous irradiation has restricted its use to more appropriate purposes, although it is possible that it is still overused in some areas of dermatologic practice. Clinicians need to be aware of the time interval between irradiation and the development of its late sequelae, and the incidence of these sequelae. Appropriate irradiation exposure history should be a part of the evaluation of every patient.
High resolution computed tomography, Part 1: Soft tissues of the neck
Authors: Swartz Joel D. , Korsvik Holly , Saluk Patricia H. , Popky George L. 
Published: February 2007

AbstractNormal and pathologic anatomy of the soft tissues of the neck is clearly delineated with high resolution computed tomography (CT). The CT densities of soft tissues, fat, and enhanced blood vessels are strikingly different from each other and, therefore, mass lesions are clearly discernable. Often, a histologic diagnosis may be suggested with a high level of confidence based on the location and tissue characteristics.
Pilomatrixoma of the head and neck
Authors: Toback Jeffrey M. , Hoover Larry A. , Dudley James P. 
Published: February 2007

AbstractPilomatrixoma is an uncommon neoplasm which occurs most frequently in the head and neck region. It usually presents as a slowly growing dermal or subcutaneous mass. Unfamiliarity with this lesion may lead the physician to mistake it for more common infectious or neoplastic processes. Most pilomatrixomas are benign and are adequately treated by local excision. Since a spectrum of clinical and histologic aggressiveness (pilomatrixoma carcinoma) has been noted in some lesions, a more aggressive surgical approach for such tumors is recommended. Two patients with pilomatrixoma are presented to emphasize the diagnostic confusion that can occur.
The incidence of hypercalcemia in squamous cell carcinoma of the head and neck
Authors: Dorman E. B. , Yang H. , Vaughan C. W. , Hong W. K. , Strong M. S. 
Published: February 2007

AbstractHypercalcemia is a well‐recognized phenomenon in squamous cell carcinoma of the head and neck, but the incidence of hypercalcemia in this group of patients is not clear. We have reviewed the records of 166 patients with squamous cell carcinoma of the head and neck presented at the Boston VA Medical Center over a 2‐year period (October 1981 to September 1983). Hypercalcemia (> 11 mg/dl), for which a benign etiology could not be identified, occurred in the clinical course of seven patients (4.2%). Of the hypercalcemic patients, 5/7 (71.4%) had advanced stage IV disease and serum calcium levels ranging from 11.2 to 15 mg/dl at presentation. The incidence of hypercalcemia in this stage IV group was 5/78 (6.4%). On the basis of concomitant serum alkaline phosphatase, x‐ray films, and radionuclide bone scans in these patients, bone metastases or a humoral factor were felt to be the etiologic agent. Six of the seven patients died within 77 days of the onset of the hypercalcemia despite vigorous antihypercalcemic and chemotherapeutic measures, and the remaining patient is under chemotherapy at present. We conclude that hypercalcemia is a late manifestation of advanced squamous cell carcinoma of the head and neck and is an ominous prognostic sign. Hypercalcemia without bone metastases is presumably due to the production of ectopic parathormone (PTH)‐like substances from the tumor. To control this hypercalcemia, the underlying tumor must be treated vigorously in conjunction with symptomatic treatment. It should be noted that of 166 patients not all have been followed to the end stage of their disease and, thus, the true incidence of hypercalcemia may be slightly higher than 4.2%.
Plexiform ameloblastoma of the maxilla with extension to the skull base
Authors: Komisar Arnold 
Published: February 2007

AbstractAmeloblastomas are locally invasive benign tumors believed to originate from the developing dental lamina. Maxillary ameloblastomas are rare, comprising only 20% of all ameloblastomas. Of these, 90% arise posterior to the canine tooth. As tumors of the posterior maxilla grow slowly, symptoms are few until the tumor has reached considerable size. At the time of presentation there may be evidence of extension into anatomic areas adjacent to the posterior maxilla. Hemimaxillectomy through wide surgical exposure has the best chance of achieving tumor control. However, once the tumor has extended beyond the confines of the maxilla the prognosis for control of the disease is poor.