bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complications associated with free jejunal graft reconstruction of the pharyngoesophagus—a multiinstitutional experience with 52 cases
Authors: Gluckman Jack L. , McDonough John J. , McCafferty Gerard J. , Black Robert J. , Coman William B. , Cooney Timothy C. , Bird Russell J. , Robinson David W. 
Published: February 2007

AbstractFifty‐two patients who underwent reconstruction of the pharynx and esophagus using the free jejunal graft were retrospectively reviewed. The complications were categorized into those associated with the resection, those associated with the harvesting of the graft, and those related to the reconstruction per se. In this series, the graft failure rate was 7.6% with an overall success rate of 90.3%. Graft necrosis was found to be the most serious complication occurring in four patients. Methods of detection of graft necrosis and management of these complications are discussed.
A model for staged compression of the vascular pedicle in a porcine myocutaneous flap
Authors: Cummings Charles W. , Trachy Ronald E. 
Published: February 2007

AbstractThere is a need for a laboratory model that would allow assessment of the effects of vascular pedicle compression in the myocutaneous flap. We describe a technique as used in the pig that responds to the needs of technical reproducibility and sequential compromise of vascular flow as measured by laser velocimetry and dermofluorometry.
Unusual anatomic presentations of inverting papilloma
Authors: Astor Frank C. , Donegan J. Oliver , Gluckman Jack L. 
Published: February 2007

AbstractDue to their tendency to recur, and a potential for malignancy, inverting papillomas of the nasal cavity and paranasal sinuses pose a challenge to the head and neck surgeon. Although the majority of these benign neoplasms arise from the lateral nasal wall, middle meatus, and ethmoid complex, they occasionally originate from atypical areas in which Schneiderian membrane is present. Four unusual anatomical presentations of inverting papilloma are presented and discussed.
Midline alopecia reduction combined with hair transplantation
Authors: Unger Martin G. , Unger Walter P. 
Published: February 2007

AbstractThe advantages gained by incorporating alopecia reduction (AR) in patients undergoing hair transplantation, or with patients who have previously had hair transplantation, are delineated. The specific advantages of the midline elliptical pattern are discussed. Clinical considerations that determine whether ARs are necessary are the degree of baldness, laxity of the scalp, age of the patient, and ultimate goal of the individual. The advantages and disadvantages of performing ARs or hair transplantation first are discussed and the new concept of minireductions also outlined.
Medical treatment of male pattern alopecia (androgenic alopecia)
Authors: Tromovitch Theodore A. , Glogau Richard G. , Stegman Samuel J. 
Published: February 2007

AbstractThe causes and potential causes of androgenic alopecia in men and women are discussed. The scientific attempts at reversing this process are detailed including use of estrogen, thyroid, progesterone, and minoxidil. At present, the practical approach for the clinician is to ascertain in females that an androgen overproduction syndrome is not present. A therapeutic trial of topical progesterone at a 2%–5% concentration appears to be reasonable when the physician and patient appreciate the limitations of this approach.
Thyroid carcinoma presenting as a parapharyngeal mass
Authors: Robbins K. Thomas , Woodson Gayle E. 
Published: February 2007

AbstractNodal metastases from occult head and neck primaries presenting as a pharyngeal space mass are unusual. In this report, a patient with dysphagia and a large parapharyngeal mass was found to have metastatic papillary thyroid carcinoma. Although it is common for such tumors to metastasize to regional lymph nodes, to our knowledge, this is the only reported case of a thyroid neoplasm masquerading as a primary parapharyngeal space tumor. It indicates upward lymphatic spread of tumor to involve the lateral retropharyngeal nodes. This pattern of spread is in keeping with Rouviere's description of a direct lymphatic pathway from the posterior surface of the superior thyroid lobe to the lateral retropharyngeal nodes. The case presentation is intended to alert the reader of this possibility and to emphasize the inclusion of regional metastatic nodal disease as a possible cause of parapharyngeal space masses.
Metastases to the larynx
Authors: Batsakis John G. , Luna Mario A. , Byers Robert M. 
Published: February 2007

