bluuebunny/crossref_metadata_2025_split huggingface dataset:
Isolated pericardial metastasis of parotid tumor origin
Authors: Sulkes Aaron , Weshler Zeev , Dolberg Leah , Biran Shoshana 
Published: February 2007

AbstractInvolvement of the heart in cases of parotid tumors has rarely been described and then only in cases where there was widespread metastatic disease. We report here the case of a patient with a pleomorphic‐type adenocarcinoma arising from a parotid gland, in which the patient developed a malignant pericardial effusion as the first and only evidence of distant metastasis. The effusion resolved following radiation therapy (4,000 rad) to the pericardial area, and the patient was alive and disease‐free one year after the diagnosis of pericardial metastasis was established. The literature on the metastatic spread of malignant parotid tumors with particular emphasis on cardiac dissemination is reviewed.
The role of the free jejunal graft in reconstruction of the pharynx and cervical esophagus
Authors: Gluckman Jack L. , McDonough John , Donegan J. Oliver 
Published: February 2007

AbstractReconstruction of the pharynx and cervical esophagus presents a formidable problem for the head and neck surgeon. The use of a free jejunal graft offers a reliable and effective means of performing this reconstruction. Experience with 17 cases forms the basis of this report, which emphasizes technique and complications.
Reconstruction of the columella with nasolabial flaps
Authors: Nicolai J. P. A. 
Published: February 2007

AbstractA one‐stage operation is described for reconstruction of large defects of the columella nasi, the lower part of the nasal septum, and the vestibular floors. Nasolabial flaps are transposed on a cranial, de‐epithelialized pedicle, and passed deep to the nostrils into the vestibular cavity. The method is illustrated with four case reports.
The pathology of head and neck tumors: Mucosal melanomas, part 13
Authors: Batsakis John G. , Regezi Joseph A. , Solomon Alvin R. , Rice Dale H. 
Published: February 2007

AbstractPigmented lesions, including melanomas, of the mucous membranes of the head and neck are far outnumbered by their counterparts in the skin. This relative dearth is partially responsible for the fact that scientific inquiry into mucosal melanomas has not kept pace with the advances in knowledge of the pathogenesis of cutaneous melanomas and their diagnosis and treatment. Integral to these latter advances have been the refinements in clinical and histologic classification and clinicopathologic correlations with quantitative evaluation of melanomas of skin—enhancements that up to now have been singularly lacking for mucosal melanomas. This report acknowledges this slowness in progress, presents recommendations for purifying the nomenclature of pigmented lesions of the mucosae, and at the same time, also notes the poorer prognosis for melanomas of the upper aerodigestive tracts, as a group, when compared with cutaneous melanomas. Only prospective studies will answer the question of whether the poor prognosis is intrinsic to these mucosal melanomas or whether delay in detection and removal are responsible.
Radiation therapy for melanomas of the head and neck
Authors: Harwood Andrew R. , Lawson Victor G. 
Published: February 2007

AbstractThis report reviews experience with radiation therapy in 77 patients with melanoma of the head and neck, a lesion traditionally but incorrectly considered to be radiation‐resistant. Thirteen patients with lentigo malignum and 18 patients with lentigo malignum melanoma have been primarily irradiated. In 11 of the 13 patients, the lentigo malignum has been locally controlled with no recurrence from 6 months to 5 years following treatment. One patient had a local recurrence and was salvaged with further radiation therapy, and one patient had residual tumor after irradiation and was salvaged with simple excision. Seventeen of 18 patients primarily irradiated had lentigo malignum melanomas that have been locally controlled from 6 months to 6 years after irradiation. One patient had a local recurrence and was salvaged by excisional surgery. There have been no deaths from lentigenous melanoma, and the cosmetic results of treatment are excellent. We concluded that radiation therapy is a simple, effective out‐patient treatment for lentigo maligna and lentigo maligna melanoma. Nonlentigenous melanoma was irradiated after incisional biopsy in 6 patients; local control was obtained in 4 patients although 1 died of distant metastases. Fifteen patients were irradiated after excisional biopsy (margins inadequate); 14 of 15 had local control although 6 died of metastases. Only 2 of 16 patients irradiated for recurrent melanoma were controlled. Analysis of local control versus irradiation fraction size revealed that 17/24 (71%) achieved local control with a dose per fraction of greater than 400 rad as compared with 3 of 12 (25%) in those being irradiated with a dose of less than 400 rad per fraction. We concluded that nonlentigenous melanoma is not radiation resistant and that local excision followed by radiation therapy with a large dose per fraction deserves further study, particularly in melanomas of the head and neck where wide local excision is not possible due to age of the patient or location of the tumor. Nine mucosal melanomas have been primarily irradiated and four have been locally controlled.
A technique for preservation of spinal accessory nerve function in radical neck dissection
Authors: Weitz Jean W. , Weitz Stephen L. , McElhinney A. J. 
Published: February 2007

