[Salivary gland drainage into the thyroglossal duct].

Background: Failure in regression of the thyroglossal duct is one of the most common reasons for midline swellings in the neck. Several authors have described recurrent thyroglossal duct remnants with persisting draining sinuses. However, few have described accessory salivary glands that drain into the thyroglossal duct.

Survival of patients with squamous cell carcinoma of the supraglottic larynx--thirty-five-year experience with radiotherapy.

A retrospective comparison of treatment policies in two institutions revealed a change in the reliance on radiotherapy. Since 1978, high-energy, high-dosage radiotherapy has played a prominent role in the primary therapy of squamous cell carcinoma of the supraglottic larynx. Statistically, the overall determinate survival rate has improved compared with results during the preceding period, but the death rate from intercurrent disease and second primary cancers has remained unchanged.

Recurrence after different primary treatment for cancer of the supraglottic larynx.

Retrospective analysis of patient records at two hospitals was performed with the principal goal of clarifying the role of primary radiotherapy ill patients with squamous cell carcinoma of the supraglottic larynx. Primary surgery was frequently performed during the first period from 1958 to 1978. Primary radiotherapy with surgery in reserve was the prevailing therapy during the second period from 1978 to 1993.

[Laser surgery of laryngeal cancer (T1 glottis). New therapeutic alternative].

The standard treatment for patients with T1a vocal cord cancer has been radiotherapy. From October 1995 selected patients have undergone laser surgery and up until March 1997 we had treated 16 patients. The results so far have been satisfactory with only one recurrence.

[Free vascular grafts in reconstructions in the head and neck region].

Since 1989, 40 free-tissue grafts were used in 39 patients to repair defects following major head and neck ablative surgery (n = 32) and for reconstruction of the mandible because of osteoradionecrosis or trauma (n = 7). The radial forearm flap was used in 17 patients (five including a segment of radius), the lateral arm flap in seven, fibula in five and a segment of ileum for restoration of the hypopharynx in 11 cases. Three radial forearm flaps and the bone in one lateral arm flap failed.

Relationship of intraoperative rupture of pleomorphic adenomas to recurrence: an 11-25 year follow-up study.

Background: 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.

Fistulae following laryngectomy in patients treated with irradiation.

The development of fistulae following 197 consecutive laryngectomies performed from 1980 to 1987 have been examined. Fistulae were present in 28 patients (14 per cent). Age, T-classification, daily level of radiation dose and the time lapse between diagnosis and operation did not seem to influence the rate of fistula development.

Combined radiotherapy and surgery in the treatment of neck node metastases from squamous cell carcinoma of the head and neck.

A prospectively recorded series of 107 patients with clinical neck node metastases from head and neck squamous cell carcinomas, treated in 1983-1988, and with initial local control, is evaluated. Eighty-eight patients received preoperative, and were operated 4-6 weeks after radiotherapy, and 19 received postoperative radiotherapy. Forty-four of the neck specimens in the preoperatively treated patients showed vital tumor tissue, 7 with positive and 37 with negative resection margins.

Computed tomography in T1 carcinoma of the larynx.

The findings at computed tomography (CT) were reviewed in 33 patients with laryngeal carcinoma classified as T1 at clinical examination. CT revealed extralaryngeal growth and thus changed the classification to T4 in 6 of the 20 patients with a supraglottic primary tumor, but in none of the 13 patients with a glottic tumor.

Experience with reconstructive surgery in 137 cases of head and neck cancer.

A retrospective analysis of 137 patients treated with reconstruction of defects following head and neck cancer surgery is presented. From 1976 through 1984, 151 regional flaps were used: 43 pectoralis myocutaneous, 29 deltopectoral, 19 forehead, 17 nasolabial, 14 combinations of the aforementioned and 15 other types. The minimum follow-up was two years.

Value of routine follow-up in patients treated for squamous cell carcinoma of the head and neck.

