bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vertical partial laryngectomy for recurrent glottic carcinoma after irradiation
Authors: Croll Gerard A. , Van Den dBroek Paul , Tiwari Ramu M. , Manni Johannes J. , Snow Gordon B. 
Published: February 2007

AbstractVertical partial laryngectomy after a full course of irradiation was performed in 26 patients as salvage surgery for recurrent or residual glottic carcinoma. An excellent cure rate and conservation of function was obtained, while complications were few. A prerequisite for this type of surgery is a limited extent and infiltration of the recurrent local tumor growth. As the great majority of local recurrence appears within the first 2 years after radiotherapy, frequent follow‐up during this period is stressed for early detection of a recurrence.
Congenital granular cell epulis causing polyhydramnios
Authors: Ophir Dov , Marshak Gabriel 
Published: February 2007

AbstractWe report a case of an extremely large granular cell epulis situated on the maxillary alveolar ridge of a newborn. It obstructed the infant's mouth and caused polyhydramnios. The lesion was detected in utero by ultrasonography and removed after birth in the delivery room, with satisfactory results. It is evident that the epulis increased in size during the last phase of pregnancy. The literature concerning this peculiar lesion is reviewed and theories of histogenesis are discussed.
Psychosocial ramifications of childhood malignancy for the child and family
Authors: Copeland Donna R. 
Published: February 2007

AbstractThe changes that occur in a child's life following the diagnosis of cancer extend to other members of the family and, through time, far beyond the biologic cure of the disease. The responses of the family to this stress and the ways in which they cope with it will depend partially on their own resources and partially on the severity of the disease and its treatment. This paper describes the factors that influence the family's adaptation to illness and presents a case example that illustrates criteria useful in assessing the need for psychologic consultation in childhood cancer patients and their families. Also presented are guidelines for the physician in his/her continuing observation and follow‐up of these patients and families.
Complications following laryngectomy
Authors: Shemen Larry J. , Spiro Ronald H. 
Published: February 2007

AbstractThe complications following 100 consecutive laryngectomies performed at our hospital during a recent 18‐month period are reviewed. The complication rates for total laryngectomy (63 patients) and extended laryngectomy (37 patients) were 19% and 49%, respectively, while the fistula rates were 8% and 27%, respectively. These rates were influenced primarily by the extent of surgery and the type of reconstruction, which during this interval included primary closure, pectoralis major myocutaneous flap, or gastric transposition. In comparison to our previous study, when the deltopectoral flap was used for patching the pharynx, the fistula rate for extended laryngectomy has decreased as a result of our use of myocutaneous flaps and greater expeience with gastric transposition. Currently, we use the pectoralis major myocutaneous flap for pharyngeal repair if the mucosa would otherwise be closed under tension. All circumferential defects are repaired with a gastric transposition.
Adenoid cystic salivary gland carcinoma: A clinicopathologic correlation
Authors: Matsuba Howard M. , Simpson Joseph R. , Mauney Marc , Thawley Stanley E. 
Published: February 2007

AbstractBetween 1960 and 1980, 71 cases of adenoid cystic carcinoma (ACC) were reviewed according to treatment modality and clinical course. Histologic review of pathologic slides was performed to classify the tumors into their predominant histologic pattern (tubular, cribriform, solid). The predominant histologic patterns of the tumors were equally divided between tubular and cribriform. Very few were classified as a solid pattern. In the patients receiving the same type of therapy (surgery and irradiation), the cribiform and tubular variants of ACC demonstrated no difference in the rate of distant metastases and overall survival. The cribriform variant demonstrated a significantly worse prognosis in terms of local recurrence rate. The patients who had a solid histologic pattern of ACC appeared to have an overall worse prognosis in terms of distant metastases and long‐term survival. The long‐term survival of patients with ACC may be related to the development of distant metastases despite local control.
Thyroglossal duct carcinomas: Light and electron microscopic studies
Authors: Ronan Salve G. , Deutsch Elise , Ghosh Luna 
Published: February 2007

AbstractTwo cases of papillary carcinoma arising in thyroglossal duct cysts are reported. Electron microscopic studies were done on both cases and similar ultrastructural features were noted. When compared with a case of papillary adenocarcinoma arising in the thyroid gland proper, no difference was seen both at the light microscopic and ultrastructural levels.
Cranioplasty with a silicone prosthesis and split rib grafts
Authors: Chicarilli Zeno N. , Ariyan Stephan 
Published: February 2007

