Intravenous antibiotics for refractory rhinosinusitis in nonsurgical patients: preliminary findings of a prospective study.

Background: Some patients with persistent chronic sinusitis have either had unsuccessful surgery or have simply refused surgery. In nonsurgical candidates, when oral antibiotics and traditional therapy are unsuccessful, home intravenous (i.v.

Endoscopic repair of a nasal septal perforation.

The repair of septal perforations represents a challenging problem, with numerous techniques existing to address the defect. The use of sinonasal endoscopy represents a novel approach to solving this problem. By using the endoscope, excellent visualization and exposure can be achieved without excessive dissection.

Abnormalities of molecular regulators of proliferation and apoptosis in carcinoma of the oral cavity and oropharynx.

Objective: Abnormalities in genes regulating cell proliferation and death may affect disease outcome in squamous cell carcinoma (SCC) of the head and neck.

Methods: Proliferative activity (Histone H3 in-situ-hybridization (HISH) labeling index (LI)) and the genes and/or gene products of Cyclin D-1, c-erbB-2, Bcl-2, p21, and p53, were investigated in 35 patients with SCC of the oral cavity and oropharynx, previously studied for p27 expression.

Results: Overexpression or very low expression of Cyclin D-1 was associated with unfavorable disease outcome and shorter time-to-recurrence.

The 'parachute' bolster technique for securing intraoral skin grafts.

Successful skin grafting of intraoral defects can be challenging. The tie-over bolster method is the most popular technique in use today. We describe an alternate method of securing intraoral skin grafts--the "parachute" bolster technique--and we present a case report.

Electroporation therapy for head and neck cancer including carotid artery involvement.

Objectives: Electroporation therapy with intralesional bleomycin (EPT) is a novel, technically simple outpatient technique in which high-voltage electric impulses delivered into a neoplasm transiently increase cell membrane permeability to large molecules, including cytotoxic agents, causing localized progressive necrosis. Unlike many laser ablation methods, EPT can treat bulky tumors (>2 cm) with complete penetration. Our recent publication confirms an excellent response rate in the use of EPT in a clinical trial.

Endoscopic and electroporation therapy of paranasal sinus tumors.

The purpose of this article is to introduce the concept of endoscopic and electroporation therapy for the treatment of sinonasal carcinomas. Electroporation therapy is a technique that combines intralesional injection of bleomycin combined with application of high-voltage square wave electrical impulse into the tumor. A transient increase in cell membrane permeability allows intracellular entry of bleomycin, with subsequent cytotoxicity.

Prognostic significance of p27 expression in carcinoma of the oral cavity and oropharynx.

Objective: To study the role of p27, a cyclin-dependent kinase inhibitor, as a prognostic indicator in squamous cell carcinoma of the oral cavity and oropharynx.

Study Design: Retrospective review of 35 patients with squamous cell carcinoma of the oral cavity and oropharynx who presented to Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois, between 1986 and 1995.

Electroporation therapy of head and neck cancer.

The purpose of this paper is to introduce the concept of electroporation therapy and present our results from using this new technique combined with intralesional bleomycin in head and neck cancer patients. Electroporation therapy is a technique wherein high-voltage electric impulses delivered into a neoplasm transiently increase cell membrane permeability to large molecules, including cytotoxic agents. In this phase I/II study, extremely low-dose bleomycin sulfate was electroporated into head and neck malignant neoplasms in 10 patients.

Regulators of proliferation and apoptosis in carcinoma of the larynx.

Expression of interrelated gene products regulating cell proliferation and apoptosis may be disordered in squamous cell carcinoma (SCC) of the larynx compared with normal squamous mucosa. Certain of these abnormalities, alone or in combination, may be of prognostic significance in low-stage carcinomas of the larynx. A retrospective study of archival material was made.

The use of percutaneous implants for the prosthetic rehabilitation of orbital defects in irradiated cancer patients: a report of clinical outcomes and complications.

