Biomedical subjects

H S Millar

Publications and source records attributed to H S Millar.

12 recordsLinked to original sources

PubMed1993

The case against open neck biopsy.

Many patients present with lateral neck lumps due to benign or malignant conditions, and they may be difficult to differentiate clinically. It is detrimental to perform an open neck biopsy on a patient with a cancer originating from the head and neck region (upper aerodigestive tract or skin) prior to definitive treatment. The biopsy interferes with the assessment and management of the neck, increasing morbidity. It may also decrease curability and perhaps induce fungation. A protocol to avoid the need for an open biopsy, using fine needle aspiration cytology and a thorough examination of the upper aerodigestive tract is recommended. The authors also recommend combined radical radiotherapy and surgery for the patient who has had an open biopsy. A thoughtless biopsy is both needless and harmful.

Biopsy↗

PubMed1987

Lymph node dissection for head and neck cancer.

A retrospective analysis of 141 neck dissections performed at the Royal Melbourne Hospital from 1975 to 1981 has been carried out with a view to identifying the prognostic factors. When a neck dissection is performed, the site of the primary disease did not affect the 5 year survival rate. A conservation neck dissection, especially when performed electively, had the best prognosis. Radiotherapy did not affect the overall survival rate in patients having a neck dissection, while chemotherapy appeared to exert a beneficial effect on patients with advanced disease. While clinical nodal staging was an important prognostic indicator, the number of nodes pathologically involved was not. Histologic differentiation of the tumour was not prognostically significant, whereas extracapsular nodal disease was. Most (70%) treatment failures occurred in the neck, while systemic metastases occurred in 12% of patients.

Adult↗

PubMed1986

Internal carotid artery epistaxis.

Epistaxis from the internal carotid artery (ICA) or bleeding from the ICA at the skull base is a rare, frightening, and difficult management problem. We present five cases, with a variety of causes--in all of which the patients survived massive hemorrhage--and suggest a protocol for management of the condition.

Adult↗

PubMed1984

Transfer of human nasal papilloma into nude mice.

We transferred tumor tissue from two inverted schneiderian nasal papillomas to hypothymic nude mice. Tissue from one tumor, which later underwent malignant change, was transferred three times. Forty days lapsed before growth was evident, with a subsequent period of rapid growth. Histologic appearances of the primary tumor and xenografts were similar. Although the data are derived from only two cases, our findings suggest that the capacity of these tumors to grow in nude mice may be an index of their malignant potential.

Adolescent↗

PubMed1979

Results of treatment of head and neck carcinoma with high dose methotrexate.

Forty four patients with squamous cell carcinoma of the head and neck from a variety of primary sites were treated with high dose methotrexate with folinic acid rescue from 1975 to 1977. The overall response rate was 66%. Response duration was short with a mean of 16 weeks. The usefulness of this technique in the treatment of head and neck cancer is discussed.

Carcinoma, Squamous Cell↗

PubMed1978

Current trends in the treatment of cancer of the larynx.

The case histories of 250 patients with cancer of the larynx presenting to the Peter MacCallum Hospital, the Alfred Hospital and the Royal Melbourne Hospital in the ten-year period 1966 to 1975 have been reviewed to determine: The results of primary irradiation treatment of T1N0 and T2N0 glottic cancer; The comparative results of primary irradiation plus salvage surgery as compared with primary radical surgery for T3N0 glottic and supraglottic cancer; and The surgical morbidity of secondary salvage laryngectomy following irradiation as compared with that of primary total laryngectomy. These findings are compared with those of a previous study of cancer of the larynx for the period 1956 to 1965.

Combined Modality Therapy↗

PubMed1978

Temporal bone resection for cancer.

Fifteen patients with cancer involving the temporal bone have been considered for radical surgical treatment by partial resection of the temporal bone during the past 12 years. All but one had undergone previous treatment by local surgery and/or irradiation. Two patients proved to be inoperable at surgical exploration. Three types of partial resection of the temporal bone and described to encompass disease involving the concha, the mastoid and squamous areas of the temporal bone, the ear canal, the middle ear, and the parotid gland. Closure of the surgical defect has been achieved in five cases using the residual pinna, in four cases with scalp flaps, and in five cases with a deltopectoral flap. Complications have been surprisingly few, with only one postoperative death. In one case communicating hydrocephalus persisted until death from residual disease many months later. Minor repair failure occurred in two patients. No attempt has been made to restore facial nerve function by grafting procedures. Long-term survival has been disappointing; however, it is considered that such radical surgery remains justified in selected cases for relief of the pain and disfigurement caused by chronic ulcerating neoplastic disease.

Aged↗

PubMed1973