AbstractA method to reconstruct visible cranioplasty defects involving the anterior cranium with the durability of bone and the exacting contours of the custom silicone implant is described. This technique is simple, quick, and does not require intraoperative assessment of subtle contours. The patient has a rigid underlying bony support with a perfectly contoured external surface. In patients with cranioplasty involving the cranium anterior to the hairline, we take advantage of both split rib grafts and a silicone prosthesis in one stage to obtain optimal results.
Sphenoid sinus brown tumor, hypercalcemia, and blindness: An unusual presentation of primary hyperparathyroidism
Authors: Schweitzer Vanessa G. , Thompson Norman W. , McClatchey Kenneth D. 
Published: February 2007

AbstractThis is a first report of primary hyperparathyroidism (HPT) masquerading as a destructive fibrous sphenoid sinus “Brown tumor” associated with progressive blindness and hypercalcemia. Diagnosis of a Brown tumor was delayed despite serial computerized tomography of the head and repeated transnasal and transethmoid sphenoid biopsies demonstrating diffuse fibrosis. Only detection and medical evaluation of hypercalcemia, demonstrating elevation of both serum calcium and C‐terminal parathyroid hormone with an elevated chloride/phosphate ratio, prompted neck exploration, thus confirming a solitary left superior parathyroid adenoma. Postoperative normocalcemia occurred synchronously with the return of light perception and the arrest of sphenoid sinus and parasellar erosion. Although maxillary Brown tumors of secondary HPT have been reported, this is the first report of osteitis fibrosa of the sphenoid sinus. Differential diagnosis of an erosive sphenoid lesion with cranial nerve dysfunction, exclusive of inflammatory or vascular disease, should include sarcoidosis, primary and metastatic sphenoid carcinoma, fibrous dysplasia, giant cell reparative granuloma, midline lethal granuloma, chordoma, and chondrosarcoma. Furthermore, the bony destructive lesions with concomitant hypercalcemia of sarcoidosis and HPT are distinguishable by radiographic and laboratory analyses and by the Dent corticosteroid suppression test. Hypercalcemia of primary HPT is associated with elevated serum C‐terminal parathormone, osteitis fibrosa, a negative Dent test, and a chloride/phosphate ratio greater than 33 in 94% of primary HPT patients. Hypercalcemia of sarcoidosis is associated with a normal or decreased C‐terminal parathormone assay and a positive Dent test, as well as elevated serum immunoglobulins and erythrocyte sedimentation rate, and a positive angiotensin‐converting enzyme assay. Although in primary HPT the incidence of hypercalcemia approaches 100% with the incidence of osteitis fibrosa less than 7%, the mortality of undiagnosed hypercalcemia approaches 60%. A delay in diagnosis and in curative parathyroidectomy can result in unnecessary complications as demonstrated by this report of progressive blindness associated with a destructive sphenoid Brown tumor.
Surgical treatment of early‐stage carcinoma of the oral tongue—would adjuvant treatment be beneficial?
Authors: O'brien Christopher J. , Lahr Christopher J. , Soong Seng‐Jaw , Gandour Michael J. , Jones J. Michael , Urist Marshall M. , Maddox William A. 
Published: February 2007

AbstractA group of 97 patients with clinical stage I and stage II squamous carcinoma of the oral tongue, treated by partial glossectomy alone, has been reviewed to define prognostic indicators. Sixty‐seven patients were staged T1NO and 30 were T2NO. Disease recurred in 28 patients (27%) and the most common site of failure was the ipsilateral neck (21%). The incidence of initial recurrence did not vary significantly with patient age, sex, T‐stage, or when tumor size was examined in other subdivisions. The presence of perineural invasion significantly increased recurrence rate (P = 0.003) and decreased survival (P = 0.002). Disease‐free survival at 5 yr was 73% for patients with T1 tumors, and 62% for T2 tumors. This difference was not significant. In this low‐risk patient population with early stage carcinoma of the oral tongue, partial glossectomy is adequate treatment in most cases. However, we recommend postoperative radiation therapy to the primary site and ipsilateral neck for patients with perineural invasion. No evidence could be found to support adjuvant local therapy or elective neck treatment in the remaining patients.
Scapular free flap for repair of massive lower facial composite defects
Authors: Granick Mark S. , Newton E. Douglas , Hanna Dwight C. 
Published: February 2007

