bluuebunny/crossref_metadata_2025_split huggingface dataset:
Problems of terminal head and neck cancer patients
Authors: Shedd Donald P. , Carl Allen , Shedd Charlotte 
Published: February 2007

AbstractIn recent years, there has been increased interest in defining what constitutes good quality of care for the terminal cancer patient. Progress in this area depends upon adequate knowledge of the problems in the terminal period for patients with cancer in specific sites. The present study is a survey of the final period of life in 60 head and neck cancer patients. The average survival time from diagnosis to death was 17.2 months. The mean time of hospitalization was 4 months. Pain was a problem in 85% of the patients, with feeding problems in 62% and respiratory difficulties in 43%. Eighty‐six percent of the patients died in a hospital setting, with the average duration of the final hospitalization being 68 days. Our analysis documents the complex problems in the terminal phase of a head and neck cancer patient's life. These problems challenge medical facilities caring for such patients to develop programs that will provide the best possible levels of care for head and neck cancer patients and to develop approaches that will reduce the suffering experienced by the patient's family.
Radiologic evaluation of irradiated cartilage grafts on the facial skeleton of sheep
Authors: Donald Paul J. , Wildes Thomas O. , Miller Donald C. , Hahn Jeanine 
Published: February 2007

AbstractAugmentation mentoplasty is a commonly performed procedure for correction of retrognathia and microgenia. Implantable Silastic prostheses have become the mainstay of therapy, but have some disadvantages. One of the most important complications is erosion of the underlying mandible. An attempt was made to produce an experimental animal model to test the efficacy of irradiated costochondral cartilage in this regard. In order to prevent a biological material from eroding the underlying bone, the irradiated sheep cartilage grafts were placed subperiosteally, deep to a pair of large muscles of facial expression in five Suffolk sheep. Irradiated cartilage was used as the test material and merthiolate‐treated cartilage as the control. Only 1 of the 20 grafts showed any absorption after 1 year, and this was only 1 mm in depth. Because of the meager amount of absorption of irradiated cartilage grafts, the ease with which they can be carved, and their ready availability, they would appear to be ideal implants for chin augmentation.
Surgical treatment of parathyroid disease: A review
Authors: Colacchio Thomas A. , Gerfo Paul Lo , Feind Carl 
Published: February 2007

AbstractSince the first parathyroidectomy was performed by Mandl in 1925, there have been many advances in our understanding of the parathyroid gland and its related disorders of calcium homeostasis. Our ability to establish the diagnosis of parathyroid neoplasia and locate the source of autonomous parathormone production has also dramatically improved. Nevertheless, it was the advent of the routine calcium and phosphate screening done on the sequential multiple analyzer (SMA‐12) that has caused a tremendous increase in the number of patients who are diagnosed to have hyperparathyroidism and who therefore present for surgical treatment. Essential for successful and uncomplicated treatment of this disorder is a thorough understanding of the anatomy, physiology, and pathology of the parathyroid glands. This review will consider the parathyroid glands in their normal state, as well as the diagnosis and management of the various disorders associated with them.
Repair of nasal fistula secondary to radiation therapy for Eales's disease
Authors: Fried Marvin P. 
Published: February 2007

AbstractEales's disease is characterized by neovascularization and idiopathic retinal and vitreous hemorrhages. Therapy in the past included the use of radiation. A case is reported of a patient who received a dose of 15,000 roentgens (approximately 14,250 rad) to the right eye via temporal and nasal portals. He subsequently lost vision in that eye. Thirty years after the radiation was administered, a nasocutaneous fistula developed, and it was closed with a forehead island flap.
Dental management and prosthetic rehabilitation of patients with head and neck cancer
Authors: Carl William 
Published: February 2007

AbstractDentistry has a significant supportive role in the management of head and neck cancer. Early preparations for prosthetic rehabilitation of patients who are in need of maxillary resections, and the use of prostheses in patients who have undergone partial mandibulectomies are explained. Patients being treated by radiation for tumors in the head and neck area require particular preventive care and instructions in oral hygiene. Systemic chemotherapy for tumors distant from the head and neck may precipitate severe oral complications. Occurrence and management of these problems are discussed.
The pathology of head and neck tumors: Neoplasms of cartilage, bone, and the notochord, part 7
Authors: Batsakis John G. , Solomon Alvin R. , Rice Dale H. 
Published: February 2007

