bluuebunny/crossref_metadata_2025_split huggingface dataset:
Histocytologic grading of mucoepidermoid carcinoma of major salivary glands in prognosis and survival: A clinicopathologic and flow cytometric investigation
Authors: Hicks M. John , El‐Naggar Adel K. , Flaitz Catherine M. , Luna Mario A. , Batsakis John G. 
Published: February 2007

AbstractBackground. Controversy exists regarding the role of a 3‐tiered grading system for mucoepidermoid carcinoma (MEC) of salivary glands in prognosis and survival. This retrospective investigation evaluated a 3‐tiered grading system modified from Healey by Batsakis and Luna and compared various clinical, pathologic, and flow cytometric parameters and overall survival among MECs of differing grades.Methods. Forty‐eight patients with 7 low‐grade (LG), 23 Intermediate‐grade (IG), and 18 high‐grade (HG) MECs of parotid (n = 43) and submandibular (n = 5) glands were studied. Data were analyzed using categorical statistics (Wilcoxon, Kruskal‐Wallis and Chi‐squared tests where appropriate).Results. Mean ages were 42 years for patients with LG tumors; 47 years, IG; and 59 years, HG (p = 0.02). Gender ratio (p < 0.001) changed from female predominance in LG (6 F:1 M) and IG (2.1 F:1 M) to male predominance in HG (3.5 M:1 F). Mean tumor stage was 1.4 LG, 2.4 lG, and 3.6 HG (p < 0.005). Tumor size increased from 2.1 cm for LG to 3.8 cm for HG (p = 0.01). Margins were involved by tumor in 0% LG, 44% IG, and 61% HG (p < 0.001). Lymph node involvement was 0% LG, 22% IG, and 72% HG (p < 0.001). DNA aneuploidy (DNA index < 0.9 or > 1.1) was present in 0% LG, 13% IG, and 28% HG (p = 0.05). Proliferative fraction (S + G2M) was 5% LG, 7% IG, and 13% HG (p = 0.008). Radiotherapy was administered in 14% LG, 35% IG, and 61% HG (p = 0.03). Recurrences (local and/or metastatic) occurred in 0% LG, 39% IG, and 61% HG (p = 0.009). Survival was decreased significantly (p < 0.0001) with increasing tumor grade (100% LG, 70% IG, and 22% HG).Conclusion. Histologic grading of mucoepidermoid carcinomas of major salivary glands, using the modified Healey 3‐tiered system, correlates well with clinical, pathologic, and flow cytometric factors which influence the prognosis and overall survival in affected individuals. © 1995 Jons Wiley & Sons, Inc.
Radiotherapy for merkel cell carcinoma of the skin of the head and neck
Authors: Suntharalingam Mohan , Rudoltz Marc S. , Mendenhall William M. , Parsons James T. , Stringer Scott P. , Million Rodney R. 
Published: February 2007

AbstractBackground. Merkel cell carcinoma is a relatively rare neuroendocrine carcinoma of the skin. It arises in the head and neck region in approximately 50% of cases. Its aggressive behavior predisposes patients to local‐regional recurrence and distant metastases after surgical excision alone. In this article, we describe our experience with Merkel cell carcinoma of the head and neck.Methods. Of 18 patients with Merkel cell carcinoma treated in the Department of Radiation Oncology at the University of Florida, 12 patients who had primary tumors in the head and neck region are reported. Eight patients were treated at initial diagnosis (group A), and four were treated at the time of local‐regional recurrence (group B).Results. Local‐regional control was achieved in seven of eight patients in group A and all four patients in group B. One patient in group A and all patients in group B developed distant metastases and eventually died of their disease. Bone exposure developed in one patient, requiring surgical debridement and hyperbaric oxygen treatment.Conclusion. Patients with Merkel cell carcinoma of the head and neck should be treated aggressively. Our data suggest that local‐regional recurrence is a harbinger of distant metastases. We recommend that these patients receive treatment to both the primary site and draining lymphatics at initial presentation. The role of chemotherapy remains unclear.
Nonsquamous cell malignant neoplasms of the nasal cavities and paranasal sinuses
Authors: Spiro Jeffrey D. , Soo Kee Chee , Spiro Ronald H. 
Published: February 2007

