The relationship of the facial canal to the annular sulcus.
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Biometry↗
Biomedical subjects
C J Krause
Publications and source records attributed to C J Krause.
Olfactory neuroblastoma: the results of modern treatment approaches at the University of Michigan.
A retrospective study was undertaken to review patterns of treatment and survival for patients with olfactory neuroblastomas at the University of Michigan since the introduction of craniofacial resection in the late 1970s. Recent results were compared to previous reports. Disease-free and overall survival for patients with Kadish stage B tumors were unchanged from prior years. Improvement in both disease-free intervals and overall survival was evident for patients with stage C tumors. Interestingly, in two patients with "unresectable" local disease, complete responses to induction chemotherapy followed by radiotherapy were noted.
Adolescent↗
The management of parotid neoplasms.
In recent years, the management of parotid gland neoplasms has changed considerably, to include a more aggressive surgical approach and multimodality therapy. An organized approach to surgical management and the rationale for postoperative irradiation for selected tumors are presented. A review of several studies supporting the efficacy of postoperative irradiation is included. The principles of palliative management of adenoidcystic carcinoma are unlike those for most other malignancies, and include repeated use of limited procedures to control local and regional disease over extended periods of time, and delayed treatment of distant disease until the patient becomes symptomatic.
Antineoplastic Agents↗
Aneurysmal bone cyst of the ethmoid.
Although nearly 500 cases of aneurysmal bone cyst have been recorded in the English literature, involvement of the facial bone is uncommon. To our knowledge, this is the first case of extragnathic, facial aneurysmal bone cyst to be reported in the English literature. A left ethmoid aneurysmal bone cyst was found in a 20-year-old pregnant woman who had a 5-month history of progressive left periorbital swelling, left cystic nasal mass, progressive nasal obstruction, blurred vision, and occasional diplopia. The diagnostic evaluation included a sinus series, facial lamiograms, and an EMI scan. Needle aspirates taken frequently from the intranasal cyst consisted of a dark bloody fluid. The surgical procedure, using external rhinotomy approaches, pathologic findings, and a literature review are presented.
Adult↗
Nasofacial defect following fibrosarcoma excision and radiotherapy.
For initial reconstruction, Dr. Burget suggests that he would have advanced the cheek flap medially toward the nasal septum and, subsequently, reconstructed the missing right half of the nose with a forehead flap and cartilage grafts. Dr. Panje suggested early prosthetic rehabilitation, while Dr. Krause's concepts were similar to Dr. Burget's, with forehead flap nasal reconstruction, after cheek reconstruction to the nasofacial and nasolabial lines with a medially advanced cheek flap. Dr. Panje recommended an immediate maxillary denture prosthesis, as did Dr. Krause (who supplemented this with foam rubber). Dr. Burget placed the prosthesis 3 weeks after tumor ablation. For skin grafts, Drs. Panje and Burget suggested split thickness grafts to all new surfaces to decrease wound contracture, while Dr. Krause used dermis grafts for the same purpose. Other reconstructive methods mentioned were the (1) cervical tubed flap, (2) free scapular flap, (3) Washio flap, (4) tissue expansion, and (5) nasolabial flap. Suggestions for isolated defects included: Lower eyelid--increase internal support by building up the prosthesis; release lower lid from deltopectoral flap and V-Y advancement; support graft or irradiated cartilage (1-2 mm sheet) under orbicularis oculi. Nasal ala--bring present ala down and insert cartilage graft; turn internal skin down and fill the resulting defect with a composite graft. Upper lip--multiple Z-plasty. Retrodisplacement of cheek due to maxillectomy--release buccal scar; skin graft the raw internal surface and build up prosthesis.
Adult↗
Characterization of tumor antigen in epidermoid carcinoma.