AbstractThe scapular osteocutaneous free flap provides excellent tissue for reconstruction of massive lower facial defects. Five cases of full‐thickness cheek and lip defects associated with mandibular loss were successfully repaired with sandwiched osteocutaneous scapular flaps plus a parascapular or latissimus dorsi flap. In two instances the osteocutaneous scapular flap was harvested along with a parascapular skin paddle. The other three patients had latissimus dorsi myocutaneous units taken with the scapular osteocutaneous flap from the same subscapular pedicle.
Examination of swallowing after total laryngectomy using manofluorography
Authors: McConnel Fred M. S. , Mendelsohn Martyn S. , Logemann Jerilyn A. 
Published: February 2007

AbstractInvestigation of postlaryngectomy dysphagia is usually limited to the standard barium swallow. Manofluorography (mano, manometry; fluoro, videofluoroscopy; graphy, picture) is a new technique that permits analysis of simultaneous manometry and videofluoroscopy of deglutition. Manofluorography provides more detailed analysis of the swallowing dynamics during the pharyngeal stage of deglutition than either barium studies or manometry used alone. This study uses manofluorography to examine swallowing in two patient groups, total laryngectomees and total laryngectomees with tongue impairment, to analyze the role of various anatomic components in the swallowing process. Pharyngeal transit times were prolonged in both patient groups studied, with the tongue impairment group exhibiting the longest times. The postlaryngectomy pharynx offered greater resistance to bolus flow. The laryngectomy patients compensated by using increased lingual propulsion, whereas the patients with tongue impairment and total laryngectomy could not. This emphasizes the importance of the tongue in bolus propulsion in the pharynx. Other postoperative changes in swallowing are discussed.
Rhabdomyosarcoma of the soft palate in three patients with follow‐up of longer than ten years
Authors: Maso Maurizio Dal , Kushner Joseph H. , Dedo Herbert H. 
Published: February 2007

AbstractRhabdomyosarcoma of the head and neck is a rare childhood neoplasm. Most occur in the orbit, which accounts for the scarcity of papers on modern techniques of treatment of soft palate rhab‐domyosarcomas. Only 30 cases of soft palate rhabdomyosar‐coma have been reported in recent years and none had long‐term follow‐up periods (>10 yr). This study reports three cases of pediatric soft palate rhabdomyosarcomas treated with surgery, radiotherapy (two of three), and chemotherapy. The complications that occurred in one patient are discussed.
Desmoplastic squamous cell carcinoma of the tongue simulating myositis or fasciitis
Authors: Norris Charles M. , Mustoe Thomas A. , Ross Jeffrey S. , Goodman Max L. 
Published: February 2007

AbstractAn unusual form of squamous cell carcinoma of the tongue is reported, the “de novo” submucosal evolution of which is unique. Histologic definition of this malignancy and its distinction from clinically similar benign and malignant conditions are detailed through a brief review of the relevant differential diagnoses. The importance of circumspect diagnostic reassessment when the clinical behavior of a lesion contradicts apparent histologic benignancy is emphasized and treatment inferences are drawn.
Malignant salivary tumors—analysis of prognostic factors and survival
Authors: O'brien Christopher J. , Soong Seng‐Jaw , Herrera Guillermo A. , Urist Marshall M. , Maddox William A. 
Published: February 2007