AbstractNeoplasms of the supporting tissues in the head and neck are outnumbered by their histologic counterparts in the trunk and extremities. This is especially true for tumors of bone, cartilage, and the remnants of the notochord. Malignancies occurring in all three tissues, however, are just as lethal as those sited elsewhere. Chondrosarcomas and osteogenic sarcomas of the facial bones are resistant to all conventional modes of therapy, manifest many recurrences, and have an often protracted morbidity. The craniocervical chordoma manifests a similar biologic course. For the tumors of cartilaginous origin and the osteogenic sarcomas, the initial surgical attempt at removal is of key importance. Neoplasms present at the margins of resection have a poor prognosis. Chordomas are not likely to be cured by any modality.
Multicentric squamous‐cell carcinoma of the upper aerodigestive tract
Authors: Gluckman Jack L. , Crissman John D. , Donegan J. Oliver 
Published: February 2007

AbstractIn an attempt to define the true frequency of multiple primary squamouscell carcinomas of the upper aerodigestive tract, 3 separate population groups were studied. The results of this investigation confirmed the high incidence of multicentric carcinomas in the upper aerodigestive tract, lung, and esophagus. The clinical significance of this phenomenon is discussed, particularly its effect on patient survival and its possible relationship to local tumor recurrence. The value of routine panendoscopy in the initial assessment is stressed as well as the need for a lifelong follow‐up of these patients.
Clinical and radiologic aspects of maxillonasal dysostosis (binder syndrome)
Authors: Delaire J. , Tessier P. , Tulasne J. F. , Resche F. 
Published: February 2007

AbstractMaxillonasal dysostosis, described by Binder in 1962, is probably more common than one would think from the small number of cases that have been published (fewer than 40). We have seen 37 cases of this syndrome over a period of 8 years. Diagnosis of the syndrome is easy because of its characteristic anomalies of the upper lip and nose: smallness of the nose, a groove under the columella, a “half‐moon” appearance of the nasal apertures, absence of the nasal spine, and projection of the chin. In addition, we have observed several associated abnormalities: convergent strabismus (2 cases), mongolism (1 case), labiomaxillopalatine cleft (1 case), and, of particular note, numerous abnormalities of the cervical spine, frequently associated with mandibular prognathism. In view of the frequency of the latter abnormalities, Binder syndrome might well be called a “nasomaxillovertebral syndrome”.
Parotid cancer: A rational basis for treatment
Authors: Johns Michael E. 
Published: February 2007

AbstractParotid gland cancers are uncommon neoplasms whose management is complicated by their variable histopathology, their equally variable clinical course, and the intricate relationship of the facial nerve to the parotid gland and potential threat to the muscles of facial expression. In order to expand the limited familiarity with this unusual cancer that any single surgeon may acquire, a review is presented of factors influencing survival, including histopathology, lymph node metastasis, facial nerve palsy, skin involvement, size (stage), recurrence, pain, deep lobe and distant metastasis. The personal experiences of the author, experiences at the University of Virginia, and those in the literature were reviewed to derive the principles of treatment based on the TNM staging system and histopathologic diagnosis.
Radiologic evaluation of the cerebellopontine cistern and the internal auditory canal
Authors: O'Connor Sheilah M. , Sackett Joseph F. 
Published: February 2007

AbstractRadiologic evaluation of patients with unilateral sensorineural hearing loss depends on the quality of the computed tomographic (CT) scanner. Two scanners were evaluated in the present study: one utilizing thick collimation (10‐ and 13‐mm sections) and the second utilizing thin collimation (1.5‐mm sections). In both evaluations, intravenous contrast medium was used to exclude a cerebellopontine angle mass. If the cerebellopontine cistern is normal and there is clinical evidence of an intracanalicular lesion, air or metrizamide CT is used. When 10‐ and 13‐mm sections are used, air provides the best contrast with overlapping sections. When 1.5‐mm sections are used, coronal CT shows metrizamide in the internal auditory canal.
Radiologic evaluation of the normal adult nasopharynx
Authors: Keller Jeanne D. 
Published: February 2007