AbstractA new technique is described that preserves trapezius muscle function in radical neck surgery while cutting that part of the spinal accessory nerve which courses through the sternocleidomastoid muscle. The technique takes advantage of the little‐known fact that, in humans, the trapezius muscle has dual innervation. The C2‐3‐4 motor root is joined to the distal portion of the spinal accessory nerve to give motor function to the trapezius muscle. This procedure will save shoulder mobility in the majority of patients who undergo radical neck dissection. The technique is accomplished rapidly with the use of the gastrointestinal stapler in the scalene fat pad.
Carcinomas of the oral cavity: Analysis of various pretherapeutic classifications
Authors: Platz Helmut , Fries Rudolf , Hudec Marcus , Tjoa A. Min , Wagner Roland R. 
Published: February 2007

AbstractIn a retrospective study of 802 patients with carcinomas of the oral cavity, the most frequently used classifications—AJC 1967, UICC 1973, UICC 1978, and AJC 1978—were analyzed. In this study, the unequivocally defined objective of a classification of malignant tumors, namely, the creation of prognostically homogeneous categories which differ mutually in their prognosis, is not attained by any of the 4 classifications. In several experiments, the possibility of improvements in the T and N categories is demonstrated. In order to achieve a more exact assessment of the prognosis of patients with carcinomas of the oral cavity, however, multidimensional analyses of prognostically relevant factors, with a prognosis index as a goal, are necessary.
Immunodeficiency diseases: Head and neck manifestations
Authors: Harris Jeffrey P. , South Mary Ann 
Published: February 2007

AbstractInfections of the upper respiratory tract are common to both the immunodeficient and the normal child during their development. The most common head and neck manifestations of immunodeficiency disease are recurrent suppurative otitis media, tonsillitis, sinusitis, rhinitis, and nasopharyngitis. Often the head and neck specialist is confronted with a child with one or more of these problems and must institute the appropriate therapy or decide on an avenue for further investigation. This paper outlines the major immunodeficiency states, discusses the immune defects thought to be responsible for the spectrum of clinical findings, and suggests a systematic approach to the evaluation of these difficult diseases. The recognition of immunodeficient individuals is an important step in their treatment so that adjunctive immunological therapy can be provided.
The importance of the pedicle for the survival of a vascularized free flap: An experimental study on rats
Authors: Fried Marvin P. , Horowitz Zeev , Kelly James H, 
Published: February 2007

AbstractIt has been assumed, but never shown experimentally, that the survival of a free vascularized full‐thickness island flap is based on the vascular pedicle. A study using the rat was designed to assess the three parameters of flap survival: the vascular pedicle, the recipient bed, and the perimeter of the recipient area. Isolation of the pedicle by ligation caused flap necrosis in 18 out of the 20 groin flaps. An intact pedicle, with the other two parameters excluded, led to flap survival in 75% (9 of 12 flaps). Our results indicate that the critical factor to island flap survival in the immediate postoperative period is the vasculature supplying the pedicle. The two other factors are of limited importance.
Treatment of a large hemangioma in the head and neck region
Authors: Smith Arlan R. , Van Urk H. , Vaandrager M. , Van Der Meulen J. C. 
Published: February 2007

