bluuebunny/crossref_metadata_2025_split huggingface dataset:
Failure in the neck following multimodality treatment for advanced head and neck cancer
Authors: Vikram Bhadrasain , Strong Elliot W. , Shah Jatin P. , Spiro Ronald 
Published: February 2007

AbstractFailure in the neck is an important cause of morbidity and mortality in head and neck cancer. Patients who underwent therapeutic or elective radical neck dissection at Memorial Sloan‐Kettering Cancer Center between 1960 and 1966 developed recurrence of cancer in the dissected neck in 36.5% of the cases when metastatic carcinoma was present in the cervical lymph nodes at one level, and in 71.3% when metastases were present at multiple levels. 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 the combination of surgery and elective postoperative radiation therapy. Of these, 106 patients underwent radical neck dissection and 94 were proven to have metastatic carcinoma in the neck. Eleven patients developed recurrences in the neck. Recurrence developed in 16% of 19 patients with metastases at one level, and in 13% of 75 patients with metastases at multiple levels. For 53 patients, radiation therapy was started within 6 weeks after neck dissection and only 2% of them developed recurrence in the neck; for 41 patients, radiation therapy started later than 6 weeks and 29% of them developed recurrence (P < 0.01). Comparison of these data with our historical control group suggests a decrease in the number of failures in the neck when a multimodality treatment is used. It appears, however, that irradiation must be started within 6 weeks after surgery for the best results.
Failure at distant sites following multimodality treatment for advanced head and neck cancer
Authors: Vikram Bhadrasain , Strong Elliot W. , Shah Jatin P. , Spiro Ronald 
Published: February 2007

AbstractFailure at distant sites has generally not been regarded as a major cause of morbidity and mortality in head and neck cancer. Among patients with advanced cancer of the mouth and throat, treated at Memorial Sloan‐Kettering Cancer Center between 1960 and 1965, over 75% succumbed because of failure to control the disease, but distant metastases were the primary cause of failure in only 4%. More recently, with better local‐regional control of cancer using multimodality treatment, failure at distant sites has become much more of a problem, however. Between 1975 and 1980, we treated 114 previously untreated patients with stages III and IV epidermoid carcinoma of the oral cavity, oropharynx, hypopharynx, and larynx with a combination of surgery and postoperative radiation therapy. Twenty‐seven patients also received preoperative chemotherapy. Twenty patients developed distant metastases (12 in the lungs, 7 in the spine, and 1 on the trunk). The incidence of distant metastases was higher in those patients who presented with palpable cervical lymph nodes than in those who did not (25% vs. 4%, P < 0.05), and especially in those patients who pathologically had metastases at multiple levels in the neck than in those who had metastases at a single level or had negative nodes (35% vs. 5%, P < 0.05). Therapeutic strategies aimed at decreasing the incidence of distant metastases in patients with advanced head and neck cancer should be studied in patients who are pathologically found to have lymph node metastases at multiple levels in the neck.
Craniofacial microsomia in a parasite of a heteropagus conjoined twin: A clinical and histopathologic evaluation
Authors: Silbermann M. , Bar‐Maor J. A. , Auslander L. 
Published: February 2007

AbstractThis report evaluates a rare case of craniofacial microsomia in a partially developed, malformed heteropagus conjoined twin. In this instance, several major components of the craniofacial complex were involved: bones, cartilage, teeth, salivary glands, auditory apparatus, cerebrum, cranial nerves, and ocular neuroepithelium. In addition, cervical vertebrae and appendicular long bones were markedly affected. To date, the underlying disorder (whether genetic, metabolic, or environmental) responsible for the development of this congenital malformation is not fully understood. Our clinical and pathologic examinations tend to suggest that an apparent lack of an adequate arterial blood supply to the growing embryo could have contributed to the elaboration of this complex syndrome. The fact that the parasite's blood supply relied mainly upon a single, medium‐sized artery (1.5 mm in diameter) could have brought about local ischemic milieus during the critical phases of embryogenesis; hence, impeding the preprogrammed migration of neural crest cells to their end targets in the upper branchial arches. In such a case, the normal sequence of cell differentiation is damaged, which in turn imposes a severe impact on the morphogenesis of the various tissues composing the craniofacial complex.
Osteoradionecrosis: Predisposing factors and outcomes of therapy
Authors: Beumer John , Harrison Richard , Sanders Bruce , Kurrasch Madeline 
Published: February 2007

