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Biomedical subjects

A J Ballantyne

Publications and source records attributed to A J Ballantyne.

At least 19 recordsLinked to original sources
PubMed1991

The infrahyoid musculocutaneous flap in head and neck reconstruction.

The infrahyoid musculocutaneous flap (IHMF), as first described by Wang in 1986, is mainly nourished by the superior thyroid vessels through the perforators of the infrahyoid muscles (i.e., sternohyoid muscle, sternothyroid muscle, superior belly of the omohyoid muscle). This thin flap, usually extending from the hyoid bone to the sternal notch at the central part of the anterior neck, provides a skin island of about 4 by 8 cm. After these muscles have been divided from their origins, the flap can be freely transferred on its pedicle of superior thyroid artery to cover the soft tissue defect created after surgical ablation of cancer of the midface, parotid region, oral cavity, oropharnyx, or hypopharynx. From April 1987 to October 1990, our department successfully performed this flap procedure in 22 patients (cancer of the buccal mucosa 8, lower gum 5, floor of mouth 2, tongue 2, lower lip 2, parotid gland 1, skin 1, hemangioma of buccal mucosa 1). Two were treatment failures, three had partial dermal necrosis (distal third of flap surface), and the remainder had no major complications. The donor sites were closed either primarily or by means of a small, local skin flap. Contraindications to the flap are previous thyroid surgery, radical neck dissection, irradiation to the anterior neck, and hairy neck skin. We believe our results indicate that the IHMF is a versatile, reliable flap that may be used in combination with other regional flaps, such as the pectoralis major flap. It obviates the need for a microvascular free flap in many cases.

Carcinoma, Squamous Cell↗
PubMed1985

Neck dissection for cancer.

Control of metastatic disease in the neck is only a part of the spectrum of treatment of a patient with head and neck cancer. Concepts as to how to manage both the primary cancer and the possible metastases in the neck are constantly changing, and new combinations are being proposed almost daily. This article focuses mainly on the various surgical procedures that have been advocated in an attempt at controlling metastatic disease in the neck. The author has not considered the role of control of the primary cancer nor the significance of distant metastases in the rate of survival of patients with head and neck cancer. The frequency with which patients with cancer of the upper aerodigestive system develop second primaries indicates that we are only dealing with a portion of the problem. We have no way of reversing the premalignant changes that have probably developed in the epithelial surface of the smokers/alcoholics who constitute such a large percentage of the patients with whom we deal.

Adenocarcinoma↗
PubMed1979

Malignant melanoma of the scalp.

Malignant melanoma of the scalp has a significantly worse prognosis than cutaneous melanoma arising in other head and neck sites. In this series, 125 patients were treated for Stage I invasive melanoma of the scalp and followed 3 to 19 years. Survival rates for these patients were calculated on the basis of several factors. Survival after treatment was not affected by the age and sex of the patient, size and site of the primary, or treatment of the primary lesion, although local failure was higher among those treated by primary excision and closure. Patients undergoing elective neck dissection with histologically negative nodes had significantly better survival rates than those with histologically positive nodes or patients in whom a neck dissection was not performed.

Adolescent↗
PubMed1979

Plexiform neurofibroma of the head and neck.

Ten patients with plexiform neurofibroma of the head and neck were observed at M.D. Anderson Hospital between 1956 and 1978. The clinical presentation and the long-term follow-up of the most interesting cases are presented. This is a chronic disease that causes cosmetic and functional deformity because of the size or the position of the tumor, or both. No patient exhibited malignant transformation. Because all of the disease cannot be removed, the surgical procedures should not be radical but should be designed to relieve symptoms or improve cosmesis.

Adult↗
PubMed1978

Radical or modified neck dissection: a therapeutic dilemma.

Three hundred ten evaluable patients received a classic, functional, or spinal accessory-nerve-sparing neck dissection during 1970 to 1975. The functional procedure was at least equal to the classic procedure in the patients in whom it was employed. The spinal accessory-nerve-sparing operation is offered as an alternative to the classic procedure in all patients in whom the nerve is not directly invaded by cancer. If these guidelines are followed, the patient will rarely experience the pain and shoulder dysfunction that result from the loss of the trapezius muscle, while the chances of control of cancer in the neck remain optimal.

Head and Neck Neoplasms↗
PubMed1978

Changes in the adenylate energy charge of Nippostrongylus brasiliensis and Nematodirus battus during the development of immunity to these nematodes in their host.

Infection of rats with 2000 infective juveniles of Nippostrongylus brasiliensis and of lambs with 60 000 infective juveniles of Nematodirus battus results in a well-marked immunity to these nematodes in their respective host. There is a fall in the adenylate energy charge value of these nematodes during the course of these infections, reaching values of 0.37 in males and 0.27 in females of N. brasiliensis, and 0.31 in males and 0.23 in females of N. battus towards the end of the infections. In hosts given relatively small numbers of infective juveniles, the values for the nematodes removed from the hosts late in the infection remain at a relatively high level. These results indicate that the immune response of the host may affect the energy status of these nematodes, and this could help to explain their subsequent expulsion from the immune host.

Adenine Nucleotides↗
PubMed1977

Prognostic effect of tobacco and alcohol use in patients with oral tongue cancer.

A retrospective case analysis shows that patients with oral tongue cancer who have chronically used tobacco and alcohol have an increased incidence of death due to tumor, due to a second primary cancer, and due to intercurrent disease when compared with patients with oral tongue cancer who have never used tobacco or alcohol. This difference is not explained by a difference in tumor staging, patients' ages, or type of treatment received.

