M Speiser | PubMed Health

PubMed1993

[Cervical lymph node metastases].

The investigative procedure of clinically diagnosed cervical lymph node metastases is discussed. Cervical lymph node metastases can be the first manifestation of a carcinoma. The corresponding primary tumor is diagnosed in the ENT area (mouth, pharynx, larynx) in 80% of the cases and in bronchi or esophagus in 10%; therefore, a detailed ENT examination and an upper panendoscopy must be undertaken. Wedge excisions of lymph node metastases are contraindicated, since they produce an artificial rupture of capsule and open the door to extranodal tumor growth. Excision of cervical lymph nodes, which are clinically related to a cervical lymph node metastasis, should only be carried out within the framework of a diagnostic and therapeutic concept.

Bronchial Neoplasms↗

PubMed1993

The subcranial approach for fronto-orbital and anteroposterior skull-base tumors.

We describe 78 patients with fronto-orbital and sphenoethmoidal tumors surgically treated with the subcranial approach. This approach was developed by us in 1978 primarily for the treatment of skull-base trauma and craniofacial anomalies. Since 1980, we have extended the indications to include tumor resections. This extended anterior exposure of the anterior fossa skull base, including the sphenoidal and clival planes, enables an en bloc tumor removal obviating the transfrontal approach or lateral rhinotomy. In contrast with the conventional transcranial approach, the anterior subcranial approach provides an extended exposure of these locations, avoiding frontal lobe retraction. Reduction of complications, such as recurrent cerebrospinal fluid leaks, postoperative brain edema, damage to cranial nerves, and infection plus decreased hospitalization, are the major advantages of this procedure.

Adolescent↗