AbstractA 15‐year‐old girl with a large hemangioma in the head and neck region was treated with selective embolization and microvascular reconstructive surgery (using a free latissimus dorsi flap) to cover the defect after total ablative surgery.
The pathology of head and neck tumors: Papillomas of the upper aerodigestive tracts, part 18
Authors: Batsakis John G. , Raymond A. Kevin , Rice Dale H. 
Published: February 2007

AbstractThe human papillomavirus class of DNA viruses are more than circumstantially related to oral and airway papillomas. Whether they are fully oncogenic, in the malignant sense, without other agents is questionable. Recent advances in molecular virology and the use of genus‐specific (common) antigen‐antibody reactions have identified papillomavirus in laryngeal and oral papillomas. Laryngeal and oral papillomas could be precancerous lesions, but they show a low‐risk and long‐time interval leading to malignancy unless significant iatrogenic or host variables—such as radiotherapy or immuno‐incompetence—are added. Two different papillomas in the larynx can be recognized; a nonkeratinizing, papillomavirus‐related lesion, and a keratinizing, usually solitary papilloma, which may or may not be related to a virus genesis and may be equated with a keratosis or clinical leukoplakia.
Closure of perforations of the septum including a single‐session method for large defects
Authors: Meyer Rodolphe , Berghaus Alexander 
Published: February 2007

AbstractIt is the impression of the authors that, although the overall frequency of septal perforations has decreased, the proportion of large defects has increased. Therefore, in addition to the methods for surgical treatment of small perforations, a particular description is given of a new procedure in which an extramucosal technique is used, which permits closure of even large perforations in a single session. Very large defects of more than about 2 cm in diameter can be closed most reliably with a three‐step procedure using a pedicled flap from the oral vestibule.
Intratumoral BCG cell‐wall preparation therapy and surgery in bovine ocular carcinoma
Authors: Kleinschuster Stephen J. , Bier Jürgen , Rapp Herbert J. , Smart Ross A. , Van Kampen Kent R. , Walters Jeffrey L. 
Published: February 2007

AbstractInbred animal tumor models with artificially induced tumors are inadequately comparable with human neoplasias. Thus, cows with squamous cell carcinomas developing spontaneously in the head and neck region were used for experimental investigations on the immunotherapy of malignant tumors. This experimental model served to investigate the therapeutic effect of a single intratumoral application of bacille Calmette‐Guerin (BCG) cell‐wall preparations (CWP) in comparison to local and radical surgical procedures. One hundred twenty‐nine tumor‐bearing cows were divided into 5 groups. Group 1 received a single intratumoral injection of BCG‐CWP. The procedures in Groups 2 and 3 involved local (primary tumor) and radical (primary tumor and draining lymph nodes) surgery, respectively. A procedure was developed for the radical operation in accordance with the method used for radical neck dissection in patients with head and neck tumors. Group 4 remained untreated and Group 5 received sham (improperly compounded) BCG‐CWP. Twenty‐six percent of the animals treated with BCG‐CWP, and 52% treated with local surgery, were clinically tumor free 2.5 years after treatment, while none of those that had undergone radical surgery showed any evidence of tumor recurrence. In the control groups (Groups 4 and 5), progressive tumor growth was characteristic for all except one animal that had spontaneous remission. The favorable outcome of BCG‐CWP treatment in a bastard animal population with spontaneously developing squamous cell carcinomas in the head and neck region may possibly be attributed to the fact that this experimental system involves a tumor with very marked tumor‐specific transplantation antigens. The successful experimental results obtained with BCG‐CWP therapy have led to a prospective, randomized study in patients with squamous cell carcinomas in the head and neck region.
Pectoralis major myocutaneous island flap revisited: A sentinel vessel simplifying dissection
Authors: Kaplan Ivor B. , Harwick Robert D. 
Published: February 2007

