bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neck dissection after twice‐a‐day radiotherapy: Morbidity and recurrence rates
Authors: Parsons James T. , Mendenhall William M. , Cassisi Nicholas J. , Stringer Scott P. , Million Rodney R. 
Published: February 2007

AbstractBetween March 1978 and April 1986, 56 patients underwent planned unilateral, and five patients underwent planned bilateral, radical neck dissections following high‐dose twice‐a‐day radiotherapy, usually with 60Co. Neck dissections were generally performed 6 weeks after radiotherapy. The overall rate of control of disease in the neck in all 61 patients was 81% at 5 years. Patients who underwent neck dissections following radiotherapy had significantly higher rates of heck‐disease control than patients treated by radiotherapy alone during the same time period for stages N2A‐N3A and N2B‐N3B, but not for N1 disease. No carotid ruptures or fatal complications occurred. The rate of wound complications was judged to be acceptable.
Radiographic evaluation for nasal dysfunction: Computed tomography versus plain films
Authors: Davidson Terence M. , Brahme Folke J. , Gallagher Mitchell E. 
Published: February 2007

AbstractSixty‐two patients, presenting to the Nasal Dysfunction Clinic at the University of California, San Diego, were radiographically examined with plain sinus x‐rays and computed tomographic (CT) scans. The x‐rays were evaluated independently, and the reported findings were compared. In maxillary sinuses the CT and plain film observations corresponded poorly with a concordance of 77%. There was a tendency to overread the plain films. In the ethmoid sinuses the lack of concordance between CT scans and plain films was 76%, and a tendency to under‐read the plain films was noted. In the lower nasal compartment the correspondence between CT and plain film readings was 57%, with a notable tendency to overread the plain films. In the olfactory recess, the CT/plain film concordance was 66%. At our institution, a sinus CT series costs $400; a conventional sinus series costs $102. The CT radiation dose is 5.2 to 6.5 cGY compared with 1.4 cGY for plain films.We conclude that plain films are unreliable and no longer routinely indicated for the evaluation of nasal and paranasal sinus disease. When radiographic evaluation is indicated a limited CT series provides superior information. Exceptions may include children and some cases of sinus disease isolated to a single sinus.
Circulating immune complexes and chemotherapy response in patients with head and neck cancer
Authors: Blazar Beverly A. , Fried Marvin P. , Strome Marshall , Clark John R. , Sereno Patricia , Rodliff Susan , Caminear David 
Published: February 2007

AbstractAn assay which could prospectively predict a response to chemotherapy prior to instituting therapy would be beneficial, especially for nonresponders. We evaluated at random a total of 50 patients with previously untreated stage III and IV head and neck squamous cell carcinoma for T‐cell subsets and levels of circulating immune complexes (CIC). Of this group 23 patients had induction chemotherapy as their first modality of treatment. These patients received standard protocols of therapy consisting of cisplatin, 5‐fluorouracil, methotrexate, and bleomycin. Of the laboratory measures assessed, only CIC correlated with clinical response to chemotherapy [no response (NR), partial response (PR), complete response (CR)] at the completion of the induction period (two to four cycles). Levels of CIC were determined by a polyethylene glycol (PEG) precipitation assay, and measured by spectrophotometry at 280 nm. In our population of all head and neck cancer patients, CIC were elevated (mean ∓ SD values: 0.475 ∓ 3.8 compared with controls: 0.184 ∓ 0.07). In the NR group, the mean ∓ SD was 0.707 ∓ 0.43 (P = 0.001). Complete responders had a mean value of 0.332 ∓ 0.21; partial responders had a mean value of 0.255 ∓ 0.13. On the basis of the values determined, patients with markedly elevated levels of CIC would be predicted to respond poorly, or not all, to current induction chemotherapy protocols.
Pectoralis myocutaneous flap for replacement of cervical esophagus
Authors: Cusumano Robert J. , Silver Carl E. , Brauer Richard J. , Strauch Berish 
Published: February 2007