AbstractAdenoid hypertrophy complicates the radiographic evaluation of the adult nasopharynx. To define the limits of normal soft‐tissue thickness of the nasopharynx on the lateral film, I measured the profiles of 2 different groups of adult patients: 60 patients examined by x‐ray for trauma who had no sinus disease or nasopharyngeal complaints and 30 patients examined by x‐ray who had nasopharyngeal complaints necessitating biopsies. Histologic examinations of the biopsy specimens indicated benign disease, usually caused by an inflammatory process. The asymptomatic group showed a more uniform appearance of the nasopharynx than the symptomatic patients, who had a wide variation in the thickness of the nasopharynx. The symptomatic group manifested nasal and eustachian tube obstruction, frequently associated with serious otitis media. When the soft‐tissue thickness of the nasopharynx was correlated with age, nasopharyngeal thickening was unusual in asymptomatic persons older than 30 years. Conversely, persons over 30 with nasopharyngeal thickening were often symptomatic and had biopsies indicating some inflammatory change in the nasopharynx.
Computed tomography of the larynx: A clinical and pathologic study
Authors: Gregor R. T. , Lloyd G. A. S. , Michaels L. 
Published: February 2007

AbstractRecent interest in the application of computed tomography (CT) to the evaluation of laryngeal tumors, and the fact that the larynx offers the unique opportunity of whole organ study after total laryngectomy, led to a prospective study of laryngoscopy, conventional tomography, and CT in relation to pathologic findings. The results showed that CT gives an exact assessment of laryngeal anatomy and tumor involvement, particularly in the paracordal and pre‐epiglottic spaces. The laryngeal cartilages, which are not well demonstrated by any other means, are accurately delineated by CT. There is also good demonstration of the laryngeal surface of the epiglottis, including the anterior commissure, which is poorly shown by other radiologic methods and is sometimes poorly seen on laryngoscopy. Because CT and conventional tomography present images at 2 different planes, at right angles to each other, we believe that CT is entirely complementary to conventional tomography.
The pathology of head and neck tumors: The occult primary and metastases to the head and neck, part 10
Authors: Batsakis John G. 
Published: February 2007

AbstractMetastases from carcinomas to the head and neck, either to lymph nodes or to extranodal sites, arise most often from known primary neoplasms. However, some are from a clinically inapparent neoplasm—the so‐called occult primary. If the metastasis is an epidermoid carcinoma in a lymph node, the odds clearly favor the primary being in the upper aerodigestive tract. The success rate of discovery is variable, however, and a significant number of primaries remain undetected. Metastatic adenocarcinomas, to either nodal or extranodal sites, are most often from infraclavicular neoplasms. In general, the incidence of metastases to the head and neck from visceral primaries below the clavicle follows the general incidence of the primary cancer itself. Renal‐cell carcinoma is the exception since its frequency of metastases to the head and neck exceeds the expected incidence in the general population. Branchiogenic carcinoma is more a conceptual than a literal clinicopathologic entity. The diagnosis should be made with reluctance and only after fulfillment of several rather stringent criteria.
Management of burns of the head and neck
Authors: Wachtel Thomas L. , Frank David H. , Frank Hugh A. 
Published: February 2007

AbstractBurns of the head and neck with or without respiratory tract injury remain a serious and complex problem. Care of patients with this injury requires astute frequent clinical examinations, repeated laryngoscopy or flexible bronchoscopy, and serial laboratory investigations. Superb monitoring and care by the entire burn team with frequent dialogue among the individuals with specialized knowledge, mature clinical judgment in regard to therapy, and long‐term follow‐up help burn victims survive the injury and achieve the best possible functional ability and cosmetic appearance. There are no simple answers or rote decisions in the management of these injuries. The challenge requires the most innovative and creative care coupled with large amounts of hard work. Many of the recent advances in the management of burns of the head and neck have permitted these patients to survive and have helped them to return as functioning members of society.
Non‐Hodgkin's lymphoma of the nose and paranasal sinuses: A study of 17 cases
Authors: Kapadia Silloo B. , Barnes Leon , Deutsch Melvin 
Published: February 2007