AbstractEleven cases of metastases to the intrinsic larynx are reported. This number constitutes the largest collection from a single institution in the literature and brings the total recorded cases to 83. Cutaneous melanomas are the preponderant primaries, followed by renal cell carcinomas, and carcinomas of the breast and lung, respectively. The supraglottis is the favored site for the metastatic deposit; the glottis, the least frequently involved area.
Metastatic carcinoma of oral soft tissue
Authors: Zohar Yuval , Ben‐Tovim Reuven , Gal Rivka , Laurian Nelu 
Published: February 2007

AbstractMetastatic carcinomas to the oral region are rare. Most of the lesions are located in the bones of the jaw. The medical literature contains quite a few examples of metastatic lesions located strictly in the oral soft tissue. We present two cases of oral soft tissue metastatic carcinoma of urogenital origin.
The need for elective irradiation of occult lymphatic metastases from cancers of the larynx and pyriform sinus
Authors: Marks James E. , Breaux Sherry , Smith Peter G. , Thawley Stanley E. , Spector Gershon G. , Sessions Donald G. 
Published: February 2007

AbstractThe incidence of palpable and occult cancer and the absence of cancer in lymph nodes were determined for individual sites in the larynx and pharynx of 540 patients who underwent neck dissection. The incidence of palpable cancer in lymph nodes was lowest for cancers of the central supraglottis and transglottis (32–41%), intermediate for cancers of the marginal supraglottis and glossoepiglottis (48–57%), and highest for cancers of the pyriform sinus (69%). The incidence of occult cancer in lymph nodes for individual sites in the larynx and pharynx was determined by pathologic study of neck dissection specimens from 253 patients without palpable lymph nodes (NO neck). The incidence of occult lymphatic metastases in the NO neck and the need for elective neck irradiation were least for cancers of the transglottis and central supraglottis (14–16%), intermediate for cancers of the glossoepiglottis and the marginal supraglottis (20–38%), and greatest for cancers of the pyriform sinus (47%). The risk of nodal recurrence increased from 8% for those without cancer in lymph nodes to 38% for those with occult or palpable cancer in lymph nodes. A policy of observing the NO neck in patients with a low incidence of occult lymphatic metastases and a low risk of neck recurrence to avoid the unnecessary irradiation of many to benefit a few is discussed.
Staffieri's procedure revisited
Authors: Vuyk Hadé , Tiwari Rammohan , Snow Gordon B. 
Published: February 2007

AbstractOur long‐term experience with Staffieri's procedure in 42 patients is presented. Our results were evaulated regarding voice production, aspiration problems, and pharyngocutaneous fistula formation. Approximately 50% of the patients were successfully rehabilitated. Twenty‐five percent of the patients did not use the neoglottis for speech production, mostly because of stenosis of the neoglottis. The remaining 25% had serious aspiration problems that needed treatment. It was striking that half of these patients initially benefitted from the Staffieri procedure and had no aspiration problems. These 42 patients were compared with a group of 43 patients who underwent conventional total laryngectomy in the same period. After total laryngectomy and Staffieri's procedure, >35% of the patients had a pharyngocutaneous fistula, while after conventional total laryngectomy the fistula rate was <20%. The average postoperative stay in the hospital was longer in the Staffieri group. In the long run, the results of this surgical technique do not justify its further use, especially after previous radiotherapy.
False‐positive and false‐negative neck nodes
Authors: Ali Shaukat , Tiwari Ram M. , Snow Gordon B. 
Published: February 2007

AbstractWe report our experience of the incidence of false‐positive (i.e., clinically positive and histologically negative) and false‐negative (i.e., clinically negative and histologically positive) neck nodes and define their relationship to the primary site, T‐stage, and the histologic grade of the primary lesion. Clinical and pathologic records of 255 patients with squamous cell carcinoma (SCC) of the head and neck who underwent 266 radical neck dissections were reviewed. We did not find any relationship between the T‐stage of the primary tumor and the incidence of the false‐positive and false‐negative neck nodes. Regarding the primary site, the benefit of an elective neck dissection is likely to be maximum in oropharyngeal SCC and minimum in supraglottic SCC. The incidence of false‐negative neck nodes was lower in well differentiated primary lesions.
Survival results from a phase III study of simultaneous versus 1‐hour sequential methotrexate—5‐fluorouracil chemotherapy in head and neck cancer
Authors: Browman George P. , Levine Mark N. , Russell Rosemary , Young J. E. M. , Archibald Stuart D. 
Published: February 2007