AbstractThe authors report experience with 10 cases of pharyngoesophageal replacement with tubed pectoralis major myocutaneous (PM) flap. Six patients had primary reconstruction following total pharyngolaryngectomy for cancer; the other 4 had severe pharyngoesophageal stenosis requiring resection and replacement following previous laryngectomy. Seven of the patients were octogenarians, 6 had been irradiated previously, and all were severely debilitated. Two patients died postoperatively of cardiac disease. The remaining eight regained satisfactory with lasting deglutition. Four fistulae healed spontaneously, and one postoperative stenosis responded to a single dilitation. The interval to swallowing was 10‐21 days in nonirradiated patients and 3‐13 weeks in irradiated patients. There was one local recurrence 6 months after resection; the other patients remained free of disease. The authors conclude that the tubed PM flap is a reliable technique for pharyngoesophageal reconstruction that is particularly useful in elderly and debilitated patients.
Evaluation and treatment of acute laryngeal fractures
Authors: Schild Joyce A. , Denneny Elise Cheng 
Published: February 2007

AbstractTreatment of laryngeal fractures continues to evolve, and the airway now can be restored without stenosis or aspiration in most cases. However, the best treatment of vocal cord dysfunction from trauma remains uncertain, and the value of computerized tomographic scan (CT) is controversial. In this report, we describe the symptoms, radiologic findings, and treatment of 15 consecutive cases of laryngeal trauma. The value of CT for assessing the cricoarytenoid area is discussed. We also found CT to be reliable for defining the extent of soft tissue trauma and for diagnosing the presence and displacement of any fractures. Endoscopic photographs are compared with CT scan photographs to illustrate the correlation of CT with the degree of trauma. Finally, we present a method of laryngeal fracture repair using autologous thyroid cartilage.
Intraoral adenoid cystic carcinoma: The role of postoperative radiotherapy in local control
Authors: Van Waal Jacqueline E. Der , Snow Gordon B. , Karim Abul B. M. F. , Waal Isaac Van Der 
Published: February 2007

AbstractFourteen cases of adenoid cystic carcinoma (ACC) of the intraoral salivary glands with positive surgical margins have been reviewed in order to determine the role of postoperative radiotherapy in local control. Since local control was obtained in all patients, postoperative radiotherapy seems an adequate treatment to deal with the problem of positive surgical margins at the microscopic level, in cases of intraoral ACC, making additional surgical treatment redundant.
Gorham's disease affecting the maxillofacial skeleton
Authors: Anavi Yakir , Sabes William R. , Mintz Sheldon 
Published: February 2007

AbstractTwenty‐one cases of Gorham's disease in the maxillofacial region are described in the literature. This case is an additional one. The disease has a slight male predominance. All cases involved either the mandible alone or in association with the maxilla or other bones of the head and neck. The most common symptoms were pain, tooth mobility, mandibular pathological fractures, and facial deformity. The mean duration of symptoms prior to diagnosis was 6.4 years. Treatment included surgery, radiotherapy, and various medications, alone or combined. Four patients died of their disease. The diagnosis of the initial biopsy was incorrect in 45% of these cases. The current case appears to be the only one successfully treated by excision and autogenous bone graft reconstruction. In order to make an accurate diagnosis, the histologic featuares should be correlated with the clinical features.
Microvascular flaps in head and neck reconstruction
Authors: Morais‐Besteiro Júlio , Cernea Claudio R. , Medina Santos Luiz R. Dos , Brandão Lenine G. , Ferreira Marcus C. , Ferraz Alberto R. 
Published: February 2007

AbstractTwenty‐six patients with head and neck tumors were submitted to 27 microvascular reconstructive procedures. In 15, the mandible was reconstructed using the rib (4), iliac crest (7), and scapula (4). Nine patients underwent craniofacial reconstructions with the latissimus dorsi (5), rectus abdominis (2), greater omentum (2), and scapular (1) flaps. Two patients received a jejunum (1) and a stomach plus greater omentum (1) flaps for pharyngoesophageal reconstruction. Three illustrative cases, one from each group, are presented in detail. Good results were obtained in 22 patients (85%), with both functional and morphological rehabilitation. There were five flap losses (two in the same patient) due to thrombosis of the microvascular anastomoses. There was no operative mortality, and the average operative time was 11 hours. The good results observed in these very advanced cases show that there is a place for these complex procedures in the treatment of selected cases of head and neck tumors.
Serum tumor markers of head and neck cancer: Current status
Authors: Hanna Y. N. , Papay Francis A. , Gupta Manjula K. , Lavertu Pierre , Tucker Harvey M. 
Published: February 2007

