Sixteen patients were monitored for vestibular ototoxicity while receiving cisplatin in dosages of 180 mg/M2. The incidence of preexisting vestibular functional abnormalities (31%) was higher than the incidence of ototoxicity (18%). Although the number of patients was not large enough for meaningful statistical comparison, the incidence of vestibular ototoxicity from cisplatin was low for the dosage levels employed. Based upon the results of this study, the following recommendations are made for monitoring cisplatin vestibular ototoxicity. 1. All patients should receive vestibular tests prior to cisplatin administration. 2. Subjects, who have reduced (or asymmetric) vestibular function upon pretherapy testing, should be monitored at least weekly for any change in function while receiving cisplatin. 3. Subjects who are normal prior to therapy need to be tested only when cumulative doses exceed 400 mg. The severe nausea and vomiting associated with cisplatin chemotherapy is not related to vestibular ototoxicity.

Adult↗

PubMed1981

Advanced carcinoma of the tongue. Management by total glossectomy without laryngectomy.

A major goal of any surgical program for patients with tumors is to cure their cancer. Patients requiring total glossectomy usually are seen initially with far-advanced disease, often after failure of other treatment modalities. As a result, they may be suffering from constant pain as well impairment of speech and deglutition. The prognosis is poor, and palliative surgery with good rehabilitation of the speaking and swallowing mechanisms becomes a reasonable, albeit limited, objective. Our series does show that properly selected patients can be successfully rehabilitated after total glossectomy with out laryngectomy. This successful rehabilitation begins with good patient selection and preoperative preparation. Postoperative rehabilitation requires the interplay of a highly motivated patient and a well-coordinated health care team. The physician, nurse, speech pathologist, dietitian, and social worker all have important roles in ensuring the patient's return to a good quality of life. The surgeon will direct the efforts of the team. To the nurse and the speech pathologist falls much of the bedside job of instructing and motivating the patient. Because such effective rehabilitation has been demonstrated by the success of our patients, we advocate preserving the larynx whenever possible in the patient who must undergo total glossectomy.

Carcinoma↗

PubMed1975

Phaco-emulsification of cataracts.

Explore the source record for details and available documents.

Cataract Extraction↗

PubMedDate not supplied

Preliminary trial of nonrecombinant interferon alpha in recurrent squamous cell carcinoma of the head and neck.

Fourteen patients with recurrent squamous cell carcinoma of the head and neck (SCCHN) were treated with 10 x 10(6) U of nonrecombinant interferon alpha (IFN) intramuscularly (IM) daily for 3 days every 28 days. There were 11 men and 3 women, with ages ranging from 48 to 74 years. Patients had previously been treated with surgery (9 patients), radiotherapy (13 patients), or chemotherapy (8 patients). All patients had measurable disease by physical exam and radiologic evaluation and a performance status of less than or equal to 2 (ECOG). Patients were treated for a minimum of 3 months and continued on therapy until disease progression. The dose and treatment schedule of IFN was well-tolerated. Toxicities included low-grade fever, mild anorexia, and malaise. Treatment was stopped in 1 patient due to the development of atrial fibrillation. One death occurred as a complication of aspiration pneumonia 2 weeks following the onset of therapy and was not felt to be related to IFN therapy. Of the 14 patients treated, there was 1 complete response (30+ months) of a base of tongue primary. Two patients had stabilization of disease (SD, 8 and 12 months). One patient had a mixed response with resolution of subcutaneous nodules. The remaining 10 patients died of progressive disease. Immunological assessment was performed on 8 patients. The 1 patient who had a complete response was noted to have markedly low pretreatment natural killer (NK) cell activity and a subsequent sharp rise in activity after initial treatment. We conclude that low-dose cyclic IFN is well-tolerated in patients with recurrent SCCHN and has potential antitumor activity.

Aged↗