Tumor antigens have been isolated from nine epidermoid carcinomas of the head and neck. The most strongly reactive antigens have a molecular weight of congruent to 25,000-50,000 daltons, though other antigens weighing congruent to 120,000-400,000 daltons were noted in six of the tumors. The most strongly reactive antigens had a pI between 8.36 and 8.40. The cross reactivity of these antigens will be studied next. It is hoped that the purified tumor antigen will be useful in the development of an immunodetection system for epidermoid carcinoma.
Antibodies, Neoplasm↗
Current concepts of tumor immunology. I. Basic immunologic concepts.
Interest in tumor immunology grew out of the study of host response to microbial infections during the second half of the 19th century. However, the growth of interest in transplantation during the 1950s and 1960s is largely responsible for the great surge of scientific investigation into tumor immunobiology which we are experiencing today. Tumor cells possess certain abnormal antigens in addition to their normal complement of transplantation antigens. These abnormal antigens evoke an immune response in the host, which involves both the humoral and the cell-mediated systems. Though the cell-mediated (thymus derived) system is generally conceded the most important role in tumor cell destruction, the humoral (bursal-equivalent derived) system also plays a role in host response which is presently less clearly understood. Certain aspects of the humoral response (blocking factors) actually appear to inhibit the host response against a tumor. This complex system of host immune response to tumor has been termed the immunosurveillance system.
Animals↗
Current concepts of tumor immunology. II. Tumor immunodetection.
A great deal of investigation is presently underway to develop methods of effectively assessing the status of an individual patient's immune system. Such methods might provide a means of early detection of tumor or of indicating prognosis so that treatment modalities may be tailored to individual patient needs. The cell-mediated response may be monitored using intradermal skin tests and in vitro lymphocyte stimulation and cytotoxicity tests. Humoral responses have been monitored using assays for antibodies against tumor specific as well as tumor associated antigens. Assays have been developed which are capable of detecting circulating fetal antigens in very small concentrations. Thus far no one assay technique has proven to be sufficiently sensitive nor specific to be clinically useful. However, by utilizing a battery of tests before, during and after treatment, it is possible to determine a great deal about individual patient response to treatment and prognosis. With so many investigators focusing upon this problem, it seems likely that more effective methods of immunodetection will soon be developed.
Antibodies, Neoplasm↗
Current concepts of tumor immunology. III. Immune therapy.
It is apparent that development of consistently effective methods of immunotherapy must await a more thorough understanding of the immune response to cancer. However, even those forms of immunotherapy which have been developed to date indicate a tremendous potential. It appears that immunotherapy may be most useful as an adjuvant to established forms of treatment. Surgery, radiation therapy and/or chemotherapy are used to remove all of the gross tumor, with immune therapy then employed to destroy the small foci of tumor which remain. As methods are developed which are effective in counteracting the immunosuppression of tumors, other means of immunotherapy may be found which are capable of destroying tumor cells while not affecting the adjacent normal tissue. Thus, the future of immune therapy holds great promise. As more is learned about the immune response to cancer, advances in therapy will certainly follow.
Antibodies, Neoplasm↗
Ultrasonic analysis of head and neck neoplasms. Correlation with surgical findings.
Ultrasonography of head and neck neoplasms is useful in the preoperative evaluation of patients. Inflammatory masses demonstrate high reflectivity in a homogeneous pattern and have diffuse borders. Similarly, lipomas show medium to high reflectivity and have a homogeneous pattern, but are well outlined. Mixed tumors of the major salivary glands have a characteristic heterogeneous pattern and are well outlined. Malignant lesions demonstrate low reflectivity in a homogeneous or heterogeneous pattern and have poorly outlined or diffuse borders. Cysts of the head and neck are well outlined and devoid of interior echoes.
Adolescent↗
Extended transantral approach to pterygomaxillary tumors.
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Adolescent↗
Clinical nasal obstruction and objective respiratory mode determination.