AbstractThe serum level of a variety of substances shows significant changes in head and neck cancer patients. Such substances are collectively called biochemical tumor markers. To date, most markers lack a high degree of specificity and sensitivity. However, serial measurement of markers showing elevated pretreatment levels may help in monitoring response to therapy. Other potential uses of tumor markers include earlier detection of recurrence and/or metastasis, and possible prediction of prognosis. Measurement of more than one marker seems to enhance the diagnostic accuracy of the test. Some markers show significant correlations with various immune parameters in head and neck cancer patients and may have a possible role in potentiating the immunodepressed status of such patients. A review of currently reported tumor markers in head and neck cancer showing their nature, sources, uses, and limitations is presented.
Hemangiopericytoma of the maxillary sinus and skull base
Authors: Abdel‐Fattah Hesham M. , Adams George L. , Wick Mark R. 
Published: February 2007

AbstractSince 1949, only 52 cases of hemangiopericytoma (HPC) of the nos eand paranasal sinuses have been reported in the literature. Of the latter, only 2 originated from the maxillary sinus. This article reports 2 new cases. One arose in the maxillary sinus and involved the pterygopalatine fossa, skull base, and infratemporal fossa. The second tumor was located in the sphenoethmoidal recess. A new combination of techniques for resection of hemangiopericytoma of the skull base is described. Prognostic criteria for such tumors are reviewed, in conjunction with histological diagnosis.
Parapharyngeal fibrolipoma
Authors: Kennedy Kevin S. , Wotowic Paul J. , St. John James N. 
Published: February 2007

AbstractAlthough approximately 13% of lipomatous tumors occur in the head and neck, most of these are found in the immediate subcutaneous tissues, and lipomas of the deep head and neck tissues are rare. Lipomas consist of adipose tissue separated by fine fibrous trabeculae; if the amount of fibrous tissue is appreciable, the designation of fibrolipoma is used. We describe an unusual case of a parapharyngeal fibrolipoma with airway narrowing and ipsilateral compromise of the carotid artery and internal jugular vein blood flow. Diagnosis of deep head and neck lipomata is facilitated by utilizing computed tomographic analysis and angiography. The transcervical approach to the skull base which allows complete resection of this lesion is described.
Immunohistologic study of mononuclear cell infiltrates in oral squamous cell carcinomas
Authors: Hirota Jyusui , Ueta Eisaku , Osaki Tokio , Ogawa Yasuhiro 
Published: February 2007

AbstractIntensity of mononuclear cell infiltrates in 50 oral cancer tissues was evaluated by immunohistochemical stainings. The intensity of the infiltrates was graded into four degrees from marked (+ + +) to absent (‐); and the degree of each infiltrated lymphocyte subpopulation including Leu‐3a3b/Leu‐2a ratio was matched against clinical and histopathologic features. The vast majority of the infiltrated lymphocytes had antigens which were reactive with anti‐T cell antibodies. In T cell subsets, Leu‐3a3b+ cells infiltrated clearly (grade ++ or +++) in 44 cases, and infiltration greater than grade + + of Leu‐2a+ cells was found in nearly half of the cases (26 of 50). In contrast, B cells (Leu‐14+ cells) were obviously detectable in only a few cases, and moderate or marked infiltration of the natural killer (NK) population (Leu‐11b+ cells) was not observed. Regarding correlation of T cell infiltrates with clinicopathologic features of the tumors, the degrees of Leu‐4+ cell and Leu‐2a+ cell infiltration became weak with advancing T stage. Leu‐2a+ cells also infiltrated weakly into diffusely invading tumors. Out of 28 cases with no metastasis, 22 cases (78.6%) showed grade ++ ∼ + + + of Leu‐2a+ cells, and only 4 (18.2%) of 22 cases with lymph node metastasis were clearly positive for Leu‐2a+ cells (p < 0.001). However, Leu‐3a3b+ cell infiltration was only slightly related to T stage, metastasis, and to mode of invasion. Therefore, the Leu‐3a3b/Leu‐2a ratio increased significantly in advanced (T3 + T4) tumors, metastasized cases, or diffuse invasion type.
Home enteral nutrition via gastrostomy in advanced head and neck cancer patients
Authors: Campos Antonio Carlos L. , Butters Michael , Meguid Michael M. 
Published: February 2007