AbstractBackground. Nonsquamous cell malignant tumors of the nasal cavity and paranasal sinuses are an uncommon and diverse group of neoplasms. Our goal was to define the relative frequency and distribution of these neoplasms, as well as treatment and outcome.Methods.This retrospective study analyzed 106 patients with nonsquamous cell malignant neoplasms of the nasal cavity and paranasal sinuses treated at our institution between 1966 and 1982.Results. Pathology included: salivary type carcinoma (33 patients); sarcoma (25 patients); melanoma (18 patients); esthesioneuroblastoma (11 patients); lymphoma (11 patients); and anaplastic cancer (9 patients). Most tumors arose in the nasal cavity (50%), followed by the antrum (39%), ethmoidsinus (9%), and frontal sinus (2%). Fifty‐four percent of all patients were treated with surgery alone. Determinate 5‐year and 10‐year cure rates were: esthesioneuroblastoma, 70% and 50%; lymphoma, 45% and 30%; anaplastic, 33% and 25%; salivary, 31% and 18%; sarcoma, 25% and 21%; and melanoma, 19% and 0%.Conclusions. Overall survival for patients with nonsquamous cell malignant neoplasms of the nasal cavity and paranasal sinuses is poor, particularly with follow‐up extended to 10 years. Local recurrence is the major source of treatment failure. We were unable to demonstrate any survival advantage in the group of patients who received surgery and radiotherapy in combination. © 1995 Jons Wiley & Sons, Inc.
Mucosal melanoma of the nasal cavity and paranasal sinuses
Authors: Kingdom Todd T. , Kaplan Michael J. 
Published: February 2007

AbstractBackground. Mucosal melanomas of the nasal cavity and paranasal sinuses are rare and do poorly.Methods. Seventeen patients treated from 1981 to 1993 at a single referral center were retrospectively reviewed.Results. Thirteen patients underwent surgical resection, with seven receiving postoperative radiotherapy. Eight had microscopically negative margins. The actuarial 2‐year and 5‐year survivals for this group of 13 were 67% (8 of 12) and 20% (2 of 10). The local recurrence rate was 85% (11 of 13) and distant metastases occurred in 31% (4 of 13) patients. In the absence of metastatic disease, resection of recurrent tumor correlated with disease‐free intervals ranging from 3 months to 40 months.Conclusions. Those who received postoperative radiotherapy appeared to have done better with increased disease‐free intervals and prolonged survival. Negative surgical margins were not predictive of a more favorable outcome. Surgical resection followed by postoperative radiotherapy is appropriate and resection of recurrent tumor should be considered. © 1995 Jons Wiley & Sons, Inc.
Retropharyngeal adenopathy as a predictor of outcome in squamous cell carcinoma of the head and neck
Authors: McLaughlin Mark P. , Mendenhall William M. , Mancuso Anthony A. , Parsons James T. , McCarty Patricia J. , Cassisi Nicholas J. , Stringer Scott P. , Tart Roger P. , Mukherji Suresh K. , Million Rodney R. 
Published: February 2007

AbstractBackground. Little information about the incidence of retropharyngeal adenopathy and its impact on prognosis has been published.Methods. For 774 patients with squamous cell carcinoma of the nasopharynx, oropharynx, hypopharynx, or supraglottic larynx, pretreatment CT and, in selected cases, MRI scans were reviewed to determine the presence of rotropharyngeal adenopathy. Results were analyzed in 619 patients treated with curative intent to determine the prognostic impact of retropharyngeal adenopathy.Results. The highest incidence of retropharyngeal adenopathy was seen in patients with nasopharyngeal (74%) and pharyngeal wall (19%) cancers. The number of cervical nodal groups involved was the most significant factor (p < .0001) relating to the incidence of retropharyngeal adenopathy. The rates of neck relapse (40% at 5 years) and distant metastasis were significantly higher in patients with retropharyngeal adenopathy, and the rates of 5‐year relapse‐free survival and absolute survival were significantly lower.Conclusions. Retropharyngeal adenopathy is a strong predictor of poor prognosis, particularly for patients with advanced neck disease. © 1995 Jons Wiley & Sons, Inc.
Immunolocalization of desmoglein and intermediate filaments in human oral squamous cell carcinomas
Authors: Imai Kazushi , Kumagai Shigehiro , Nakagawa Kiyomasa , Yamamoto Etsuhide , Nakanishi Isao , Okada Yasunori 
Published: February 2007