AbstractA group of 113 patients with malignant salivary gland tumors was retrospectively reviewed to analyze the association of clinical and histologic factors with survival. These factors were patient sex and age, tumor site, clinical stage, histologic diagnosis, tumor grade, and whether or not final surgical margins were clear. There were 57 parotid, 40 minor salivary, and 16 submandibular gland cancers. The histologic groups were mucoepidermoid carcinoma (49 patients), adenoid cystic carcinoma (31), adenocarcinoma not otherwise specified (18), acinic cell carcinoma (7), malignant mixed tumor (5), squamous cell carcinoma (2), and undifferentiated carcinoma (1). Univariate analysis of clinical factors showed that age and clinical stage significantly influenced survival. At 10 yr the predicted cumulative survival rates for Stage I, II, III, and IV tumors were 74%, 56%, 32%, and 10%, respectively. Tumor grade was the only significant histologic factor. This was most obviously reflected among patients with mucoepidermoid carcinomas. Cumulative survival at 5 yr was 94% for those with low‐grade tumors and 26% for high‐grade tumors. By multivariate analysis, clinical stage, age, and tumor grade remained highly significant. Analysis of patients with only Stage I and II disease demonstrated that the significant factors were patient age, tumor site, tumor grade, and whether or not surgical clearance was achieved. These results suggest that clinical stage should not be the exclusive determinant of the extent of surgery and that the selection of patients, for adjuvant therpay may be improved by an awareness of these prognostic factors.
Preauricular approach to infratemporal fossa
Authors: Wetmore Stephen J. , Suen James Y. , Snyderman Nancy L. 
Published: February 2007

AbstractWe present an approach to the skull base that allows access to both the infratemporal fossa and the middle cranial fossa with minimal morbidity. This approach is different from most of the previously described approaches in that it uses a preauricular incision, preserves the facial nerve, and avoids the mastoid bone. It involves dividing the zygomatic arch and displacing it inferiorly, dividing the malar eminence (zygoma) and displacing it anteriorly, and cutting the coronoid process and retracting it superiorly with the attached temporalis muscle. Reconstruction is accomplished by using the temporalis muscle or a pericranial flap to cover the dura, a free fat graft to fill the space left by tumor excision, and by wiring the zygomatic arch and malar eminence into their original positions. Case reports of both benign and malignant lesions are presented.
Role of transoral irrigation in mediastinitis due to hypopharyngeal perforation
Authors: Santos Gil Hauer , Shapiro Barry M. , Komisar Arnold 
Published: February 2007

AbstractMediastinitis resulting from perforations of the hypopharynx is a life‐threatening complication associated with a high morbidity and mortality. In cases of perforation, which are not amenable to primary closure, transoral irrigation has been found to be an effective means of therapy. This technique rapidly controls sepsis, favoring the closure of perforations of the hypopharynx and cervical esophagus. Using this technique we have had no mortality attributed to mediastinitis in patients with mediastinitis due to perforation of the hypopharynx, cervical and thoracic esophagus.
Manofluorography of deglutition after supraglottic laryngectomy
Authors: McConnel F. M. S. , Mendelsohn M. S. , Logemann J. A. 
Published: February 2007

AbstractManofluorography (mano: manometry, fluoro: videofluoroscopy, graphy: picture) provides a simultaneous display of manometry and fluoroscopy on one video screen. This study uses mano‐fluorography to analyze the swallowing patterns of nine patients who had undergone supraglottic laryngectomy. The results show that during swallowing the pharyngeal mechanism for preventing aspiration depends upon three processes: (1) tight lingual‐laryn‐geal contact, (2) coordination of the swallowing reflex, and (3) tongue base and pharyngeal constrictor clearing of the hypopharynx and laryngeal inlet. Anterior suspension of the larynx under the tongue base serves to improve lingual‐laryngeal contact. This close contact during deglutition protects the airway from the bolus and also opens the postcricoid region, aiding bolus passage into the esophagus. Impairment of the swallowing reflex, which can cause severe aspiration before the swallowing reflex is triggered, can be rehabilitated by swallowing therapy. Minor aspiration is commonly caused by impaired clearing of the superior hypopharynx after supraglottic laryngectomy.
Spread of squamous cell carcinoma to the nonirradiated edentulous mandible—A preliminary report
Authors: McGregor Ian A. , Gordon Macdonald D. 
Published: February 2007

AbstractThe changes in the mandible and in its relationship to surrounding soft tissue structures after loss of the teeth are described; the regular presence of deficiencies in the cortical bone along the line of the occlusal ridge is emphasized. Resection specimens of squamous carcinoma of the oral cavity not treated by radiotherapy were examined where there was mandibular involvement by tumor, and showed that the main route of tumor entry into the bone was through the occlusal ridge. Subsequent perineural spread along the inferior alveolar nerve has been found to be a regular occurrence.
High resolution CT scan of temporal bone fractures: Association of facial nerve paralysis with temporal bone fractures
Authors: Aguilar Eugenio A. , Yeakley Joel W. , Ghorayeb Bechara Y. , Hauser Michelle , Cabrera Juan , Jahrsdoerfer Robert A. 
Published: February 2007