Alcohol Drinking↗
PubMed1977

Head and neck cancer developing in patients with pre-existing reticuloendothelial malignancies.

Second primary tumors develop in up to 20% of patients with reticuloendothelial malignancies (REM). At the M. D. Anderson Hospital between 1944 and 1975, there were 29 patients with pre-existing reticuloendothelial malignancies who developed second primary tumors of the head and neck. The presence of pre-existing REM complicated staging of the head and neck lesion in 14 of 29 cases (48%). In patients with clinically palpable nodes the status of involvement was correctly assessed in only 4 of 14 instances (28%). Though only 3 of 29 patients (10%) survived for 5 or more years, the average survival from diagnosis of head and neck cancer to last follow-up or death was 31 months. Patients with REM in conjunction with head and neck melanoma or with squamous carcinoma of the facial skin or lip had an average survival of 20.7, 40.3, and 51.3 months respectively. Patients with REM in conjunction with second primaries involving the oral cavity, nasal, or oral pharynx, hypopharynx, or larynx did poorly with an average survival of only 8.5 months.

Carcinoma, Squamous Cell↗
PubMed1976

Cancer of the skin of the nose. Treatment by total skin excision and three-quarter thickness skin graft.

We describe a method of treatment and repair of superficial cancers of the skin of the nose. In 124 patients in whom excision of the lesion and a split thickness skin graft were used, 77% were alive and free of their disease after five years of follow-up. Three patients in whom a skin graft was performed were unavailable for follow-up, and 15 patients developed local recurrence either in the area of excision or in the surrounding skin. The method is easy, reliable, and the cosmetic results are satisfactory.

Aged↗
PubMed1976

Analysis of survival and disease control in stage I melanoma of the head and neck.

From 1958 through 1969, 357 patients were treated for melanoma of the head and neck. Of these, 166 had invasive, clinical stage I disease. All patients had wide local excision of the primary. Elective regional node dissection was performed in sixty-nine patients and in the remaining ninety-seven observation only was elected. Retrospective analysis of these 166 patients considered (1) survival and disease control, (2) sites and timing of failures, and (3) the effect of sex, site, type of biopsy, skin grafting, and regional node dissection on disease control and survival. More than 80 per cent of the local recurrences developed within the first twenty-four months. Similarly, in the patients not undergoing initial neck dissection, 80 per cent of those who subsequently had clinically positive regional nodes did so within twenty-four months. In the sixty-nine patients undergoing elective regional node dissection, the survival rate was 33.5 per cent at five and ten years in those with histologically positive nodes. Those patients with elective neck dissections having histologically negative nodes had a survival rate of 75.8 and 67.1 per cent at five and ten years, respectively.

Adolescent↗
PubMed1975

Scalene node biopsy in carcinoma of the cervix. Pelvic and para-aortic lymphadenectomy.

Twenty-eight patients with advanced untreated carcinoma of the cervix had selective pelvic and para-aortic lymphadenectomy and a scalene fat pad biopsy to determine the extent of their disease prior to treatment. None of these patients had palpable supraclavicular lymph nodes, but 18 had metastatic cancer in one or more pelvic lymph nodes; in the remaining 10 patients, all lymph nodes were free of metastatic cancer. Of the 18 patients with metastatic cancer in the pelvic lymph nodes, 9 also had metastatic cancer in the para-aortic lymph nodes, and 1 had metastatic cancer in a scalene lymph node. This patient had extensive cervical cancer with positive pelvic and para-aortic lymph nodes, unilateral ureteral obstruction, and cancer growing through the posterior culde-sac into the pelvic peritoneum. From this study, it appears that scalene lymph node biopsies are of limited value in evaluating patients with advanced cancer of the cervix. Unless the patient has extensive metastases, scalene lymph nodes rarely contain metastatic cancer.

Biopsy↗
PubMed1975

Late sequelae of radiation therapy in cancer of the head and neck with particular reference to the nasopharynx.

Sequlae of radiation therapy may be late in occurring and varied in their manifestations. Although some are untreatable and progressive, the risk of development of some other sequelae can be minimized by careful application of radiotherapy or by ancillary measures, such as dental decay prophylaxis. Some of the serious sequelae secondary to radiation therapy of the nasopharynx have been summarized. These include radiation myelitis, paralysis of the cranial nerves, stricture of the pharynx, radiation-induced cancer, and necrosis with fatal hemorrhage.

Adult↗
PubMed1975

Hypopituitarism after external irradiation. Evidence for both hypothalamic and pituitary origin.

Endocrine complications after radiotherapy for tumors of the head and neck are thought to be relatively rare. The availability of synthetic hypothalamic hormones for clinical investigations and the radioimmunoassay of hormones have enabled us to study function of the hypothalamic pituitary axis in 15 patients who had radiotherapy for nasopharyngeal cancer. Fourteen had evidence of endocrine deficiency. Twelve patients had evidence of hypothalamic dysfunction, 7 developed primary pituitary hormone deficiencies, and 3 developed primary hypothyroidism. These results indicate that [1] secondary hypopituitarism due to a hypothalamic lesion after radiotherapy for nasopharyngeal cancer may be more common than suspected in the past; [2] primary hypopituitarism after irradiation of extracranial tumors can occur; and [3[ primary hypothyroidism may result from irradiation of regional neck nodes.

Adolescent↗