AbstractEighty‐three episodes of osteoradionecrosis are reported. Of those episodes affecting the mandible (78), 23 (29.5%) required radical resection. The most common precipitating factors were postradiation extractions (22/83), periodontal disease (19/83), and preradiation extractions (17/83). Those episodes initially located within the zone of attached mucosa fared well with conservative measures while those initially located beyond the zone of attached mucosa fared poorly. In bone necroses where the external radiation dose to the affected bone exceeded 7,000 rad, the mandibular resection rate was high (44%). The most effective way of resolving advanced bone necroses was achieved with a course of hyperbaric oxygen therapy combined with a surgical sequestrectomy.
Reconstruction for cervical irradiation ulcers with myocutaneous flaps
Authors: Strawberry Carl W. , Jacobs Jonathan S. , McCraw John B. 
Published: February 2007

AbstractRadiation‐induced skin changes are commonly seen in patients who have been treated for head and neck malignancies. Some of these skin changes can progress into chronic postradiation ulcers, which despite aggressive medical wound management will not resolve spontaneously. Skin grafts and local cutaneous flaps located within the radiation field are unreliable and rarely provide adequate stable coverage. In this article, the authors report a combined experience of 52 patients whose postradiation cervical ulcers were successfully and reliably treated with myocutaneous flaps.
Deep neck abscesses secondary to methylphenidate (Ritalin) abuse
Authors: Zemplenyi Jan , Colman Marc F. 
Published: February 2007

AbstractMethylphenidate (Ritalin) abuse has been and continues to be a major medical and social problem. In the past 6 months, we have seen five deep neck abscesses secondary to intravenous Ritalin abuse. This constitutes more than 50% of the deep neck abscesses seen by us in the same time period. The pathogenesis is related to an inflammatory foreign‐body reaction to the fillers in the methylphenidate tablets, followed by superinfection by oral or cutaneous flora. Mixed flora infections with weakly pathogenic organisms may also occur.
Reconstruction of the larynx and cervical trachea with the pectoralis major myocutaneous island flap
Authors: Eliachar I. , Goldsher M. , Moscona A. R. , Hurwitz D. J. 
Published: February 2007

AbstractTrauma to the anterior cervical region, whether blunt or penetrating, is life threatening and often causes a major loss of tissue to both the larynx and the trachea. We report our experience in reconstructing the larynx and trachea with the pectoralis major myocutaneous island flap in an unusual case of extensive traumatic cervical injury.
High resolution computed tomography in evaluation of the temporal bone
Authors: Swartz Joel D. , Russell Kamal B. , Wolfson Robert J. , Marlowe Frank I. 
Published: February 2007

AbstractHigh resolution computed tomography has completely replaced conventional multidirectional tomography in the evaluation of the temporal bone. Unprecedented detail is now available for evaluation of both middle ear and inner ear structures. A sampling of our experience in the evaluation of tubotympanic disease, otosclerosis, trauma, neoplastic disease, and congenital abnormalities is included in this publication. The state of the art in evaluation of sensorineural hearing loss is also illustrated.
Facial fractures: Hippocratic management
Authors: Gahhos Fivos , Ariyan Stephan 
Published: February 2007

AbstractHippocrates, the famous Greek physician of the fifth century B.C., is considered to be the “Father of Medicine.” Little, however, is known about his principles for the management of facial trauma. In this article, the Manuscripts in Ancient Greek, which deal with the management of mandibular fractures and dislocations, and with nasal and midfacial fractures have been translated and discussed. Hippocrates' methods for reducing mandibular dislocations and treating fractures of the mandible by wiring the teeth and immobilizing the jaw are described. His technique of closed reduction and immobilization of deviated nasal fractures with internal packing and rigid dorsal splints remains timeless. Hippocrates has taught us how to achieve medical wisdom through accurate clinical observation and practical creative ideas. The discovery of x‐rays and antisepsis only furthered his established sound principles for the management of facial trauma.
Internal carotid artery aneurysm: A singular anomaly
Authors: Evans Colin Everson 
Published: February 2007