AbstractThere were 79 patients with squamous cell head and neck cancer randomized to receive simultaneous or 1 hour sequential methotrexate‐5 fluorouracil (MTX—5‐FU) chemotherapy: 47 patients were previously untreated and 32 patients had recurrent disease. The treatment groups were comparable for important prognostic features. The median survival for the 47 newly prsenting patients was 22 months and for recurrent disease patients was 14 months. No difference could be detected in the survival of patients who received simultaneous versus sequential chemotherapy. When only chemotherapy responders were compared, no difference in survival was detected for those who received sequential versus simultaneous therapy. Subsequently, 19 chemotherapy responders received radical radiation therapy, and 15 were rendered disease‐free whereas only 4 of 17 chemotherapy nonresponders were rendered disease‐free by subsequent radiation (P =.002). The survival of the 19 chemotherapy responders was 34 months compared with 16 months for the 17 chemotherapy nonresponders treated with radiation. We conclude that there is no therapeutic advantage for 1 hour sequential MTX‐5 FU chemotherapy compared with simultaneous use of these drugs in squamous cell head and neck cancer. Chemotherapy responders are more likely to respond to radiation therapy.
Pedicled myocutaneous flap of latissimus dorsi muscle for reconstruction of anterior and middle skull defects: An alternative
Authors: Seckel Brooke R. , Upton Joseph , Freidberg Stephen R. , Gilbert Kenneth P. , Murray Joseph E. 
Published: February 2007

AbstractThree cases are presented demonstrating the use of a pedicled myocutaneous flap of latissimus dorsi muscle to reconstruct large defects of the anterior and middle skull after ablative surgery for carcinoma. This method is proposed as an alternative to reconstruction with a free myocutaneous flap in selected patients.
One‐stage total mandibular reconstruction with rib, pectoralis major osteomyocutaneous flap
Authors: Bhathena Hosi , Kavarana N. M. 
Published: February 2007

AbstractOne stage reconstruction of the mandible and lower third of the face with pectoralis major osteomyocutaneous flap incorporating the rib on a muscular pedicle in oral cancer case is described. The composite tissue provides the exact replacement of lost tissues. The technique described replaces adequate mucosa, soft tissue, and bone with minimum functional loss at the donor site. Two ends of the refashioned rib were anchored to masseteric muscle mass and zygoma. This has established functional rehabilitation of chewing, swallowing, and speech in a short period.
Malignant fibrous histiocytoma of the parotid gland associatedwith polycythemia
Authors: van Wingerden Jan J. , van Rensburg Pieter G. , Coetzee Barry P. 
Published: February 2007

AbstractAlthough malignant fibrous histiocytoma (MFH) is thought to be the most common soft tissue tumor of late adult life, it is extremely uncommon in the parotid gland. A case of MFH in the parotid is reported, associated with polycythemia, which remitted following surgical extirpation of the tumor.
Fractures of the sphenoid bone
Authors: Ghobrial Wadie , Amstutz Samuel , Mathog Robert H. 
Published: February 2007

AbstractFractures of the sphenoid bone occur following injury to the orbit and base of the skull. Such fractures are important since they can cause loss of vision and damage to various neural and muscular tissues. Ocular injury is also commonly associated. This paper reviews the hospital records of 112 consecutive patients with fractures of the base of the skull for the cause, frequency of signs and symptoms, and treatment of the sphenoid bone injury. Various deformities and dysfunctions are correlated with imaging data and classified to describe specific clinical syndromes. Several cases of sphenoid bone fracture serve as examples of diagnostic and treatment techniques.
Epiglottitis in immunocompromised patients
Authors: Colman Marc F. 
Published: February 2007

AbstractModern medical oncology has made dramatic improvements in the prognosis of many malignancies. Many of the treatment regimens used by the chemotherapist have the potential to profoundly depress the immune system. At UCLA Medical Center, three patients developed epiglottitis secondary to the fungus Candida albicans, while profoundly immunocompromised. All three had severe pain and odynophagia. The patients were all managed medically and none went on to airway obstruction. The natural history of this process is reviewed.
Surgical treatment of oral cavity carcinoma
Authors: Silver Carl E. , Glackin Brigid K. , Brauer Richard J. , Lesser Martin L. 
Published: February 2007

