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Biomedical subjects

S Mark Taylor

Publications and source records attributed to S Mark Taylor.

10 recordsLinked to original sources
PubMed2005

Sentinel lymph node biopsy in N0 squamous cell carcinoma of the oral cavity and oropharynx.

OBJECTIVES: To ascertain the feasibility of sentinel lymph node (SLN) localization by preoperative lymphoscintigraphy and intraoperative gamma probe radiolocalization and to determine the predictive value of the SLN for occult metastasis of the neck in N0 squamous cell carcinoma of the oral cavity and oropharynx. DESIGN: A prospective study of 20 consecutive patients with N0 squamous cell carcinoma of the head and neck who underwent lymphoscintigraphy and SLN biopsy. INTERVENTIONS: On the day before surgery, each patient who completed the study underwent a submucosal peritumoral injection of unfiltered technetium 99m sulfur colloid followed by lymphoscintigraphy. Focal areas of radioactivity were marked on the overlying skin. The following day, the patients underwent resection of the primary tumor, elevation of subplatysmal flaps, identification and removal of the SLNs as identified by gamma probe, and complete neck dissections. RESULTS: Lymphoscintigraphy and gamma probe radiolocalization accurately identified 1 or more SLNs in all 20 patients. In 4 (20%) of the 20 patients, the SLN correctly identified metastatic disease. In no instance was the SLN negative when the lymphadenectomy specimen was positive. CONCLUSIONS: In this study, the SLN had a negative predictive value of 100%. Sentinel lymph node biopsy is feasible and appears to accurately predict the presence of occult metastatic disease. Although further study is warranted, SLN biopsy could potentially guide head and neck oncologists to the patient with N0 disease who would benefit most from selective neck dissection and prevent the morbidity of unnecessary neck dissection.

Adult↗
PubMed2004

Fourth branchial cyst presenting with right-sided vocal cord paralysis.

Fourth branchial anomalies are rare entities. Despite this, they must be considered when presented with a low lateral neck mass, recurrent lower neck abscesses, or recurrent suppurative thyroiditis. The truly unique presentation of this case highlights the importance of including these anomalies in the differential diagnosis for all neck lesions.

Biopsy, Needle↗
PubMed2003

Prospective cohort study comparing subcutaneous and sub-superficial musculoaponeurotic system flaps in superficial parotidectomy.

OBJECTIVE: To compare subcutaneous and sub-superficial musculoaponeurotic system (SMAS) flaps with regard to aesthetic result and Frey's syndrome following superficial parotidectomy. SETTING: A tertiary care centre. METHODS: A prospective cohort study of 45 patients who underwent superficial parotidectomies for benign disease between 1991 and 1996. All 45 patients completed self-administered questionnaires. Questions regarding perception of a facial contour deformity, Frey's syndrome, and scar rating were included. A total of 28 patients agreed to further direct patient evaluation where starch-iodine testing, photographs of the facial scar and contour, and facial nerve assessment were performed. RESULTS: Overall aesthetic results were acceptable in both groups. Scar rating was consistently higher in the sub-SMAS cohort compared with the subcutaneous group. Similarly, facial contour was found to be superior in the sub-SMAS group. Facial nerve function was normal in both groups. The overall incidence of subjective Frey's syndrome on questionnaire was 45%; however, the incidence of objective Frey's syndrome by starch-iodine testing was higher at 65%. We did not find a significant difference in the incidence of Frey's syndrome between the subcutaneous and the sub-SMAS groups. CONCLUSIONS: Sub-SMAS flaps result in superior facial contours and incisional scars following superficial parotidectomy compared with the subcutaneous flap elevation technique. We found no difference between these flaps with regard to the incidence of Frey's syndrome.

Cicatrix↗
PubMed2002

Fasciocutaneous flap reconstruction of the tongue and floor of mouth: outcomes and techniques.

OBJECTIVES: To quantify functional and other outcomes after major resection and fasciocutaneous free-flap reconstruction of the tongue and floor of mouth, and to describe reconstructive technique. DESIGN: A hypothesis-generating, retrospective cohort study of 43 patients who underwent, at minimum, a hemiglossectomy and resection of the floor of the mouth for oral cancer followed by fasciocutaneous free-flap reconstruction. SETTING: A tertiary academic medical center in the midwestern United States. MAIN OUTCOME MEASURES: Speech intelligibility, swallowing, interval to decannulation, length of stay, free-flap success rates, patient survival, and complications. RESULTS: Thirty patients underwent oral tongue reconstructions, and 13, tongue base reconstructions. Median intelligibility scores were greater among patients in the tongue base group (98% intelligibility) than in the oral-tongue group (76% intelligibility) (P<.001). Of the 38 patients undergoing swallowing evaluation, 32 (85%) were able to feed entirely by mouth, most with mild to moderate dysphagia. All patients underwent decannulation (mean interval, 13.7 days). The mean length of hospital stay was 11 days, and free flaps in 42 patients (98%) survived. Twenty-eight patients (65%) were still alive by the end of the study, yielding a mean survival time of 27.4 months. Seven patients (16%) had severe medical and 3 (7%) had major surgical complications. CONCLUSION: The folding techniques used in this study for reconstruction of the tongue with fasciocutaneous free flaps were associated with recovery of adequate speech and swallowing in most patients.

Adult↗