AbstractA 9‐year‐old Indian boy was found to have an aneurysm of the left internal carotid artery. The vessel was heavily atherosclerosed, and the distal segment of the artery was tortuous and dilated. Serum lipid estimations showed the presence of type IIB hyperlipoproteinemia, with evidence of the disease in the patient's identical twin sibling and 37‐yearold father. There was also a marginal increase in serum triglycerides in a 4‐year‐old younger brother. The patient's 29‐year‐old mother was unaffected. The patient had suffered hemolytic disease as a newborn, which resulted in kernicterus and subsequent mental retardation. This incident is considered to have been the result of a proven glucose‐6‐phosphate dehydrogenase deficiency. The aneurysm was resected and arterial continuity was ensured by using an end‐to‐end anastomosis. Postoperative blood flow studies showed normal flow patterns in the reconstituted artery. Postoperatively, the patient's mental performance increased dramatically; it is hypothesized that such progress is the consequence of an improvement in the blood supply to the limbic system, following the operative procedure.
Traumatic arteriovenous malformation of the external carotid arterial system
Authors: Marks Malcolm W. , Argenta Louis C. , Dingman Reed O. 
Published: February 2007

AbstractTraumatic arteriovenous (AV) malformations of the face and scalp are rare lesions characterized by multiple endothelial‐lined channels between the arterial and venous systems. If improperly managed they have a high propensity to recur, and may result in severe cosmetic deformity. Lesions should be delineated by arteriography unless small and localized. They are managed by complete excision and ligation of arterial feeding vessels. Five cases of traumatic AV malformation of the face and scalp and their management are reported.
Arterial blood supply to the infrahyoid muscles: An anatomical study
Authors: Eliachar I. , Marcovich A. , Shai Y. Har , Lindenbaum E. 
Published: February 2007

AbstractThe arterial supply to the infrahyoid strap muscles originating from the superior thyroid artery (STA), the inferior thyroid artery (ITA), and the internal mammary artery (IMA), also called the internal thoracic artery, were investigated. Intraarterial silicone dye was injected into eight fresh cadavers followed by dissections. The blood supply to the infrahyoid muscles was found to be segmented in nature with the dividing line at the level of the cricoid ring. No axial pattern of vascularization could be demonstrated within the strap muscles. The skin overlying these muscles is supplied by tributaries arising from the above‐described arteries. Application of the information gathered is discussed in consideration of local myocutaneous and myoosseous flaps for reconstructive surgery, particularly of the larynx and trachea.
The incidence of occult metastases for cancer of the oral tongue and floor of the mouth: Treatment rationale
Authors: Teichgraeber John F. , Clairmont Albert A. 
Published: February 2007

AbstractOne hundred thirty‐six surgical cases of squamous cell carcinoma of the oral tongue and floor of the mouth at the Emory University Hospitals were reviewed for the incidence of occult metastases. Thirty‐five percent of the T1 T2 lesions of the anterior tongue had occult metastases. The figure was 31.5% for similarly staged lesions of the floor of the mouth. The presence of regional metastases resulted in a 2‐year determinate survival rate of 37% and 32% for patients with oral tongue and floor of the mouth lesions, respectively. The poor prognosis in the study for delayed cervical metastases and the high incidence of occult cervical metastases have led the authors to propose a more aggressive therapy for the clinically negative necks in these two sites of squamous cell carcinoma of the oral cavity.
Surgical stents for the head and neck cancer patient
Authors: Martin Jack W. , Jacob Rhonda F. , Larson David L. , King Gordon E. 
Published: February 2007

AbstractSplit‐thickness skin graft reconstruction following intraoral cancer surgery maintains functional mobility within the oral cavity and gives excellent support for the final intraoral rehabilitative prosthesis. We describe the use of a dental material, called tissue conditioner, for skin graft immobilization as an alternative to the usual gauze bolus and thermoplastic materials following surgery in various intraoral anatomic sites.
Surgical pathology of olfactory neuroblastoma
Authors: Harrison Donald 
Published: February 2007