AbstractBackground. Information is limited as to how to predict the malignant behavior of the oral squamous cell carcinomas. The invasive and metastatic phenotype of the carcinoma cells may be related to changes in the expression of desmosomal and cytoskeletal proteins.Methods. To investigate the expression of desmoglein, cytokeratins, and vimentin, 22 biopsy specimens of oral squamous cell carcinomas were examined by immunohistochemistry. The data were analyzed by morphometry with reference to the cell differentiation, mode of invasion, and cervical lymph node metastasis.Results. The expression of desmoglein, a major desmosomal glycoprotein, was remarkably reduced in the poorly differentiated, highly invasive, and metastatic carcinomas. Although the immunohistochemical expression of cytokeratins in the carcinoma cells was a good marker for the differentiation status of the carcinomas, the level of expression demonstrated no correlation with tumor invasiveness or lymph node metastasis. On the other hand, the vimentin expression was inversely correlated to the differentiation and mode of invasion, and carcinomas in the metastatic group had significantly higher levels of vimentin expression than the nonmetastatic group.Conclusion. The results suggest that immunohistochemical examination of desmoglein and vimentin in oral squamous cell carcinomas is valuable in evaluating the malignant behavior of tumors. © 1995 Jons Wiley & Sons, Inc.
Langerhans' cell histiocytosis: Head and neck manifestations in children
Authors: Quraishi Muhammad S. , Blayney Alexander W. , Walker David , Breatnach Fin B. , Bradley Patrick J. 
Published: February 2007

AbstractBackground. Langerhans' cell histiocytosis (LCH) is an uncommon, poorly understood granulomatous disease, characterized by the idiopathic proliferation of Langerhan's cells or their marrow precursors. In 1985, the Philadelphia Workshop adopted the term “Langerhans' cell histiocytosis” (LCH) to differentiate it from reactive and neoplastic causes of histiocytosis.Methods. This study includes 73 pediatric patients diagnosed with this condition in Dublin, Ireland, and Nottingham, England, during a 34‐year period (1959 to 1993). These patients are reviewed with respect to clinical presentation, difficulty with making a histological diagnosis, their management, and outcome.Results. A total of 49 patients (67%) had head and neck involvement. Bony involvement was the most frequent sign, most frequently located in the skull. There were 11 deaths (15%) in this series, all associated with multisystem disease, and nine of these deaths were in children younger than 2 years of age.Conclusions. The role of otolaryngologists is important in the early and accurate evaluation, staging, and diagnosis of LCH. It may mimic more common diseases, such as otitis externa, acute mastoiditis, skin rash, gingivitis, or cervical lymphadenopathy. Patients with multisystem disease may be so ill at presentation that the head and neck lesions may be overlooked. The current management of LCH has become increasingly conservative, and in the 1990s, fewer cases are given chemotherapy or radiotherapy. The prognosis is very good for single‐system disease and poor for multisystem disseminated disease with early onset. © 1995 Jons Wiley & Sons, Inc.
Radical, modified, and selective neck dissection for cutaneous malignant melanoma
Authors: O'Brien Christopher J. , Petersen‐Schaefer Karin , Ruark Deborah , Coates Alan S. , Menzie Stuart J. , Harrison Richard I. 
Published: February 2007

AbstractBackground. The roles of modified and selective neck dissections in treating patients with clinical metastatic melanoma and the place of adjuvant radiotherapy are unclear. In the elective setting, the efficacy of various selective dissections also requires clarification.Methods. The prospectively documented experience of the senior author (COB) was analyzed. A total of 175 patients had 183 neck dissections and 92 parotidectomies in 6 years. There were 75 therapeutic and 108 elective operations. Modified or selective neck dissections were performed in 58% of patients with clinical neck metastases. All but two elective operations were modified or selective dissections. Postoperative radiotherapy was given to 27 dissected necks. Minimum follow‐up was 12 months, and 86% of patients were followed up for 2 years or to neck recurrence.Results. Nodes were histologically positive in 80 dissections. The cumulative rate of control of metastatic melanoma in the neck was 86% at 5 years. Neck recurrence developed in 14% of radical dissections, 0% of modified, and 23% of selective dissections performed for clinical disease. Neck recurrence occurred after 5% of elective dissections. Recurrence was 7% among irradiated necks compared to 23% in nonirradiated (p‐value not significant). The 5‐year survival rate was 50%, and this was significantly worsened by increasing node involvement.Conclusions. Modified radical neck dissection is highly effective in controlling metastatic melanoma in selected patients. Selective dissections are less effective and need further study. Adjuvant radiotherapy appears to decrease the risk of neck recurrence. In the elective setting, recurrence is uncommon following the selective neck dissections described.
The QT interval following carotid artery resection
Authors: Rassekh Christopher H. , Dellsperger Kevin C. , Bollen Bruce A. , Hoffman Henry T. , Ricks‐Mcgillin Joan 
Published: February 2007