AbstractNon‐Hodgkin's lymphoma of the nose and paranasal sinuses occurred in 14 men and 3 women with a mean age of 61 years. Nasal obstruction, unilateral facial swelling, and nasal discharge were frequent initial manifestations. The maxillary sinus and nose were the commonest primary sites. Using Rappaport's classification, there were 9 histiocytic, 5 poorly differentiated lymphocytic, and 3 mixed histiocytic‐lymphocytic lymphomas. Sixteen patients had radiation therapy to the primary site, and 9 patients later received chemotherapy. Eleven patients (69%) are dead, with a median survival time of 11 months after diagnosis. Dissemination of lymphoma was the most common cause of death. Five patients (29%) are alive up to 40 months after diagnosis. Patients with poorly differentiated lymphocytic lymphoma survived longer than those with histiocytic or mixed histiocytic‐lymphocytic lymphomas (median survival times 35, 9, and 12 months, respectively). Poor response to radiation therapy and dissemination of lymphoma were poor prognostic indicators.
Management of neoplasms of the head and neck in children. II. Malignant tumors
Authors: Raney R. Beverly , Handler Steven D. 
Published: February 2007

AbstractThe otolaryngologist who treats children must have knowledge of the neoplasms that can occur in childhood. Such tumors are usually mesenchymal in origin and may be benign or malignant. Diagnosis and management of the more common benign tumors are undertaken by the otolaryngologist because local excision is generally curative. The proper treatment of malignant lesions requires a more extensive, multidis‐ciplinary team, which includes a pediatric oncologist, diagnostic and therapeutic radiologist, and pathologist, in addition to the otolaryngologist. This article outlines the types of malignant neoplasms that occur in childhood and discusses current approaches to therapy.
The pathology of head and neck tumors: Cysts of the jaws, part 12
Authors: Regezi Joseph A. , Courtney Richard M. , Batsakis John G. 
Published: February 2007

AbstractThe jaws are unique bones of the skeleton because of their intimate involvement with tooth and facial development. Abnormal sequelae of these developmental processes may give rise to cystic lesions later in life. This paper reviews the pathogenesis, clinical features, and behavior of these odontogenic and nonodontogenic cysts. Justification is found for the exclusion of the globulomaxillary, midmandibular, and midpalatine cysts from a current classification. Emphasis is placed on the importance and controversy surrounding the odontogenic keratocyst.
Recent advances in ultrasound: High‐resolution imaging of superficial structures
Authors: Scheible William 
Published: February 2007

AbstractIn the past few years, sophisticated ultrasound systems specifically designed for the evaluation of superficial organs and structures have been developed. These “high‐resolution” scanners are particularly well suited to diagnostic imaging in the neck. This review summarizes current clinical applications of this evolving technology and highlights initial experience with a prototype scanner that is now commercially available. Particular attention is directed to high‐resolution ultrasonography of the thyroid and parathyroid glands, the extracranial carotid arteries, and neoplastic and inflammatory masses of the neck.
Transtracheal microsurgical closure of tracheoesophageal fistulas
Authors: Gerhardt H.‐J. 
Published: February 2007

AbstractA patient with a 1.5‐ to 2.5‐cm tracheoesophageal fistula secondary to prolonged assisted ventilation and feeding by a nasogastric tube was operated upon by a transtracheal microsurgical approach. The advantages of this approach are as follows: (1) the surgery is not extensive and therefore does not cause much stress to the patient: (2) this technique avoids the necessity for a wide mediastinotomy or sternotomy and thoracotomy and therefore averts the danger of a widespread infection with the highly antibioticresistant bacteria that are always present in these cases; and (3) there is no risk of damage to the recurrent nerve. The ENT surgeon who is welltrained and experienced in microsurgery should try this approach in selected cases first. If this method fails, other methods are still available.
Chemotherapy for advanced carcinoma of head and neck: An effective outpatient schedule of cytoxan, oncovin, methotrexate and bleomycin
Authors: Didolkar M. S. , Coleman J. J. , Elias E. G. , Gray W. C. , Cosentino E. 
Published: February 2007