AbstractSurgical extirpation of advanced cancers of the head and neck almost always requires extensive resections that invariably necessitate some sort of large flap for reconstruction. In recent years immediate one‐stage reconstruction of large defects in the area of the tonsillar fossa and the pharynx have been facilitated by the development of myocutaneous flaps, especially the pectoralis major myocutaneous flap. With this flap, immediate one‐step reconstruction at the time of the initial operation is accomplished. Myocutaneous flaps, however, require more skill and concentration in their elevation than do skin flaps in order to preserve the axial feeder vessel running along the underside of the muscle and supplying the all‐important perforating vessels to the overlying muscles and skin. We have noticed a constant perforating vessel, approximately 2‐cm long, coming off the pectoral branch of the thoracoacromial artery medial to the cephalic vein and 2 cm below the border of the clavicle. This pierces the substance of the overlying pectoralis major muscle and runs anteriorly into the subcutaneous fatty hypodermal layer. This vessel accurately localizes the position of the proximal portion of the pectoral branch of the thoracoacromial artery before elevation of the pectoralis major muscle has been started. The imaginary line joining this vessel and the island skin flap allows simplicity in elevation of the muscle pedicle and obviates fear of transecting the arterial supply to the skin island during the dissection. We have found the vessel to be present in 26 consecutive cases over the last 12 months. We present our findings of a sentinel vessel localizing the pectoral branch of the thoracoacromial artery as a guide in liberating the muscular paddle and axial artery in elevation of pectoralis major myocutaneous island flaps.
Mandibular osteotomy in the surgical approach to the oral cavity
Authors: McGregor Ian A. , MacDonald D. Gordon 
Published: February 2007

AbstractThe improved stability that results from the combination of K‐wire transfixion of a mandibular osteotomy with direct wiring has made it possible to use a straight, as opposed to a stepped, bone cut and to avoid the invariable need for dental extractions. It has also made possible an alternative osteotomy site, immediately anterior to the mental foramen. The use of this site allows mandibular swing to take place after division only of mucous membrane and mylohyoid. It is best combined with a modified lip‐splitting incision which has been found to improve ultimate cosmesis.
A craniofacial approach to advanced recurrent cancer of the central face
Authors: Jackson Ian T. , Laws Edward R. , Martin Raymond D. 
Published: February 2007

AbstractRecurrent penetrating midface cancer results from basal cell carcinoma, squamous cell carcinoma, adenocystic carcinoma, and chondrogenic and osteogenic sarcoma. In the past, surgical resection frequently resulted in meningitis. A combined neurosurgical and plastic surgical craniofacial approach has been used for total resection of these lesions. The floor of the anterior cranial fossa has been reconstructed with an extended glabellar flap incorporating a forehead Z‐plasty. Over the past 2‐and‐a‐half years, 10 patients have been operated on successfully. Five cases with a follow‐up of over 2 years are presented.
Primary lymph nodal Kaposi's sarcoma of the parotid gland
Authors: Puterman Marco , Goldstein Jed 
Published: February 2007

AbstractTwo cases of Kaposi's sarcoma arising within intraparotid lymph nodes are presented. The tumor masses, clinically thought to be primary epithelial tumors of the parotid gland, were pathologically defined as Kaposi's sarcoma. No other evidence of this disease has been found elsewhere in either of the two patients studied. Immunologic studies performed in both patients demonstrated a depression of T‐lymphocyte function and altered cell‐mediated immunity in one. Search of the medical literature shows that these are the first two reported cases of Kaposi's sarcoma arising within lymph nodes of salivary glands.
Analysis of disability resulting from treatment including radical neck dissection or modified neck dissection
Authors: Schuller David E. , Reiches Nancy A. , Hamaker Ronald C. , Lingeman Raleigh E. , Weisberger Edward C. , Suen James Y. , Conley John J. , Kelly David R. , Miglets Andrew W. 
Published: February 2007

AbstractA multiinstitutional study to define the impact of total treatment programs involving radical neck dissection (RND) and modified neck dissection (MND) on patient' permanent disability was undertaken. A total of 243 patient responses were included in the study. Comparative analyses between the treatment groups show no advantage of one surgical operation over the other in returning patients to their pretreatment employment status. Radiation therapy was identified as adding significantly to the patient's permanent disability.
Face lift, part 2: Etiology of platysma cording and its relationship to treatment
Authors: Webster Richard C. , Smith Richard C. , Smith Karen F. 
Published: February 2007