AbstractNinety‐four squamous cell carcinomas of the oral cavity, treated on the author's service between 1969 and 1981, were evaluated. The series included squamous cell carcinomas of various intraoral sites excluding the lips and hard palate. Survical of 60 mo was 70% for stage I, 65% for stage II, 45% for stage III, and 27% for stage IV carcinoma. Twenty‐four of 34 patients with “early” cancer (stages I and II) were treated by operation alone. Too few patients with “early” cancer were treated by combined irradiation and surgery to draw conclusions regarding relative efficacy of combination therapy. Sixty patients had “advanced” cancer (stages III and IV). Five‐year survival was 37% for patients treated by operation alone, 18% after salvage surgery after failed irradiation, and 60% for patients treated by operation combined with planned perioperative irradiation. Combination therapy appeared to improve control of locoregional disease as well as survival in patients with “advanced” cancer.
Verrucous carcinoma (Ackerman's tumor) of the larynx: Diagnostic and therapeutic considerations
Authors: Lundgren Jan A. V. , Van Nostrand A. W. Peter , Harwood Andrew R. , Cullen Ron J. , Bryce Douglas P. 
Published: February 2007

AbstractVerrucous carcinoma (Ackerman's tumor) is a low‐grade malignant lesion with distinct clinical and pathologic features, distinguishing it from other well‐differentiated squamous cell carcinomas. Much of the confusion surrounding its natural history, response to therapy, and anaplastic transformation may be ascribed to the failure of critically reviewing accepted diagnostic criteria. A series of 44 patients with verrucous carcinoma of the larynx is presented, 18 of these being updated results of previously reported patients. Ackerman's tumor, although not radi‐oresistant, seems less radiosensitive than ordinary squamous cell carcinoma. The tumor's rounded, pushing margins and inability to metastasize would seem to favor endoscopic removal, saving partial laryngectomy procedures for those lesions that cannot be managed endoscopically. Extensive lesions that would require total laryngectomy for complete removal of the tumor should be treated by primary radiotherapy. It is our belief that total laryngectomy should only be performed in large lesions that fail to respond to radiotherapy and whenever medical consideration spreclude partial laryngectomy procedures.
Surgical approach to squamous carcinoma confined to the tongue and the floor of the mouth
Authors: Spiro Ronald H. , Spiro Jeffrey D. , Strong Elliot W. 
Published: February 2007

AbstractThis retrospective study concerns 105 patients treated between 1977 and 1981 who had resections of previously untreated squamous carcinomas that were localized to the oral tongue or the floor of the mouth. Almost 80% had simple peroral excisions. Elective lymphadenectomy was performed in about one‐third, all but one of whom had either T2 or T3 primaries or a surgical approach that involved entry into the neck. The determinate “cure” rate at 24 mo (median follow‐up 50 mo) was 86%. Ninety‐three percent and 78%, respectively, of those with T1 and T2 lesions remained alive and well after conservative operations, which yielded good functional results. Uncontrolled neck disease was evident in 10 of the 13 determinate patients who died as a result of their tumor. Although more of our patients with localized oral cancer now undergo elective lymphadenectomy when the primary is resected, T staging has not accurately predicted which patients are at greatest risk of metastasis. Preliminary data suggest that measurement of tumor depth may be a better way to select those patients who need elective neck therapy.
Acrylic frontal cranioplasty
Authors: Remsen Kenneth , Lawson William , Biller Hugh F. 
Published: February 2007

AbstractThe correction of contour defects of the frontal bone has been accomplished with a variety of autogenous and alloplastic materials. We report our experience in reconstructing 11 cases of congenital, traumatic, and postsurgical frontal defects with acrylic. The acrylic was cured intraoperatively within the defect in some patients, or prefabricated into a prosthesis and wired into position in others. The operative techniques for both methods of repair are detailed. The reconstruction was successful in all cases and there were no complications. The acrylic implant has been found to be well tolerated after 2–10 yr follow‐up. The value of the construction of a facial moulage is stressed, especially when restoration of the orbital rim is required.
Salivary duct carcinoma—A clinicopathologic study of 12 cases
Authors: Afzelius Lars‐Erik , Cameron W. Robert , Svensson Christer 
Published: February 2007