AbstractThis radiologic study analyzed high resolution computed tomographic (CT) scans of 22 patients with temproral bone fractures. There were 19 males and three females. Fifteen of 22 had clinical evidence of facial nerve injury ranging from mild paresis to complete paralysis. The high resolution CT scan analysis identified a characterstic fracture of the temproral bone in every patient with facial nerve injry. A high percentage of these fractures (68%) could be classified as mixed and did not fall into a longitudinal or transverse fracture category. The characteristic fracture extends from the petroytympanic fissure at the glenoid fossa to the anterior inferior aspect of the medial bony external auditory canal. It resumes at the superior aspect to the external auditory canal (scutum) extending laterally along the external canal wall. If the vector force of the fracture is projected medially, it will cross the facial nerve in its horizontal protion. Often, the evaluation of trauma patients with routine CT scans for central nervous system (CNS) (brain) evaluation is inadequate for evaluation of temporal bone fractures. A high resolution CT scan should be performed when clinical criteria warrant its use. It is recognized that the incidence of facial nerve injury may be higher in this select population.
MacFee incisions: Dispelling the myth of cervical flap vascular inadequacy
Authors: Daniell Christopher H. , Fee Willard E. 
Published: February 2007

AbstractMacFee (double horizontal) incisions have often been criticized for transecting the dominant blood supply of the central bipedicled cervical flap. To assess the viability of this flap we reviewed our recent surgical data. Ninety‐three patients who underwent 100 radical neck dissections were evaluated retrospectively for cervical skin viability after surgery. MacFee incisions were used in 50 of these; in the remaining 50 a variety of other incisions were used. With MacFee incisions no ischemic tissue loss resulted. By contrast, six patients (12%) in the comparison group experienced partial flap necrosis due to ischemia. Chi‐square analysis shows this difference to be statistically significant (P < 0.01). This study shows the bipedicled cervical flap to be durable, dependable, and sufficiently vascularized to prevent ischemic tissue loss, even when incisions were previously placed in the ipsilateral neck or antecedent radiation therapy was delivered.
Pectoralis minor flaps: An experimental study and clinical applications of osteomuscular, osteomyocutaneous, and myocutaneous models
Authors: De Azevědo Jorge Ferreira 
Published: February 2007

AbstractThe pectoralis minor myocutaneous, osteomyocutaneous, and osteomuscular flaps were used in 14 patients. Thirteen cases had mandibular replacement, with bilateral flap application in three. The first eight flaps incorporated the fifth rib and the last eight flaps included the sixth rib. In the last four cases, the flap was transferred through a subclavicular tunnel. A mentum defect was present in 11 patients. There was one total flap necrosis due to venous thrombosis caused by surgical trauma. The flap provides rich vascularization and versatility, requires a small volume, and does not present serious sequelae to the donor site. It may be performed by a two‐team approach and is a valid option for head and neck reconstruction.
Periorbital cellulitis
Authors: Jackson Keith , Baker Shan R. 
Published: February 2007

AbstractPeriorbital cellulitis is a commonly occurring infectious process limited to the eyelids in the preseptal region. It occurs with greater frequency in the pediatric age group. It is important to distinguish this disease from orbital cellulitis, a potentially lethal infectious process involving the contents of the orbit. A retrospective study of clinical and laboratory data from 137 cases with orbital and periorbital cellulitis was performed. Periorbital cellulitis was documented in 98 cases (71%) in contrast to orbital cellulitis, which was noted in 39 (28%) patients. Sinusitis was the most frequently encountered predisposing factor for the development of periorbital cellulitis occurring in 29 patients. All patients with a diagnosis of periorbital cellulitis were hospitalized and received antibiotics, the majority (95%) receiving intravenous therapy. Hemophilus influenzae was the most frequently isolated pathogenic organism. It was necessary to operate on eight patients. Six patients underwent incision and drainage of an eyelid or periorbital abscess. A distinction between perioribital and orbital cellulitis is clarified. The separation of these entities on the basis of physical examination and radiographic studies is stressed.