AbstractThe natural history of a personal group of eight patients with olfactory neuroblastoma is reviewed with particular reference to surgical pathology as revealed by a study of the operative specimens in seven of these patients. This reveals that spread to the cranial surface of the overlying dura must be considered to be present in all patients irrespective of the radiologic findings. Craniofacial resection is therefore considered to be an essential part of any treatment regimen.
The trapezius musculocutaneous FLAP in head and neck reconstruction: Potential pitfalls
Authors: Nichter Larry S. , Morgan Raymond F. , Harman David M. , Horowitz  , Edlich Richard F. 
Published: February 2007

AbstractDefects resulting from bulky tumor resection of the head and neck region represent a reconstructive challenge. The trapezius musculocutaneous paddle flap based on the transverse cervical vessels is a useful tool for the reconstructive surgeon. Failure to recognize the variable anatomy is discussed in relation to other musculocutaneous flaps used for the purpose of head and neck reconstruction. The trapezius muscle has a variably located vasculature and diverse nomenclature. The knowledge of the variance of its anatomical vasculature is essential in the successful use of the trapezius musculocutaneous flap.
Heterotopic gastric cyst of the oral cavity
Authors: Daley Tom D. , Wysocki George P. , Lovas Guyla L. , Smout Marvin S. 
Published: February 2007

AbstractThe heterotopic gastric cyst of the oral cavity is a rare lesion. A recurrent gastric cyst in the floor of the mouth of a young female patient is presented. Current theories dealing with the histogenesis of these lesions are presented and discussed. Based on the available embryologic and clinical information, a new histogenetic concept for the development of the heterotopic gastric cyst is proposed.
Radiation and thyroid carcinoma: Radiotherapy, head and neck regions, thyroid carcinoma
Authors: Auguste Louis Joseph , Sako Kumao 
Published: February 2007

AbstractRadiotherapy for benign conditions of the head and neck area was first linked to thyroid carcinoma in 1950. All the salivary glands, the parathyroids, and the facial skin can also develop neoplastic lesions in this setting. Thyroid carcinoma is most commonly papillary or mixed papillary and follicular. It is very often multifocal and can be detected by hand palpation, nuclear scanning, high resolution sonography, and needle aspiration. Each test has its limitations and appropriate protocols for screening and detection should be adapted to different medical centers. The surgical management is controversial and ranges from simple lobectomy to total thyroidectomy with adjuvant 131I treatment and thyroid suppression. We prefer total thyroidectomy if it can be performed safely. With adequate treatment the survival should be good. Prevention by administration of iodine at the time of exposure to radiation seems feasible and deserves further clinical trial.
Bilateral chylothorax complicating radical neck dissection: Report of a case with no concurrent external chylous leakage
Authors: Har‐El Gady , Segal Karl , Sidi Jack 
Published: February 2007

AbstractBilateral chylothorax as a complication of radical neck dissection is extremely rare. Six cases are reported in the English literature. All of these patients' cases were associated with a concurrent external chylous fistula, as evidenced by the appearance of a milky fluid confirmed to be chyle by chemical determination. Chyle had also been noted to leak during the operation. This presentation illustrates an additional case of bilateral chylothorax occurring after radical neck dissection, and the first case, to our knowledge, with no concurrent external lymph leakage. Anatomic and physiologic considerations are presented and possible mechanims of pathogenesis are discussed. Chylothorax has two major complications—respiratory and metabolic. A short summary of the modern concepts of treatment is presented.
Hair transplantation for male pattern baldness: Aesthetic considerations and current status
Authors: Ayres Samuel 
Published: February 2007

AbstractThe multiple punch technique of hair transplantation, utilizing the principle of donor dominance, has proven to be a cosmetically acceptable procedure in properly selected patients in the presenter's 24‐year experience. Careful planning with attention to aesthetic principles, especially in frontal hairline placement, in donor site selection and with regard to the ratio between the donor supply and the existing or potential future extent of baldness, together with meticulous surgical technique, are essential for satisfactory results. Scalp reduction, in which bald areas of crown and midscalp are serially excised, with extensive subgaleal undermining is a highly useful adjunct to grafting in many patients with moderately extensive male pattern baldness who have adequate scalp mobility by enabling the available donor supply to be concentrated and thus provide more effective coverage in the frontal scalp.
Hairline aesthetics and styling in hair replacement surgery
Authors: Mayer Toby G. , Fleming Richard W. 
Published: February 2007