AbstractSalivary duct carcinoma (SDC), a recently defined malignant tumor usually of major salivary glands, has probably been included in the group of adenocarcinomas, NOS. As yet, only a few descriptions of its clinical behavior have appeared. We have found 12 cases of SDC treated at our institution since 1970 and have reviewed their presentation and course. Despite total parotidectomy in most cases and radiotherapy in all, most patients have succumbed to their tumors, six with distant metastases. SDC appears to be a highly malignant tumor requiring aggressive combined therapy for locoregional control. The high incidence of systemic spread indicates a need for effective chemotherapy on an adjuvant basis.
Malignant hemangiopericytoma of the parapharyngeal space
Authors: Robb Peter J. , Singh Sukhpal , Hartley R. B. , Shaheen Omar H. 
Published: February 2007

AbstractHemangiopericytoma is a rare vascular neoplasm, occasionally occurring in the head and neck region. Diagnosis is made histologically, but even then, it is difficult to predict the behavior of the tumor in an individual patient. The patient described in this report presented with symptoms of parapharyngeal compression due to such a tumor. It is believed that malignant hemangio‐pericytoma has not been previously reported in this site.
Surgery of massive fibrous dysplasia and osteoma of the midface
Authors: Ragab M. Ashraf , Mathog Robert H. 
Published: February 2007

AbstractSince most bony lesions of the midface will stop growing or regress, it is generally not appreciated when fibrous dysplasia and osteoma occasionally continue to grow, causing functional and cosmetic problems. To demonstrate the potential of the disease processes and management options available to the surgeon, a series of patients with massive fibrous dysplasia and osteoma of the midface is reviewed. Most of the patients show a facial deformity alone or in combination with telecanthus, epiphora, ex‐ophthalmos, or nasal obstruction. Several types of radical and conservative surgical procedures are described to remove or control the bony lesions, to restore facial contour, and to reconstruct the sinuses, nasal passageways, lacrimal collecting system, and medial wall of the orbit.
Squamous cell carcinoma of salivary gland origin
Authors: Shemen Larry J. , Huvos Andrew G. , Spiro Ronald H. 
Published: February 2007

AbstractA 30‐year retrospective analysis of 50 patients with squamous cell carcinoma of the salivary glands was conducted, including 42 patients with parotid tumors and eight with submandibular lesions. Clinical staging, performed for 48 patients in whom adequate data were available, yielded the following results: Stage I, 17%, Stage II, 12%, Stage III, 71%. Surgery was the primary therapy in 45 patients (86%). The determinate “cure” rate at 5 and 10 years was 24 and 18%, respectively, for patients with parotid lesions and 20% for those with submandibular tumors. As with other malignant salivary gland tumors, advanced stage and pain as a presenting symptom were ominous findings. Locoregional recurrence was the usual site of failure in both parotid (51%) and submandibular (67%) cases. Radical surgical extirpation, preserving the facial nerve when possible, remains our treatment of choice. It is anticipated that planned postoperative radiotherapy will reduce our high locoregional recurrence rates.
Sphenoidotomy
Authors: Ghorayeb Bechara Y. 
Published: February 2007

AbstractBecause of the complex anatomic relations of the sphenoid, the surgical approach to this sinus was only introduced 100 years ago. There are three approaches to the sphenoid sinus: transethmoidal, transseptal, and transpalatal. We present a case report, and discuss surgical anatomy, with attention to the important anatomic relationship of the cavernous sinus and its contents. A variant of the classical, sublabial, transseptal approach is described as follows: a window is created in the face of the sphenoid. This approach is particularly applicable to the surgery of mucoceles and allows easy postoperative inspection of the sphenoid sinus.
Ultrasonographic study of the relation of metastatic nodes to the carotid artery
Authors: Yonetsu Kouichi , Ikemura Kunio 
Published: February 2007

AbstractUltrasonographic studies of the neck were performed in four patients with metastatic lymph nodes that exhibited limited mobility or fixation to the surrounding tissues on palpation to obtain information about the relationship of nodes to the carotid artery. Comparison of the ultrasonograms with the operative findings disclosed that when a metastatic lymph node adhered to the carotid artery, the lymph node pulsated with flattening of the carotid artery and the echoes between the metastatic lymph node and carotid artery were attenuated.