bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inversion of Zenker's diverticulum: The preferred option
Authors: Morton Randall P. , Bartley James R. F. 
Published: February 2007

AbstractA review of patients who had surgery for Zenker's diverticulum in our institution in recent years was conducted. A comparison of inversion versus excision of the sac shows that inversion carries lower morbidity and more rapid rehabilitation of swallowing than does excision. Inversion (plus cricopharyngeal myotomy) is to be preferred for diverticula that are neither too large to invert nor too longstanding to risk leaving subclinical carcinoma behind in the wall of the diverticulum.
Cartilage‐shaving procedure for the control of tracheal cartilage invasion by thyroid carcinoma
Authors: Park Cheong Soo , Suh Kwang Wook , Min Jin Sik 
Published: February 2007

AbstractThis study was carried out to ascertain whether the cartilageshaving procedure is appropriate to control thyroid carcinoma with tracheal cartilage invasion. Of 432 thyroid carcinoma patients treated between 1979 and 1988, 16 had tracheal cartilage invasion only. This patient population was made up of 3 men and 13 women, with a mean age of 55.8 years. Fourteen were diagnosed histologically as having papillary carcinoma and the remaining two as having follicular carcinoma. Cartilage shaving was the primary treatment in all the patients, and subsequent radioactive iodine (131) or external‐beam radiotherapy was administered to control any possible residual disease. Lifelong thyroid hormone replacement was instituted in all patients, and the follow‐up period averaged 70.7 months. Only four of the 16 patients remained disease free; the disease was not controlled in the other 12, and seven of this latter group eventually died of their disease. We feel that a more extensive resection procedure than cartilage shaving should be considered, even in patients with superficial tracheal invasion, to increase the diseasefree survival rate.
Recovery of postoperative swallowing in patients undergoing partial laryngectomy
Authors: Rademaker Alfred W. , Logemann Jerl A. , Pauloski Barbara Roa , Bowman Julia B. , Lazarus Cathy L. , Sisson George A. , Milianti Franklin J. , Graner Darlene , Cook Barbara S. , Collins Sharon L. , Stein David W. , Beery Quinter C. , Johnson Jonas T. , Baker Theresa M. 
Published: February 2007

AbstractThis study assessed the achievement of postoperative swallowing in patients undergoing partial laryngectomy surgery. Oropharyngeal swallow efficiency was used to predict time to achievement of outcome. Fifty‐five patients were followed for up to 1 year in two hemilaryngectomy and four supraglottic laryngectomy groups. Within 10 days of healing, a videofluoroscopic evaluation enabled the measurement of swallowing efficiency. Times to achievement of oral intake, removal of feeding tube, preoperative diet, and normal swallow were analyzed using actuarial curves. Patients with hemilaryngectomies achieved swallowing rehabilitation sooner than patients with nonextended supraglottic laryngectomies (p < .05) who, in turn, achieved swallowing function sooner than did patients undergoing supraglottic laryngectomies with tongue base resection (p < .05). Median time to attainment of preoperative diet in these three groups was 28 days, 91 days, and > 335 days, respectively. Higher early postoperative oropharyngeal swallow efficiency was related to earlier achievement of oral food intake and of preoperative diet (p < .05). Results show that the time course for swallowing rehabilitation covers an extended postoperative period. In some surgical groups, functional swallowing and eating may be achieved within 3 months of surgery while for other types, significant impairment remains up to 9 months postoperatively. Early radiographic assessments of swallowing function are useful in predicting the time to swallow recovery. Recovery of swallowing ability may be delayed in patients who have not achieved oral intake before radiotherapy is started.
Secondary microvascular tongue reconstruction: Functional results
Authors: Salibian Arthur H. , Allison Glenn R. , Strelzow Victor V. , Krugman Mark E. , Rappaport Irving , McMicken Betty L. , Etchepare Terry L. , Sultan Mark R. 
Published: February 2007