AbstractPunch grafting and flap surgery are proven methods of correcting baldness. Using either method, the location and shape of a new hairline on the frontal and temporal scalp is one of the most important aspects of hair replacement surgery. If the hairline is not aesthetic, the results can be unacceptable or even devastating for the patient and surgeon alike. The principles of planning the frontal and temporal hairline are presented using punch grafts as well as flaps. Postoperative styling of the “new” hair will vary depending upon the method used to transfer the hair (flaps or grafts), the local factors involved (texture, direction, density, tufting, etc.), as well as the patient's preference. The various advantages and disadvantages of styling possibilities with each method are presented. These factors should be discussed with the patient preoperatively.
Computed tomography evaluation of the nasal septal reconstructed larynx
Authors: Zohar Y. , Hadar H. , Laurian N. 
Published: February 2007

AbstractComputed tomography (CT) of the larynx was performed in 15 patients who had their larynx reconstructed by compsite nasal septal autograft after frontal, or frontolateral laryngectomy. Five representative cases each with CT scan and additional laryngoscopic documentation are presented. The CT permitted a detailed appraisal of the nasal septal grafted larynx. Our attention was directed to the image of the graft in what concerned its patterns of distortion, fibrosis or chondrification, and width of the laryngeal airway. The scan from 10 patients brought radiographic evidence that the implanted cartilage retained vitality and structural integrity.
Prominent ears—Pitanguy'S island technique: Long‐term results
Authors: Pitanguy Ivo , Fiazza Giuseppe , Calixto Carlos Alberto , Muller Paulo Malta , Caldeira Alberto M. L. , Alexandrino Adelson 
Published: February 2007

AbstractThrough the analysis of 300 cases of prominent ears operated by Pitanguy's technique with a follow‐up of 1‐15 years we observed the preservation of the aesthetic aspect as well as the cephaloauricular angle. We call attention to its easy performance and almost no incidence of early or late complications.
Accuracy of frozen‐section diagnosis in salivary gland lesions
Authors: Granick Mark S. , Erickson E. Ralph , Hanna Dwight C. 
Published: February 2007

AbstractA retrospective study is presented comparing the results of 462 frozen‐section analyses of surgically extirpated salivary gland tumors with the permanent‐section results. The overall agreement between frozen‐ and permanent‐section analyses was 95.7%. A separate review of the last 47 months of this 32‐year study revealed an accuracy rate of 98.8%. Frozen‐section diagnosis of salivary gland tumors has been reliable and clinically valuable in our practice.
The soft tissue myxoma of the head and neck region—Report of a case and literature review
Authors: Tse Jack J. , Vander Seymour 
Published: February 2007

AbstractA case of soft tissue myxoma in scalp is reported in a patient with a history of congenital cleft lip and palate. Review of the literature shows head and neck soft tissue myxoma occurs almost in every decade of life with peak occurrence in the fourth decade. Men are affected more than women. The most common location in the head and neck region is the palate, followed by the parotid area. The prognosis of this soft tissue tumor is good. Conservative surgical excision with adequte margins is the treatment of choice. Several theories concerning the pathogenesis of this tumor are discussed, with the theory that a basic error in tissue metabolism during initial growth is the most compatible to the elements of this case. Differential diagnosis regarding this type of lesion is also discussed.
A dramatic complication of peroral fiberoptic endoscopy
Authors: Burstein Fernando D. , Colman Marc F. 
Published: February 2007

AbstractThe advent of the flexible fiberoptic gastroscope has revolutionized clinical gastroenterology. The morbidity and mortality rates with flexible fiberoptic endoscopes are comparable to those associated with rigid and semirigid scopes. Insufflation devices are routinely used with flexible fiberoptic scopes. This may lead to complications, differing from those associated with rigid endoscopy. A case involving an insufflation injury to the piriform sinus is presented. The pathophysiology of insufflation injuries and their management are discussed.