Pretreatment airway management in obstructing carcinoma of the larynx.

Partial endoscopic excision of obstructing laryngeal carcinoma with the CO2 laser is an alternative to emergency tracheotomy or emergency laryngectomy whenever the airway control can be initially ensured by endotracheal intubation. The practical advantages of this approach are elimination of the septic complications of tracheotomy, the opportunity for planned preoperative chemotherapy or radiation therapy, and better nutritional and psychologic preparation of the patient for surgery.

Diagnostic value of fine needle aspiration biopsy in neoplasms of the head and neck.

In this paper, the cytologic findings of 90 aspirates obtained by the fine needle aspiration technique from head and neck masses are compared with the histology of the permanent section. The overall concurrence rate between cytologic and histologic findings for benign and malignant tumors is 80%. There is a 6.

A new method of extension-block splinting for the proximal interphalangeal joint--Preliminary report.

Many methods of treating proximal interphalangeal joint volar plate avulsions have been described, and although some of these methods are appealing, they do have certain drawbacks which limit their usefullness. This paper describes a splint which is easily made, covers only the finger involved, and blocks extensions nicely.

Prognostic indicators in induction cis-platinum bleomycin chemotherapy for advanced head and neck cancer.

A complete response to induction cis-platinum bleomycin chemotherapy significantly increases the probability of local tumor control and overall disease-free survival. Factors that favor a good response to chemotherapy are tumor histology (well differentiated), location of the primary site (oral cavity and oropharynx), nodal status (N0) and size of the primary lesion (t3 better than T4). Increased cellular maturation after chemotherapy correlates with an improved clinical response.

Topical chemotherapy of recurrent respiratory papillomatosis. A preliminary report.

Topical chemotherapy with the antimetabolite 5-fluorouracil (5-FU) has been used as an adjunct to surgical laser excision of squamous papillomas arising in the larynx and in the tracheobronchial tree. The drug has been administered intensively to eight patients with tracheotomies and disease in both anatomic regions. These patients received repeated instillations of 5-FU at concentrations from 0.

Simultaneous carcinomas of the esophagus and upper aerodigestive tract.

A review of 150 consecutive head and neck cancer patients over a 22-month period revealed a multiple primary cancer rate of 19%, 9% in the head and neck region. Nine patients (6%) had simultaneous esophageal and head and neck cancers. Complete systematic esophagoscopic examinations, in addition to barium swallow radiographic studies, are recommended for all patients with head and neck cancers.

Otolaryngologic manifestations of orbital pseudotumors.

Orbital pseudotumor is believed to be a nonspecific, acute or chronic inflammatory process involving the intraorbital soft tissue. Orbital pseudotumor may masquerade as sinusitis with orbital complications or as a severe upper respiratory tract infection. Five cases are presented to illustrate the difficulties in diagnosis when initial symptoms relate to the upper respiratory system rather than to an isolated orbital mass.

Prognostic indicators in chemotherapy for head and neck carcinoma: alkaline phosphatase levels.

Serum alkaline phosphatase (AP), total bilirubin, total protein, serum albumin, and serum glutamic oxaloacetic transaminase (SGOT) were determined in 55 patients with biopsy proven carcinoma of the head and neck prior to their induction chemotherapy with cis-platinum and bleomycin. Of the 55 patients, 40 (73%) exhibited either a complete or partial response (tumor mass decreased by over 50%) to the chemotherapy. Responses were noted more frequently in patients with elevated AP levels.

Removal of rhinophyma with the carbon dioxide laser: a preliminary report.

Surgery is the generally accepted treatment for rhinophyma. Problems associated with standard therapy include moderately profuse hemorrhage impairing accurate removal, and some difficulty in providing smooth demarcation between the rhinophyma and the surrounding tissue. Four patients with rhinophyma have been successfully treated with the carbon dioxide laser.

Treatment of T1 and in situ glottic carcinoma: the transoral approach.

Endoscopic treatment of early carcinoma of the larynx is curative, the cure rates in our experience being equal to those achieved by radiation therapy and by laryngofissure. It is highly cost effective in terms of money and of patient out-of-work time. It can be used repeatedly and does not interfere with future treatments.

Fine needle aspiration biopsy diagnosis of neck masses.

The cytologic findings in 107 aspiration smears obtained with the fine needle technique from head and neck masses were compared with the histologic findings in permanent sections. The overall concurrence rate between cytologic and histologic findings in benign and malignant tumors was 82.2 per cent.