The records of 214 consecutively registered, previously untreated patients with squamous cell carcinoma of the head and neck region were reviewed. Among the 157 patients considered "free of disease" following the primary treatment 54 developed recurrences - all but three within three years. Only in patients with carcinoma of the larynx treated with radiation alone did follow-up disclose recurrences for which further treatment resulted in a significant number of cures.

Pre-operative embolization of juvenile nasopharyngeal angiofibromas with gelfoam.

Two patients with juvenile nasopharyngeal angiofibromas are presented. Different haemorrhage-reducing operative methods were used. The cases illustrate the hazards of permanent ligation of the external carotid artery and the advantage of pre-operative embolization with absorbable Gelfoam.

Laryngectomees in Norway. Study no. 5: Problems of everyday life.

In a country-wide investigation, 20-30% of the laryngectomees were offered insufficient postoperative counselling/training about practical/somatic matters. Psychic stimulation and support was also sometimes deficient. A laryngectomy necessitates a structured rehabilitation program which should be provided by different counsellors at times when the patient is receptive to this kind of counselling.

Influence of different climates on the peak expiratory flow in laryngectomees.

Peak expiratory flow (PEF) has been measured in 61 laryngectomees before and after a fortnight's stay on the Canary Islands during the Norwegian winter season. A statistically highly significant increase in the PEF-values has been shown. The warmer climate with a higher degree of humidity in the air on the Canary Islands is the most probable cause.

Study No. 4: Social, occupational and personal factors related to vocational rehabilitation.

Sixty-nine of 110 laryngectomees (63%) in Norway resumed work after operation. Re-employment was established for most of the patients before active rehabilitation was initiated. The best situational and social guidelines for successful re-employment were residence, education, and social group.

Laryngectomees in Norway. Study No. 3: Pre- and postoperative factors of significance to esophageal speech acquisition.

The acquisition and acceptability of esophageal speech were evaluated relative to a number of variables in 188 laryngectomees. Of the population studied, 63% were rated as having socially acceptable esophageal speech (SAES) according to a rating scale developed by the author. Advanced age, persistent swallowing difficulties, and small stomas or dependency on a cannula resulted in reduced capability for acquiring SAES.

Laryngectomees in Norway. Study No. 2: pre-operative counselling and postoperative training evaluated by the patients and their spouses.

Twenty-six per cent of 189 Norwegian laryngectomees considered pre-operative counselling to be nonsatisfactory. Similarly, postoperative self-care training was rated nonsatisfactory by 55%. The quality of the pre-operative counselling had a significant influence on the patients' ability to perceive postoperative training which subsequently correlated with mastery of the laryngectomy event.

Study No. 1: Social, personal, and behavioral factors related to present mastery of the laryngectomy event.

Premorbid adjustment patterns and personality traits characterizing assumed vulnerability to stressful events have been shown, in a retrospective study, to provide valuable prognostic profiles which are highly correlated with the laryngectomees' mastery of the operation. Patients with assumed low vulnerability and/or who previously had proven or given indication of being well adjusted, mastered the laryngectomy significantly better than patients with other characteristics. Personality traits and premorbid adjustment patterns predict present mastery abilities better than any of the situational and social factors analyzed.

Tracheal changes in relation to different tracheostomy techniques. (An experimental study on rabbits).

An experimental study on rabbits was undertaken to evaluate the effect of the tracheostomy technique on the development of tracheal stenosis. An operation model was made for the purpose of excluding all pathogenetic factors in the formation of tracheal stenosis, except the surgical procedure. Five different operative methods were used: A.

Mucocele of the paranasal sinuses. A retrospective clinical and histological study.

Clinical and radiological findings in 112 patients with muco/pyocele in the paranasal sinuses are presented. The modified Lynch-Howarth operation gave a primary cure rate of 82% which is satisfactory compared with other reports. Histological examination of the mucocele membranes and anamnestic information support the theory that a mucocele develops secondary to obstruction of the sinus outlet.