AbstractBackground. Right radical neck dissection has been shown to prolong the QT interval, reportedly caused by surgical trauma to the cervical autonomic system, which may result in malignant ventricular arrhythmias. Carotid artery resection would be expected to be more likely to cause dangerous arrhythmias.Methods. We prospectively studied eight patients with electrocardiograms before and after carotid resection. Four patients had left‐sided procedures and four patients had right‐sided procedures. In addition, 11 patients were studied retrospectively. QT intervals were normal in all patients preoperatively.Results. Preoperative corrected QT intervals (QTc) were in the normal range used by our institution for all eight patients in the prospective group. There were no significant QTc changes after either left‐sided or right‐sided carotid resection. However, the retrospective group did show significant changes in QTc following right carotid resection (n = 5), but not left resection (n = 6).Conclusions. EKG changes associated with carotid resection may not be uniform and may depend on surgical technique or specific anatomic factors. Controlled prospective studies are needed to confirm the prevalence of QT interval changes in radical neck surgery.
Primary ectopic meningioma of the maxillary sinus: Case report and review of the literature
Authors: Lingen Mark W. , Rao Sambasiva M. , Hutten Mark C. , Pelzer Harold J. 
Published: February 2007

AbstractMethods. A case of a primary ectopic meningioma, arising within the right maxillary sinus, is presented. A review of English literature was also undertaken to determine the prevalence of these lesions in this specific anatomic location.Results. A total maxillectomy was performed without complications and the surgical defect was covered with an immediate obturator. The patient is well and without evidence of disease 3½ years postoperatively. A review of the English literature revealed four additional reports of primary ectopic meningiomas that were limited to the maxillary sinus.Conclusions. Primary ectopic meningiomas of the maxillary sinus are uncommon lesions which have a good prognosis when a complete resection of the neoplasm can be performed. © 1995 Jons Wiley & Sons, Inc.
Folded free radial forearm flap for reconstruction of full‐thickness defects of the cheek
Authors: Savant Dhairyasheel N. , Patel Snehal G. , Deshmukh Sanjay P. , Gujarati Rajesh , Bhathena Hosi M. , Kavarana Naozer M. 
Published: February 2007

AbstractBackground. Full thickness defects of the cheek have been conventionally reconstructed using the folded forehead flap, cervical flap, pectoralis major myocutaneous flap, or deltopectoral flap in various combinations. We report a modified technique of folding the radial forearm flap for reconstruction of full‐thickness defects of the cheek.Methods. The free radial forearm flap is a type C fasciocutaneous flap based on the radial artery along with its vena commitans and superficial forearm vein. The size and shape of the flap are determined according to the dimensions of the surgical defect. The flap is then lifted off with the fascia of the forearm making it a fasciocutaneous flap, in which the radial artery lies deep to the fascia and gives numerous branches. The flap is disconnected from the donor site only after the recipient vessels have been prepared for anastomosis. Vascular anastomosis is then performed using the operating microscope. This technique was used in 13 patients with carcinoma of the buccal mucosa who underwent full‐thickness excision of the cheek.Results. Flap edema was observed in 4 patients in the immediate post‐operative period. Necrosis of the outer paddle was seen in 1 patient. Donor site morbidity was seen in 4 patients who required dressings on an outpatient basis for up to 3 weeks.Conclusion. Single‐stage reconstruction of full‐thickness defects of the cheek with the folded free radial forearm flap is reliable and produces excellent cosmesis with minimal donor site morbidity. © 1995 Jons Wiley & Sons, Inc.
Effect of the Passy‐Muir valve on aspiration in patients with tracheostomy
Authors: Dettelbach Mark A. , Gross Roxann D. , Mahlmann Jeanne , Eibling David E. 
Published: February 2007