AbstractBetween 1978 and 1991, 56 microvascular composite flaps were used for oromandibular reconstructions: 15 for primary total and subtotal tongue reconstruction and five for secondary major tongue reconstruction. The delayed reconstructions were performed to improve the oral and pharyngeal phases of swallowing. Using a floor of the mouth composite bone grafting technique to reposition the tongue and obliterate the oral dead space intraoral food transport was improved (three of five patients), but aspiration persisted (three of four patients). When compared with 10 patients evaluated for primary total and subtotal tongue reconstruction the primary reconstruction group showed superior swallowing (eight dynamic oral transport, no aspiration) and speech results. The poor results of secondary reconstruction are attributed to scarring and irreversible damage to remaining functional muscles involved in protecting the laryngeal aditus.
Intracranial complications resulting from frontal pyocele: Case presentation and review of experience in japan
Authors: Yamasoba Tatsuya , Kikuchi Shigeru 
Published: February 2007

AbstractA case of subdural empyema resulting from an acute infection of frontal cysts is reported. Urgent surgery was performed to create a right frontal burr hole, followed by an osteoplastic frontal sinusotomy and postoperative chemotherapy. Thus, this intracranial complication was successfully treated with no further sequelae. MRI was useful for clearly revealing a transtentorial herniation and the affected site of the dura mater from which bacterial infection spread intracranially. Review of rhinogenic intracranial complications in Japan shows a dramatic decrease in the mortality rate from the preantibiotics era to the pre‐CT‐scan era, and also from the pre–CT‐scan era to the present CT‐scan era. This suggests that CT scan and, more recently, MRI, have indirectly helped to reduce the mortality rate by enabling an earlier and accurate diagnosis.
Vocal cord paralysis from prostatic carcinoma metastasizing to the larynx
Authors: Park Youn W. , Park Myoung H. 
Published: February 2007

AbstractAccording to 1992 Cancer Statistics, prostate carcinoma is once again predicted to be the most common cancer in men, exceeding the incidence of lung cancer. In American men, this cancer is estimated to be the second most frequent cause of cancer deaths by site. Although metastases have been reported in practically every organ in the body, prostatic cancer most often metastasizes to bones, regional lymph nodes, and viscera. Although secondary involvement of the larynx by malignant neoplasms arising in contiguous structures is well known, metastatic cancer to the larynx from a prostate carcinoma is rare. This report discusses a unique case that presented with hoarseness resulting from vocal cord paralysis. The diagnosis of the tumor was confirmed by immunoperoxidase stains for prostate‐specific antigen.
Validity of test occlusion studies prior to internal carotid artery sacrifice
Authors: McIvor Nicholas P. , Willinsky Robert A. , Terbrugge Karel G. , Rutka John A. , Freeman Jeremy L. 
Published: February 2007

AbstractTwenty‐nine patients with lesions of the neck, skull base, and cavernous sinus had test balloon occlusions of the internal carotid artery (ICA) to determine the feasibility of sacrifice of the artery. Only one patient (3.4%) showed evidence of cere‐brovascular compromise. Sixteen patients who tolerated test occlusions went on to ICA sacrifice. Ten patients had permanent balloon occlusion (PBO) of the ICA for cavernous aneurysms or to “trap” carotid‐cavernous fistulae (CCF). Complications occurred in three patients (30%) with permanent morbidity in one patient (10%). One patient with CCF had PBO of the proximal ICA only, resulting in an unstable neurologic state and ultimately in death. Two patients had resection of skull base tumors 2 and 6 days after PBO of the ICA. Both suffered strokes and one died. Three patients had surgical sacrifice of the ICA without PBO. Two of these patients suffered cerebral ischemia without permanent sequelae. We conclude that test occlusion of the ICA with clinical monitoring will miss a significant number of patients with inadequate cerebrovascular reserve. Sensitivity is improved by controlled reduction of systemic blood pressure during the test occlusion. Resection of a skull base tumor soon after PBO of the ICA should be done in a delayed fashion or preceded by extracranial‐intracranial arterial bypass. Patients who have had the artery sacrificed should be monitored in an intensive care setting for 48 hours to avoid hypotension, which could cause cerebrovascular ischemia. © 1994 John Wiley & Sons, Inc.
Differential movement during swallowing as an aid in the detection of thyroid pseudonodules
Authors: Siminoski Kerry 
Published: February 2007