Work-up, evaluation, and treatment planning in patients with head and neck cancer.

The patient with head and neck cancer requires the recording of a full history and physical examination and a complete evaluation of the local disease; the local findings are viewed against the general medical background. In order to arrive at the optimal treatment, the findings should be reviewed fully at an interdisciplinary conference. In the light of these discussions the responsible team should develop a treatment plan, in concert with the patient and his family whenever possible.

Modern technology in cancer therapy: status of the carbon dioxide laser.

The carbon dioxide laser has been found to be a useful surgical adjuvant in our efforts to treat carcinoma and benign tumors of the head and neck. It has been of help in establishing the proper staging, in diagnosing recurrence after radiation therapy, in re-establishing the airway blocked by tumor, and in reducing tumor mass prior to definitive therapy. It provides a simple method of excision for curative therapy.

The use of the carbon dioxide laser in the pediatric airway.

Congenital and acquired lesions of the pediatric airway present difficulties in management. Until recently, correction of these problems frequently involved an external approach to the larynx and trachea. Development of fiberoptic instrumentation, as well as the introduction of the Zeiss operating microscope, has now given the surgeon a new means to visualize the larynx and trachea.

Efficiency and safety of methidathion applied as a pour-on systemic insecticide for control of cattle lice.

Methidathion applied to cattle as a pour-on insecticide for control of lice (predominantly Linognathus vituli, but also Haematopinus eurysternus and Damalinia bovis) caused a reduction in the lice population of approximately 98% to 99% in laboratory trials at the minimum recommended dose of 4 mg/kg and a 98.8% to 100% efficiency was achieved in field trials. In a comparative efficiency trial in the laboratory methidathion at 3.

Diagnosis of infratemporal fossa tumors using percutaneous core needle biopsy.

Three patients with infratemporal fossa carcinomas presented with severe, unrelenting facial pain, weight loss, and 5th cranial nerve deficit. Erosion of the base of the skull at the foramen ovale was present in two of these patients. Histologic diagnosis of infratemporal fossa malignancy was obtained by needle biopsy of the foramen ovale region; the technique is described.

Benign tumors and lesions of the larynx in children. Surgical excision by CO2 laser.

Benign lesions of the airway in infants and children may endanger the airway and compromise laryngeal function. The CO2 laser provides an elegant method of transoral surgical excision without compromising laryngeal function or airway competence. It avoids the risks of such other treatment modalities as external surgical approaches, prolonged steroid therapy, and radiation.

Induction chemotherapy in advanced squamous head and neck carcinoma with high-dose cis-platinum and bleomycin infusion.

Forty patients with advanced head and neck cancer were treated with combined Cis-platinum-Bleomycin chemotherapy. Cis-diammine dichloroplatinum (DDP) 120 mg/m2 iv was given after prehydration, with mannitol diuresis on Day 1. On Day 3, an initial loading dose of Bleomycin 15 mg/m2 was given by rapid iv push followed by continuous 24 hour intravenous infusion of Bleomycin 15 mg/m2 Day 3 through Day 10.

Transoral management of localized carcinoma of the oral cavity using the CO2 laser.

Since 1972 we have been cautiously exploring the use of CO2 laser in the management of carefully selected cases of localized carcinoma of the oral cavity. At the present time our experience is based on the treatment of 57 patients with cancer of the oral cavity. The CO2 laser has been found to be an indispensable tool in the transoral management of T1 carcinomas, multiple superficial carcinoma, extensive leukoplakia and verrucous carcinoma.

Inverted papilloma and squamous cell carcinoma.

Since 1960, 15 patients with histologically proven inverted papilloma of the nose and paranasal sinuses have been treated at the University Hospital, City Hospital, and V. A. Hospital in Boston.

The third dimension in renal diagnosis. Scanning electron microscopy of normal and abnormal kidney.

Scanning electron microscopy, a relatively young discipline, has been used mainly for research purposes and very seldom as a diagnostic procedure. A study was made of normal and abnormal kidneys by light, transmission and scanning electron microscopes. Normal human and rat kidneys were examined under the scanning electron microscope but cellular detail was not clearly defined.

Seeding of parotid carcinoma along Vim-Silverman needle tract.

A case report of seeding of parotid carcinoma along a core biopsy needle tract is presented. Excision of the needle biopsy site at the time of definitive surgery is recommended. Aspiration needle biopsy with a fine needle is reliable, with tumor seeding less likely.