AbstractWe investigated whether home enteral feeding via a tube gastrostomy would enable patients with advanced malignant disease, who were unable to maintain themselves nutritionally via the oral route, to be independent of the hospital setting. Thirty‐nine patients with advanced upper gastrointestinal and head and neck cancer had a tube gastrostomy placed. Before discharge, the patient was trained in the care and use of the gastrostomy feeding tube. Ten patients died of their disease before they could be discharged. During the 6‐month period before gastrostomy insertion, the mean weight loss of the remaining 29 patients was 12.8%, and the mean body weight was less than 90% of ideal body weight. Prior to operation, the mean serum albumin and total lymphocyte count were 3.7 g/L and 1,087/mL, respectively. At discharge the mean caloric intake was 1.48 times resting energy expenditure. Home enteral nutrition was provided for a median of 94 days and resulted in stabilization of nutritional indices. During their median survival of 176 days, the 29 patients were admitted a total of 52 times. Twenty‐eight percent of the patients were never re‐admitted after gastrostomy and were adequately maintained at home, whereas 24% needed to be re‐admitted once. Only 48% were re‐admitted twice to assist in their nutritional management. Twenty patients received temporary home nursing services to aid in their transition. Four patients eventually resumed oral intake, and their feeding gastrostomies were removed. Home enteral nutritional support via gastrostomy enabled patients with advanced cancer to maintain their nutritional status and be independent from the hospital setting for extended periods, with the improved comfort and quality of their limited life at home in familiar surroundings in face of malignant disease.
Risk of wound infection in patients with head and neck cancer
Authors: Robbins K. Thomas , Favrot Stephen , Hanna Dinah , Cole Randolph 
Published: February 2007

AbstractThe purpose of this analysis was to determine the most important factors contributing to operative wound infections for patients with head and neck cancer. Four hundred cases were studied prospectively at M. D. Anderson Cancer Center within an 18‐month interval. Potential risk factors were categorized based on the patient, the disease, and the treatment. Sixty‐three (19.75%) wound infections were recorded. Univariate analysis identified the following factors to significantly alter the incidence of the infection: nutritional status and alcohol consumption (patient factors); T stage and N stage (disease factors); and duration of surgery, type of surgical wound, complexity of the procedure, use of flaps, blood replacement and the use of drains, nasogastric tubes, and tracheostomies (treatment factors). A logistic regression analysis identified the type of surgery, the choice of antibiotic, the presence of concomitant disease, and the N stage to represent the combination of factors most predictive of infection. The initial step toward preventing surgical wound infection is to identify the high‐risk factors. The results of this study help to define these parameters so that specific measures can be taken to counteract wound infection.
Early gold weight lid implant for rehabilitation of faulty eyelid closure with facial paralysis: An alternative to tarsorrhaphy
Authors: Sobol Steven M. , Alward Phillip D. 
Published: February 2007

AbstractAlthough tarsorrhaphy has been the mainstay of treatment for lagophthalmus associated with facial paralysis, it has many drawbacks which make it a less than ideal procedure. Gold weight implantation is a functionally and cosmetically superior alternative in many patients. Eighteen patients with both reversible and irreversible facial (eyelid) paralysis underwent early gold weight implantation for rehabilitation of faulty eyelid closure with satisfactory results. The advantages and disadvantages of this technique, when compared with other methods of correcting paralytic lagophthalmus, are discussed.
Atypical granular cell tumor of the larynx: An unusually aggressive tumor clinically and microscopically
Authors: Brandwein M. , Lebenger J. , Strauchen J. , Biller H. 
Published: February 2007

AbstractA 36‐year‐old man presented with a recurrent, rapidly enlarging laryngeal tumor causing upper airway obstruction. Microscopic study revealed a granular cell tumor (GCT) with marked atypia, pleomorphism, and pagetoid spread to the overlying epithelium. Histologic pleomorphism occurs rarely and is usually mild in laryngeal GCT. Malignant granular cell tumor (MGCT), a very unusual entity, can be diagnosed with confidence when there is clinical evidence of malignancy (i.e., metastasis). We support the concept of “atypical” GCT when marked pleomorphism is present, yet no metastasis has occurred. This will indicate to the otolaryngologist and pathologist the possibility of greater potential for aggressive clinical behavior.
Intraosseous frontal hemangioma
Authors: Hoffmann Dieter F. , Israel Jeffrey 
Published: February 2007

AbstractIntrasosseous hemangioma is a rare vascular malformation of bone infrequently described in the otolaryngologic literature. We report a case of this unusual tumor involving the frontal bone. Bone scan, computed tomographic (CT) scan, and histologic findings are illustrated. Differential diagnosis includes meningioma, eosinophilic granuloma, metastatic carcinoma, and other bony lesions. Treatment is complete surgical excision.
Carcinoma of the supraglottic larynx: A basis for comparing the results of radiotherapy and surgery
Authors: Mendenhall William M. , Parsons James T. , Stringer Scott P. , Cassisi Nicholas J. , Million Rodney R. 
Published: February 2007