AbstractThe clinical examination of neck masses is clearly imperfect and false‐positive detection of thyroid nodules, termed “pseudonodules.” remains a common problem. Movement on swallowing has been emphasized as a highly specific feature of thyroid masses, but lesions in the vicinity of the thyroid can be displaced by underlying structures during deglutition causing them to mimic thyroid nodules. Two cases are presented to illustrate how additional features of neck mass movement can help determine whether a lesion is located within the thyroid or whether it is extrathyroidal. These include the range of motion of the mass, the presence or absence of a stationary phase prior to descent, and the timing of the movements of the mass. Assessment of these parameters during the physical examination of anterior neck masses may help reduce the incidence of thyroid pseudonocules. © 1994 John Wiley & Sons, Inc.
Multidisciplinary treatment of head and neck cancer using BCG, OK‐432, and GE‐132 as biologic response modifiers
Authors: Fukazawa Hajime , Ohashi Yasushi , Sekiyama Saburo , Hoshi Hideki , Abe Michio , Takahashi Mamoru , Sato Toshihisa 
Published: February 2007

AbstractSince 1979, we have performed multidisciplinary treatment using intensive immunotherapy with biologic response modifiers (BRM) in combination with surgical treatment of oral cancer. Chemotherapy and radiotherapy were also included as part of the therapy. A historic control study was performed. Adjuvant therapy was administered by standardized methods, and the distribution of patients at various stages was similar between groups. The immunotherapy group showed a shorter treatment period, lower rates of recurrence, metastases, and side effects, greater histologic effects at the end of the first treatment, and a higher survival rate than the nonimmunotherapy group. Immunologically, immunotherapy tended to promote positive immune reactions and inhibit negative immune reactions. © 1994 John Wiley & Sons, Inc.
Chondrosarcoma of the larynx: Challenges in diagnosis and management
Authors: Bogdan Charles J. , Maniglia Anthony J. , Eliachar Isaac , Katz Robert L. 
Published: February 2007

AbstractChondrosarcoma is a rare neoplasm of the larynx with approximately 200 cases reported in the literature. The infrequent occurrence of this neoplasm, and its indolent pattern of growth, can result in a delayed or missed diagnosis, thereby jeopardizing the preservation of laryngeal function. Four cases of chondrosarcoma of the larynx are presented demonstrating the challenges in the diagnosis and management of this neoplasm. Conservation surgery remains the mainstay of therapy aiming towards preservation of the framework and function of the larynx. Two innovative reconstructive techniques are presented which made conservation laryngeal surgery possible in two of the four patients. Indeed, surgical resection with sound oncologic principles must be applied and total laryngectomy may be necessary. On rare occasion radiotherapy may be used, although its value remains controversial. © 1994 John Wiley & Sons, Inc.
Vascular basis of lateral osteotomy of the mandible
Authors: McGregor Alan D. , MacDonald D. G. 
Published: February 2007

AbstractThe sources of periosteal blood supply to the mandible have been investigated by dissection, histology, and injection studies. The facial artery has been identified as a major extraosseous source of blood supply to the body. The study confirms the importance of preserving the soft tissue attachments on the buccal aspect and lower border of the mandible during lateral mandibular osteotomy. © 1994 John Wiley & Sons, Inc.
Giant cell lesions of the maxilla and paranasal sinuses
Authors: Stolovitzky J. Pablo , Waldron Charles A. , McConnel Fred M. S. 
Published: February 2007

AbstractGiant cell lesions of the maxilla and paranasal sinuses represent a rare, locally aggressive disorder which present as a soft tissue mass with distinct histologic and clinical features. There is considerable controversy on the therapeutic modalities, the prediction of clinical behavior based on histologic features, and whether these growths are reactive or neoplastic in nature. We present our clinical experience with four of these lesions. Follow‐up ranged from 3 to 11 years. Our results and the rationale for aggressive surgical treatment will be discussed.We hypothesize that giant cell “granuloma” of the maxilla and paranasal sinuses and giant cell tumor of other bones represent a continuum of a single disease process, which may have an aggressive clinical behavior. This paper, with a literature review, will address the treatment controversy and advocate surgical resection for all giant cell lesions. © 1994 John Wiley & Sons, Inc.
Relationship of intraoperative rupture of pleomorphic adenomas to recurrence: An 11‐25 year follow‐up study
Authors: Natvig Ketil , Søberg Randulf 
Published: February 2007