Nasal obstruction represents a considerable portion of the symptoms addressed by the otolaryngologist. It has received widespread interest in the orthodontic literature as well, because of the presumed relation between nasal obstruction and facial growth, especially vertical maxillary excess. The range of normal variation in oral versus nasal breathing has not been defined. This study attempted to correlate patient symptoms with respiratory mode. A sample of 20 symptomatic adult subjects presenting with nasal obstruction was compared to a control sample of 20 asymptomatic adults by means of SNORT (Simultaneous Nasal and Oral Respirometric Technique). Nasal resistance was significantly different between the two groups, but percent nasality (that proportion of the total volume of air breathed nasally) was a more consistent and significant finding. The relevance of these results to both clinical and basic physiology is discussed.
Adult↗
Cutaneous basosquamous carcinoma of the head and neck: a comparative analysis.
Considerable debate has taken place concerning cutaneous basosquamous carcinomas. Some authors believe they are merely a variant of basal cell carcinoma, based on the apparent rare occurrence of metastases. This comparative study of 33 cases of basosquamous, 1,796 cases of basal cell, and 736 cases of squamous carcinomas arising in the head and neck demonstrates that the basosquamous lesion has the potential to recur and to metastasize, which is similar to squamous cell lesions. An aggressive primary treatment program is recommended.
Adolescent↗
A conceptual approach to local flaps.
Few procedures offer the surgeon a greater opportunity to exercise his surgical and aesthetic judgement than the design and implementation of local flaps about the head and neck. Considerations include skin color and texture match; adequacy of flap blood supply; size, location, and characteristics of the donor site defect; functional capability of the proposed flap; nature of skin tension lines created; and number of surgical procedures required. A systematic approach to local flap design and implementation is presented, and illustrations of the geometric principles involved are included.
Cicatrix↗
Infectious and noninfectious complications in major head and neck surgery.
The Hemovac drainage system was required postoperatively for 156 patients who had undergone major head and neck surgical treatment. This study distinguishes infectious complications from noninfectious complications by the aerobic and anaerobic cultures that were taken from the Hemovac line drainage and any subsequent complications. The 33% complication rate included only those of the head and neck and excluded general medical complications. Of the 52 patients having complications, 19 had infectious, 24 had noninfectious, and nine had both infectious and noninfectious complications.
Adult↗
Palatoplasty: a comparative study.
A comparative analysis of 275 patients who underwent palatoplasty between 1961 and 9171 is presented. Of these, 149 patients had a Langenbeck palatoplasty and 188 a V-Y pushback palatoplasty. Speech results in these patients were carefully assessed by experience speech pathologists using conversational and structured (word articulation tests) speech, manometric ratios, and radiographic evidence of palatal movement. Over all, 73% of the V-Y pushback patients attained acceptable speech compared to 56% in the Langenbeck category. Patients with clefts of the soft palate only had the highest incidence of acceptable speech (91% in Langenbeck, 81% in V-Y). In both categories the results were poorer in the more extensive clefts.
Adolescent↗
Evaluation of bone scan by scintigraphy to detect subclinical invasion of the mandible by squamous cell carcinoma of the oral cavity.
A prospective study using scintigraphy was performed to compare the sensitivity of the Panorex roentgenogram and the bone scan in detecting subclinical invasion of the mandible by squamous cell carcinoma of the oral cavity and floor of the mouth. Twenty-five patients with squamous cell carcinoma of the floor of the mouth were evaluated preoperatively by both the Panorex and scintigraphic techniques and the results compared with postoperative pathologic findings. In 13 (52%) of the cases, Panorex and scintigraphic techniques were comparable in detecting tumor involvement in bone. In eight cases (32%) all three modalities had normal pathologic indications of the mandible. However, in four cases (16%) results of the scintigraphic techniques were abnormal and the Panorex, normal. In four separate cases, the extent of lesion demonstrable by scintiscanning was greater than delineated by Panorex; surgical specimen confirmed this finding. Pathologic examination of operative specimens confirmed tumor involvement. These data lead us to believe that the scintigraphic techniques may be more sensitive in detecting early mandibular involvement with squamous cell carcinoma than the Panorex technique and may help alter the therapeutic approach.
Adult↗