This retrospective study evaluated the use of percutaneous craniofacial implants for the prosthetic rehabilitation of patients with a history of orbital exenteration and irradiation for oncologic tumors of the head and neck. A total of 24 implants were placed in six patients. All implants were determined to be osseointegrated at the time of uncovering.

Endoscopic ligation of the internal maxillary artery for treatment of intractable posterior epistaxis.

Lack of universal success with both transantral ligation of the internal maxillary artery and percutaneous embolization of the distal branches of the internal maxillary distribution has led to consideration of alternative techniques to control intractable posterior epistaxis. One such technique takes advantage of advances in endoscopic technology and instrumentation, as well as a nearly constant anatomic configuration. The internal maxillary artery divides into terminal branches within the pterygomaxillary fossa, sending branches through the bony maxilla to exit the posterolateral nasal wall in the posterior aspect of the middle meatus.

Tumor angiogenesis and p53 mutations: prognosis in head and neck cancer.

Objectives: To assess how p53 gene mutations and microvessel density (MVD) may be used as prognostic markers for the study and management of head and neck squamous cell carcinomas and to investigate putative associations between p53 gene mutations and MVD and the relationship of these factors to tumor response to radiotherapy and/or chemotherapy at 6 weeks.

Patients And Design: Thirty-nine patients with squamous cell carcinoma of the head and neck, stages I to IV, who were examined at Rush-Presbyterian-St Luke's Medical Center, Chicago, Ill, and its affiliated hospitals between 1993 and 1995 were monitored. Mutations in the p53 gene were identified by microdissection of tumor cells on frozen sections, followed by single-strand conformation polymorphism analysis of the products of polymerase chain reaction amplification of exons 5 to 9.

Surgical closure of persisting failed tracheoesophageal voice fistula.

Tracheoesophageal puncture (TEP) is a highly successful procedure for voice restoration. Occasionally, however, patients fail to achieve satisfactory voice or develop salivary leakage through the fistula into the trachea. Closure of the TEP is then necessary.

Mutation of p53 in squamous cell cancer of the head and neck: relationship to tumor cell proliferation.

Rapid proliferation of squamous cell carcinomas of the head and neck (SCCHN) during therapy may contribute to treatment failure. We have investigated the presence of p53 abnormalities in patients with SCCHN as a correlate of proliferation rate and other pathologic and clinical variables. p53 Mutation, as determined by polymerase chain reaction and single-strand conformation polymorphism analysis of microdissected frozen sections of tumor biopsies, was significantly associated with a high labeling index, as determined by in vivo infusion of IUdR and BrdU (P = 0.

Cyclin D1 expression in squamous cell carcinomas of the head and neck and in oral mucosa in relation to proliferation and apoptosis.

Deregulation of expression of the cell cycle regulator cyclin D1 (cD1) may be responsible for rapid proliferation of squamous cell carcinoma of the head and neck (SCCHN). We have studied the expression of cD1 in 46 SCCHNs using immunohistochemistry. Before biopsy, the patients received an in vivo infusion of iododeoxyuridine (IdUrd) for cell proliferation assessment.

Proliferation of epithelia of noninvolved mucosa in patients with head and neck cancer.

Background: Morphologically noninvolved mucosa in patients with head and neck cancer is altered by carcinogens. These alterations may include chromosome alterations, gene mutations, and other molecular abnormalities which may explain very high incidence of second tumors in this group of patients. The purpose of this study was to investigate the in vivo proliferative characteristics in epithelial tissues adjacent to the tumor in a series of patients with head and neck cancer.

Continued malignant cell proliferation in head and neck tumors during cytotoxic therapy.

The effect of cytotoxic therapy on the proliferation of squamous cell carcinoma of the head and neck in vivo in patients was evaluated before and 15-35 days after the start of therapy. To accomplish this, iododeoxyuridine was administered at t = 0, and bromodeoxyuridine was administered 15-35 days later during treatment with a tumor biopsy obtained for study immediately after each pyrimidine infusion. Monoclonal antibodies specific for the halogenated pyrimidines were used to identify cells that were in the S-phase at the time of the infusions.