AbstractBased on examination of many necks and observations at surgery and on cadavers, we believe that “platysma cords” or cervical folds are normal when the muscles are being contracted. In the aged, they do not disappear when the muscle is relaxed. We believe that they are caused by a stretching and loss of contractility of skin and fat overlying the anterior platysma muscles from aging and from the many contractions of these muscles which selectively stretch the overlying tissues. In addition, we believe that the superficial musculoaponeurotic system (SMAS), which in youth holds the muscle strongly and closely to the confines of the concavity of the neck, stretches so that the muscle webs more easily out of the concavity when contracted and is returned less completely into it upon relaxation. Treatment and prevention should be directed toward tightening the skin and the SMAS and supporting the muscle in its retrodisplaced, more youthful position.
Extrapharyngeal (anterolateral) approach to the cervical spine
Authors: Komisar Arnold , Tabaddor Kamran 
Published: February 2007

AbstractThe extrapharyngeal approach to the anterior cervical spine is a safe, rapid surgical exposure. Other surgical exposures such as the posterior, lateral, and intraoral (transpharyngeal) have inherent limitations that this approach avoids. By going anterior to the sternocleidomastoid muscle and great vessels, the surgical exposure of the anterior cervical spine is wide and the vital structures of the neck are visualized and not injured. We have used this extrapharyngeal approach to treat various disease states of the anterior cervical spine, such as trauma, osteomyelitis, neoplasia, and degenerative disease. Major complications have been neural injury, and pharyngeal fistula.
Parathyroid gland transplantation after total thyroidectomy with pharyngolaryngoesophagectomy
Authors: Freeman Jeremy L. , Brondbo Kjell , Shaw Henry J. , Rubin Allan M. , Noyek Arnold M. , Goldberg Melvyn 
Published: February 2007

AbstractSurgical treatment of extensive hypopharyngeal carcinoma often includes total thyroidectomy together with resection of the primary disease. The risk of removing or damaging the parathyroid glands is considerable; this may render the patient permanently hypoparathyroid with all the problems of management. These patients must be on lifelong supplementation and at times, due to failure to take the medication, hypocalcemic crises are precipitated. To avoid this problem, we have been identifying the parathyroid glands intraoperatively and, after pathological confirmation, have transplanted them to the forearm. Three patients who underwent this procedure are presented. All are normocalcemic without supplementation and parathyroid hormone assays on serum from the transplanted forearm show significantly elevated levels.
Failure at the primary site following multimodality treatment in advanced head and neck cancer
Authors: Vikram Bhadrasain , Strong Elliot W. , Shah Jatin P. , Spiro Ronald 
Published: February 2007

AbstractRecurrence at the primary site is an important cause of morbidity and mortality in head and neck cancer. In patients with stages III and IV disease treated surgically at Memorial Sloan‐Kettering Cancer Center between 1960 and 1970, cancer recurred at the primary site in 39% even when the margins had been deemed satisfactory, and in 73% when the margins were unsatisfactory. Between 1975 and 1980, we treated 114 previously untreated patients with stages III and IV epidermoid carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx with a combination of surgery and postoperative radiation therapy. Twenty‐seven patients also received preoperative chemotherapy. One hundred seven patients were evaluable for disease control at the primary site by the combined treatment. Cancer recurred at the primary site in 6 patients, including 2% of 47 patients whose surgical margins had been satisfactory and 10.5% of 60 patients whose surgical margins had been unsatisfactory. Of the latter, recurrence was seen in 5% of the 25 patients whose margins were less than 5 mm but were microscopically uninvolved, and in 15% of the 35 patients whose margins were microscopically involved by cancer. Comparison of these data with our historical control group suggests a decrease in the failure rate at the primary site with multimodality treatment. However, it still appears important to secure microscopically negative margins for the best results.