AbstractBackground. Intraoperative rupture of the capsule of a pleomorphic adenoma is reported to be associated with an increased recurrence rate. For many years, we have noted few recurrences among patients who experienced rupture of the capsule during surgery. Therefore, we asked “How often has surgical rupture of the capsule of a mixed parotid tumor resulted in recurrence among our patients?” This study is a summary of our clinical observations and not a methodologic one.Methods. The medical records of 346 patients operated on between 1965 and 1981 were reviewed. The surgical notes and histopathologic descriptions were examined with special reference to the relationship between surgical margins and tumor capsule. Satisfactory follow‐up was obtained from 238 patients primarily operated on in our department. The average observation time was 18 years. None of our patients received postoperative irradiation.Results. Six (2.5%) patients had a recurrence 7 to 18 years postoperatively (mean 11.8 years). This recurrence rate is of the same order of magnitude as other reports. Rupture of the capsule with macroscopic spillage of tumor cells occurred in 26 patients and two (8%) of them developed recurrent tumors. Surgical dissection close to the capsule was performed in 87 cases, with one recurrence. In the remaining 121 patients the surgical dissections were done without visualizing the tumor capsule. Three (2.5%) of these cases developed recurrent tumor. The 8% recurrence rate after capsule rupture is not statistically different from the 2% for the other patients. There was also no difference in recurrence rate between patients with microscopic positive or negative surgical resection margins.Conclusions. We question whether spillage of tumor cells from a pleomorphic adenoma plays such an important role in the development of recurrent tumors as has been previously postulated. We also question the justification and benefit of postoperative radiotherapy for patients with this benign disease. © 1994 John Wiley & Sons, Inc.
Fibrous neoplasms of the adult larynx
Authors: Rohn Gregory N. , Close Lanny G. , Vuitch Frank , Merkel Marie A. 
Published: February 2007

AbstractFibrous neoplasms of the adult larynx are uncommon and can be benign, locally aggressive, or malignant. From January 1, 1987 to December 31, 1991, 189 adult patients underwent partial or total laryngectomy for laryngeal neoplasms at the University of Texas Southwestern Medical Center‐affiliated hospitals. During this period, three (1.6%) patients were treated for fibrous neoplasms of the larynx. All three lesions arose in the true vocal fold. In one patient, a local recurrence within 6 months following partial laryngeal resection necessitated total laryngectomy. All three patients are alive and disease‐free 1 to 4 years following definitive surgery. We present these cases and discuss computed tomographic (CT), histopathologic, and electron microscopic (EM) findings. Based on this experience, surgical treatment of these lesions is recommended, the extent of which is guided by clinical, radiologic, and pathologic evaluation. © 1994 John Wiley & Sons, Inc.
DNA measurements for monitoring chemotherapy in advanced head and neck carcinomas
Authors: Welkoborsky Hans J. , Mann Wolf J. , Sanal Cem , Freije James E. 
Published: February 2007

AbstractBackground. Quantitative DNA measurements have demonstrated prognostic relevance in various malignancies, including head and neck cancer. The application of DNA measurements in monitoring and predicting the outcome of chemotherapy in treating patients with head and neck cancer was investigated.Methods. Twenty‐five patients with advanced squamous cell carcinomas of the head and neck who underwent primary chemotherapy with three courses of cisplatin and 5‐fluorouracil (5‐FU) were examined in this study. Cytologic smears from the tumor site, as well as from normal mucosa, were taken before and 1 week after each course of chemotherapy. Quantitative DNA measurements were performed using an automatic microscope and a TV‐based image analysis system. The DNA parameters (ie, mean DNA content of the tumor cells, 2c deviation index (2c Dl), 5c exceeding rate (5c ER), DNA malignancy grade, and stemline analysis) were determined from the single cell measurements.Results. Tumors which responded to chemotherapy showed a shift of the mean DNA content and stemline towards euploidy and a decrease of aneuploid tumor cells with a DNA content of more than 5c. Tumors which did not respond to chemotherapy showed a persistent high percentage of aneuploid tumor cells and a high malignancy grade. These changes in the DNA content were observed after the first course of chemotherapy. In a clinical follow‐up, patients with a shift of the DNA data towards euploidy during chemotherapy showed a significant longer recurrence‐free interval than patients with residual aneuploid cell clones.Conclusions. Quantitative DNA measurements appear to be useful in monitoring therapy and to predict the outcome after chemotherapy. Although no typical constellation was found which predicts good or bad response, the DNA data suggest that changes in the data after the first course of chemotherapy may correlate with outcome. © 1994 John Wiley & Sons, Inc.
Swallow recovery in an oral cancer patient following surgery, radiotherapy, and hyperthermia
Authors: Lazarus Cathy L. , Logemann Jeri A. , Kahrilas Peter J. , Mittal Bharat B. 
Published: February 2007