AbstractObjective. To assess potential benefit of a Passy‐Muir Speaking Valve (PMV) in decreasing aspiration in patients with a tracheostomy.Background. Many patients with tracheostomy exhibit clinically significant aspiration. It has been previously noted that aspiration can often be reduced or eliminated by plugging or removing the tracheostomy tube. Some patients, however, do not tolerate removal or plugging of their tracheostomy tube, which then leads to persistent aspiration. We postulated that a one‐way speaking valve may restore more normal subglottic and glottic air flow and reduce aspiration.Methods. Alert patients with a tracheostomy and clinical evidence of aspiration were eligible for study. Eleven patients with tracheostomy and known aspiration were studied with a modified barium swallow. Radiographic examination was used to evaluate the presence and amount of aspiration while patients swallowed both with and without a PMV in place on their tracheostomy tube.Results. Aspiration was reduced (or eliminated) during swallowing in all 11 patients when they wore a PMV, when compared to swallowing with an open (unvalved) tube. This improvement was achieved with liquids, semisolids, and pureed consistencies.Conclusion. This study demonstrates that a Passy‐Muir speaking valve facilitated swallow and reduced aspiration in patients with a tracheostomy and known aspiration. © 1995 Jons Wiley & Sons, Inc.
Fatal craniocervical necrotizing fasciitis in an immunocompetent patient: A case report and literature review
Authors: Henrich Douglas E. , Smith Timothy L. , Shockley William W. 
Published: February 2007

AbstractBackground. Craniocervical necrotizing fasciitis (CCNF) is a rapidly progressive, severe bacterial infection of the superficial fascial planes of the head and neck. Group A beta–hemolytic Streptococcus, staphylococcus aureus, and obligate anaerobic bacteria are common pathogens. The disease usually results from a dental source or facial trauma. Extensive fascial necrosis and severe systemic toxicity are common manifestations of CCNF. Recently the lay press has referred to necrotizing fasciitis in several articles about “flesh eating” bacteria, which have resulted in several deaths.Methods. We report the first case of a fatality in an otherwise immunocompetent patient. The patient was a 66‐year‐old black man with no identifiable source of infection and no history or evidence of immunocompromising disorders.Results. Despite aggressive surgical debridement and broad‐spectrum antibiotic coverage, he died 30 hours after admission from multisystem organ failure secondary to overwhelming sepsis.Conclusion. Treatment consists of early recognition of CCNF combined with aggressive surgical debridement and drainage of the involved necrotic fascia and tissue along with broad‐spectrum intravenous antibiotic coverage. Although 11 other fatal cases of CCNF have been previously reported, all had an underlying medical problem which created an immunocompromised state, usually diabetes mellitus or chronic alcoholism. We present a case report and literature review along with a discussion of the related anatomy. © 1995 Jons Wiley & Sons, Inc.
Outcome analysis of Zenker's diverticulectomy and cricopharyngeal myotomy
Authors: Witterick Ian J. , Gullane Patrick J. , Yeung Eugene 
Published: February 2007

AbstractBackground. The optimal management of Zenker's diverticula is controversial in part because of the method of categorizing treatment success or failure. Subjective and objective radiologic tests have been used to evaluate the various treatment modalities. There seems to be poor correlation between subjective and objective findings, and we tested this hypothesis in a group of patients undergoing one form of therapy (diverticulectomy and cricopharyngeal myotomy [CPM]).Methods. Eighteen consecutive patients underwent Zenker's diverticulectomy and CPM. Postoperative symptoms and abnormalities detected by barium esophagrams were evaluated after a mean follow‐up of 30.3 months (range, 7–74 months).Results. Three of 18 patients (17%) complained of dysphagia (2 occasional and not bothersome; 1 bothersome and affecting dietary intake). Postoperative static contrast esophagrams were interpreted without knowledge of the subjective symptoms. Small diverticula were identified in 8 patients (44%). There was poor correlation between symptoms and objective radiographic abnormalities with agreement of 56% and a kappa statistic of 0.23.Conclusions. Objective radiographic abnormalities are far more common than subjective complaints following diverticulectomy and CPM. Postoperative static contrast radiography is not routinely required and may be misleading because of the poor correlation between symptoms and radiographic findings. The value of dynamic videofluoroscopy needs to be evaluated. © 1995 Jons Wiley & Sons, Inc.