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Biomedical subjects

S Sobol

Publications and source records attributed to S Sobol.

12 recordsLinked to original sources

Objective comparison of physical dysfunction after neck dissection.

Thirty-five patients who underwent a total of 44 neck dissections of various types were prospectively studied to compare differences in postoperative shoulder function. Those who underwent a radical neck dissection suffered the greatest reduction in shoulder movement and had severely abnormal electromyograms. Those who underwent modified neck dissection with preservation of the spinal accessory nerve suffered less loss of shoulder function than the radical neck dissection group, but not to a significant degree at 16 weeks; however, the electromyograms of patients who underwent modified neck dissection were significantly better than those of the radical neck dissection group, which suggests that these patients may improve with time. Indeed, a reevaluation of several patients at 1 year showed improvement in both shoulder function and electromyograms in those who underwent modified neck dissection. Patients who underwent supraomohyoid neck dissection that involved minimal dissection of the spinal accessory nerve had minimal loss of shoulder function and usually, normal electromyograms at 16 weeks that documented less injury to the spinal accessory nerve. Again, these patients had improvement with time. A correlational analysis revealed that the physical parameters correlated well with the electromyographic findings, whereas each patient's perception of disability did not. These findings suggest that, in patients in whom it is oncologically sound, a neck dissection that spares the spinal accessory nerve offers significant benefit in terms of shoulder function.

Accessory Nerve↗

Palliative orbital decompression for metastatic melanoma to the orbit.

Although relatively rare, metastatic carcinomas to the orbit are the second most common orbital neoplasm in the adult. There are only ten cases reported in the literature of cutaneous melanoma metastatic to the orbit and, of these, only two had disease involving both orbits. This paper presents the third case of bilateral orbital melanoma; however, in this case, the primary site was the uveal tract in the first eye, with contralateral involvement being a metastasis of the orbital primary. The patient developed severe unilateral proptosis in his only seeing eye with progressive loss of vision. A palliative orbital decompression was performed which successfully restored visual acuity for an extended period of time. A brief discussion of the rationale for this procedure in this type of case is presented.

Ciliary Body↗

Hemilaryngectomy for verrucous carcinoma of the glottis.

Seven patients with verrucous carcinoma of the glottis treated by hemilaryngectomy are analyzed. The diagnostic criteria for this tumor are reviewed. Close cooperation between the clinician and pathologist is necessary for the correct diagnosis. The controversy regarding radiation therapy is discussed. Hemilaryngectomy is concluded to be a successful surgical modality for limited verrucous carcinoma of the larynx.

Adult↗

Malignant fibrous histiocytoma of the head and neck.

Eight cases, the largest series of malignant fibrous histiocytomas of the head and neck to date, are reported. In over one-half of the cases, the initial problems encountered in the case made the true diagnosis misleading. For correct diagnosis multiple biopsies may be required. The diagnosis is further confirmed by the clinical behavior of the tumor and its site, size, and depth of involvement. Four specific histopathologic variants are described. Wide surgical excision is the preferrred treatment. The potential role of adjunctive irradiation should be considered.

Adult↗

Immediate facial rehabilitation in poor prognosis tumor patients.

Effective rehabilitation of facial paralysis in the poor prognosis tumor patient is best accomplished by the judicious and individualized use of that combination of static or static and dynamic procedures which will correct the major deformities present immediately and with minimal morbidity. This approach may be taken at the time of tumor ablation or later when the effects of paralysis become distressingly evident. In the rare patient whose disease is controlled, additonal dynamic rehabilitative efforts may be considered subsequently.

Aged↗

Villous adenoma of the ampulla of Vater. An unusual cause of biliary colic and obstructive jaundice.

An unusual case of biliary obstruction caused by a benign villous adenoma of the ampulla of Vater is reported and the literature reviewed. Of the reported cases, 75% have jaundice or symptoms of cholecystitis. Rarely, gastrointestinal bleeding or pancreatic duct obstruction is a presenting symptom. The tumors are frequently small and can be overlooked. Operative treatment varies from excision of the tumor to pancreatoduodenal resection depending on histological evaluation, intraoperative findings, and the surgeon's philosophy.

Adenoma↗

Clinical course of unusual malignant sarcomas of head and neck.

The clinical manifestations of 29 recently encountered sarcomas of the head and neck were analyzed in an attempt to define more accurately the diagnostic characteristics and therapeutic responses of these unusual tumors. The host factors of age, sex distribution, race, habits and associated features differ sufficiently to distinguish the sarcoma from the carcinoma population. In addition, the clinical course of sarcoma patients as monitored by mode of presentation, site of involvement, tumor histology, diagnostic features and certain elements of management and outcome, further indicates that these tumors can be defined and managed as a distinct group of lesions. A review of the recent literature supports the major conclusions of this study.

Adolescent↗

Surgery for glomus tumors at the skull base.

Glomus tumors of the temporal bone frequently involve the skull base. In the present study, 34% of the tumors occurred with cranial nerve palsies and 15% invaded the CNS. The procedure for surgical resection of glomus tumors of the skull base is described. Results of the procedure included successful surgical resection of 80% of the glomus jugulare tumors and of 94% of the glomus tympanicum tumors. Tumor recurrence and persistence occurred only in the patients with CNS invasion.

Cranial Nerve Neoplasms↗