AbstractTo evaluate an effective, cell‐cycle‐specific combination chemotherapy which could be administered on an outpatient basis, COMB of Maryland (Cytoxan, Oncovin, methotrexate and bleomycin) was used in 20 patients with stage IV squamous cell carcinoma of head and neck origin. All patients had unresectable but measurable disease. Nine patients had distant metastases. Prior to this chemotherapy, 15 (75%) patients underwent radiation therapy, 12 (60%) had radical surgery, and 3 (15%) were administered other chemotherapeutic drugs. The distribution of the primary site of tumor was identical to the overall distribution of squamous cell carcinoma of head and neck found in this country. Drug dosages were: Cytoxan 100 mg/m2 p.o. days 1‐14, Oncovin 1 mg/m2 IV days 1 and 8, methotrexate 25 mg/m2 IV days 1 and 8, and bleomycin 15 units/m2 IM days 1 and 8. This cycle was repeated every four weeks. Two (10%) patients had complete response and 7 (35%) had partial response, thus giving the total response rate of 9 (45%). Seven (35%) patients had static disease and 4 (20%) had progression of disease. Duration of response was from 8 to 26+ weeks with a median duration of 17+ weeks. Response rate was statistically related to performance status and previous chemotherapy. However, it was not related to age, sex, site of origin, previous radiation therapy, or differentiation of the tumor. Increased survival (P < 0.01) was seen in responders (median 16+ weeks) as compared to nonresponders (9 weeks). Hematologic toxicity was seen in 9 (45%) patients, resulting in one chemotherapy‐related death. Overall, this chemotherapy has been well tolerated on an outpatient basis. Although 15 (75%) patients received prior radiation therapy, the results were comparable to those obtained by other, more toxic combination chemotherapeutic regimens.
Nuclear medicine in diagnosis and treatment of diseases of the head and neck. I. Salivary and parathyroid gland disease and one identification and staging of head and neck tumors
Authors: Blahd William H. , Rose Judith G. 
Published: February 2007

AbstractThe advent of both improved imaging systems and new radioactive agents has increased the effectiveness of nuclear medicine in diagnosing and treating diseases of the head and neck. In this first in a series of two articles, the role of nuclear medicine is discussed in the evaluation of diseases of the salivary and parathyroid glands, and in the identification and staging of head and neck tumors. Radionuclide studies of the salivary glands are useful in the identification of tumors and the evaluation of gland function. Such studies are a valuable adjunct in the diagnosis of Sjögren's syndrome and of acute and chronic inflammatory disease. Radionuclide imaging also has been helpful in the detection of adenomata and hyperplasia of the parathyroid glands and often complements ultrasonography localization procedures. The advent of gallium‐67 imaging has improved the staging of head and neck tumors.
Recent advances in paranasal sinus surgery
Authors: Donald Paul J. 
Published: February 2007

AbstractRecent advances in paranasal sinus surgery have occurred in the treatment of trauma and neoplasia, rather than in the more traditional management of inflammatory disease. Cranialization of the frontal sinus in severe penetrating trauma was first described in 1978. By removal of the sinus posterior wall, excision of the mucosa, and preservation of the anterior wall fragments, the forehead contour can be preserved and the cavity ablated by the forward expansion of the frontal lobes. Craniofacial surgery for malignancies of the paranasal sinuses has vastly improved the survival rate for these patients. Simultaneous en bloc resection, done transcranially to establish the margins of resection of the superior‐most extent and transfacially to ablate the site of origin of the neoplasm, has produced five‐year survival rates of 50%. Involvement of even the cavernous sinus can be handled, providing initial control of the internal carotid artery is achieved and an adequate cerebral circulation is ensured. Decompression of the optic nerve following facial trauma that results in fractures of the orbital apex remains controversial. Documented cases of progressively failing vision in such patients provides the clearest indication. Surgical decompression through the transethmoidal sphenoidal route provides excellent access to remove the maximum amount of bone from the optic canal.
Reconstruction of the hypopharynx and cervical esophagus with bilateral pectoralis major myocutaneous flaps
Authors: Strawberry Carl W. , De Fries Hugh O. , Deeb Ziad E. 
Published: February 2007

AbstractA patient is presented in whom bilateral pectoralis major myocutaneous flaps, one of which was lined by a split‐thickness graft, were used in the total reconstruction of the hypopharynx.