AbstractBackground. No study has examined the nature and extent of swallowing impairment in oral cancer patients following treatment with combined hyperthermia and interstitial radiotherapy. Few studies have examined the effects of voluntary swallow maneuvers (supersupraglottic and Mendelsohn) on pharyngeal phase swallowing in the oral cancer patient treated with surgery or radiotherapy. This study examined the effects of combined radiotherapeutic salvage treatments of hyperthermia and interstitial implantation and swallow recovery using swallow maneuvers in a surgically treated and irradiated oral cancer patient.Methods. The patient under study, a 51‐year‐old man, underwent radiotherapy, according to Radiation Therapy Oncology Group (RTOG) protocol #8419, consisting of a combination of interstitial irradiation and hyperthermia to the base of tongue, for a recurrent squamous cell cancer. He underwent videofluorographic (VFG) examination of his swallowing, a modified barium swallow at three time points: 2 days following radiotherapy treatment (VFG1), 4 weeks later (VFG2), and 8 months later (VFG3). Temporal and biomechanical analyses of swallows were performed at each time point.Results. Swallow maneuvers and time resulted in improved laryngeal elevation and laryngeal vestibule closure during the swallows on VFG2. Maximum upper esophageal sphincter (UES) opening width and duration were more normal. Fewer swallows were required for bolus clearance through the pharynx. Base of tongue tissue necrosis occurred as a complication of radiotherapy between VFG2 and VFG3, with resultant severe reduction in posterior movement of the tongue base, incomplete tongue base contact to the posterior pharyngeal wall, reduced laryngeal elevation, and incomplete laryngeal vestibule closure during swallowing at VFG3. UES opening became less normal and a greater number of swallows were required for bolus clearance through the pharynx.Conclusions. Combined interstitial irradiation and hyperthermia can cause oropharyngeal swallowing problems. Time and swallow therapy can improve these swallow disorders. Tongue base tissue necrosis can cause further swallow impairment, emphasizing the importance of the tongue base in normal deglutition. Further studies are needed to examine the impact of combined hyperthermia and interstitial implantation for treatment of tongue base tumors on swallow functioning in a larger group of patients. © 1994 John Wiley & Sons, Inc.
Bone marrow metastases from small cell cancer of the head and neck
Authors: Pierce Scott T. , Cibull Michael L. , Metcalfe Monty S. , Sloan David 
Published: February 2007

AbstractBackground. Primary small cell carcinoma of the head and neck is rare. Although the larynx is the most prevalent site of head and neck small cell carcinoma (SCC), this report will concentrate on SCC of the major salivary glands and paranasal sinuses. In all, 33 cases of paranasal sinus and 43 cases of major salivary gland SCC have been reported in the literature.Methods. We report two patients, one with submandibular gland SCC and the other with maxillary sinus SCC.A literature review of all known paranasal sinus and major salivary gland SCC with inclusion of data from these two new cases is undertaken. Discussion of all past and present cases concentrates on sites of metastasis, treatment, and survival.Results. Paranasal sinus SCCs predominantly arise from the nasal cavity, whereas the parotid gland is the primary site in three fourths of major salivary gland SCCs. One half of major salivary gland and three fourths of paranasal sinus SCCs have only local disease at presentation. Both patients in this report developed bone marrow metastases, a feature heretofore not observed in SCC from these primary sites. The patient with maxillary sinus SCC developed the syndrome of inappropriate antidiuretic hormone (SIADH).Conclusion. The paranasal sinus and major salivary glands are rare primary sites for SCCs. Long‐term survival with local therapy in patients with local disease can occur, but in patients with metastatic disease survival mirrors metastatic pulmonary SCC. © 1994 John Wiley & Sons, Inc.