AbstractAn analysis of 129 patients with 131 squamous cell carcinomas of the supraglottic larynx treated between October 1964 and April 1987 with radiotherapy alone or radiotherapy followed by neck dissection is presented. All patients had a minimum 2‐year follow‐up. Patients were excluded from analysis of disease control at the primary site and/or neck if they died within 2 years of treatment with the site(s) continuously disease‐free. Local control rates with radiotherapy and ultimate local control rates, including patients successfully salvaged after a local recurrence, were as follows: T1, 13 of 13 and 13 of 13; T2, 34 of 42 (81%) and 37 of 42 (88%); T3, 25 of 41 (61%) and 34 of 41 (83%); and T4, 3 of 9 and 6 of 9. There was no significant difference in local control rates when comparing patients who were anatomically suitable for a supraglottic laryngectomy with those who would have required a total laryngectomy. Local control rates were slightly diminished in patients with T2‐T3 lesions who had impaired or absent vocal cord mobility. The overall rates of ultimate local control with voice preservation for the entire series of 129 patients were as follows: T1, 100%; T2, 87%; T3, 69%; and T4, 57%. Cause‐specific survival rates at 5 years by stage were 1, 2 of 2; II, 10 of 12 (83%); III, 9 of 13 (69%); IVA, 4 of 6; and IVB, 7 of 22 (32%). The incidence of severe complications was 4 of 115 (3%) for T1‐T3 lesions and 4 of 14 (29%) for T4 lesions.
Tongue mobility in speech after partial glossectomy
Authors: Hamlet Sandra L. , Mathog Robert H. , Patterson Robin L. , Fleming Susan M. 
Published: February 2007

AbstractRecovery of tongue mobility in speech was investigated in 5 partial glosectomy patients. Jaw range of motion used in speech, and tongue contour changes relative to the jaw, were assessed using sequential videofluoroscopic data recorded presurgery, postsurgery, and postradiotherapy. Data from 2 normal controls were included for comparison. Tongue mobility relative to the jaw was found to be restricted postsurgery. Approximately 4 months later, following radiotherapy, tongue mobility increased. Range of jaw motion used in speech was unchanged. Results are interpreted as preliminary evidence that in this small group of cancer patients, radiotherapy following surgery did not prevent continued recovery of tongue function for speech in the early postradiation period.
Physical rehabilitation after myocutaneous flaps
Authors: Har‐El Gady , Krespi Yosef P. , Har‐El Rivi 
Published: February 2007

AbstractThe neck, shoulder, and upper trunk serve as donor sites for commonly used flaps in head and neck reconstruction. In order to prevent permanent functional disabilities, a physical therapy program was organized. The anatomy, physiology, and kinesiology of the shoulder muscles that are commonly used in myocutaneous flaps are reviewed. Their functional deficit and compensation are described. Exercise protocols for each group of muscles were developed. Prevention of postoperative “frozen shoulder” and the avoidance of tension and torsion of the transposed muscle pedicle are important during the immediate postoperative course. Strengthening the agonistic muscles and learning to use them correctly, in order to regain full range of motion, are the main long‐term goals.
Comparative study of technetium‐99M bone scans and orthopantomography in determining mandible invasion in intraoral squamous cell carcinoma
Authors: Ahuja Rajeev B. , Soutar David S. , Moule B. , Bessent R. G. , Gray H. 
Published: February 2007

AbstractThe accuracy of preoperative assessment in determining invasion of the mandible by intraoral squamous cell carcinoma was analyzed in 48 patients who underwent mandibulectomy, and the results correlated with the histopathological reports of the resected specimens. Only 50% of the patients underwent the “ideal” surgery based primarily on clinical judgement, whereas 10 patients in the series were significantly undertreated.Clinical judgement and routine preoperative x‐rays are accurate in cases where there is gross involvement of the mandible (17 of 19) but are significantly less successful in determining early bone invasion, invasion of the periosteum, or periosteal new bone formation. In such cases (26 of 48), a technetium‐99m bone scan provides additional information.A grading system for reporting orthopantomographics (OPTs) and bone scans has been developed and utilized to form a reference grid to determine the optimum extent of man dibular surgery. The results show that using the protocal, unnecessary mandibular surgery may be reduced and inadeqaute surgical excision avoided.