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Biomedical subjects

T C Calcaterra

Publications and source records attributed to T C Calcaterra.

At least 91 records · Page 5Linked to original sources
PubMed1985

Epiglottic reconstruction after supraglottic laryngectomy.

It has been well established that supraglottic laryngectomy is an effective treatment of laryngeal cancer arising above the vocal cords with cure rates equaling total laryngectomy. Although there is preservation of a near normal voice after supraglottic laryngectomy, chronic aspiration occurs in some patients particularly after extended supraglottic laryngectomy or when there is associated compromised pulmonary function. During normal deglutition, the epiglottis serves to divert food to the pyriform fossae and partially covers the inlet to the airway. These important functions can be accomplished after supraglottic laryngectomy by reconstructing a neoepiglottis from an epiglottic remnant whenever one third or more of the epiglottis can be preserved which is microscopically free of tumor. Our results in 14 patients have shown no clinically significant aspiration after epiglottic reconstruction.

Deglutition↗
PubMed1985

Diagnosis and management of ethmoid cerebrospinal rhinorrhea.

In most instances of cerebrospinal rhinorrhea, the dural defect occurs at or near the region of the ethmoid roof. The skills of the otolaryngologist are of primary importance in the diagnosis and management of this condition. In almost all cases, the dura can be repaired exclusively by an extracranial approach.

Cerebrospinal Fluid Rhinorrhea↗
PubMed1985

Supraglottic laryngectomy: series report and analysis of results.

Forty-one consecutive patients who underwent supraglottic laryngectomy at UCLA were reviewed. All of the operations were performed by or under the direct supervision of the same surgeon (T.C.). The majority (68%) had advanced squamous cell carcinoma (Stage III-IV). Approximately one half received radiation therapy as part of planned combined therapy. The overall tumor-free survival, with a two-year minimum follow-up period, was 90%. The most common site of tumor recurrence was neck metastasis. There were four laryngeal recurrences, three of which were salvaged with completion laryngectomy. There was only one completion laryngectomy for severe aspiration. The favorable results in this series are attributed to frozen section control of surgical margins, surgical or radiation therapy treatment of cervical lymph nodes at risk for metastatic disease, and the employment of surgical techniques designed to minimize aspiration.

Adult↗
PubMed1984

Preoperative CT scan evaluation for laryngeal carcinoma: correlation with pathological findings.

The advent of newer generation high resolution computed tomography (CT) scanners has revolutionized diagnostic evaluation in head and neck cancer. Since the development of conservation surgical techniques for the larynx, a precise preoperative evaluation of the extent of laryngeal involvement by carcinoma has been of prime importance. No single diagnostic study now yields more information regarding the anatomic extent of tumor than high resolution CT scanning. This study was designed to evaluate the reliability of CT scanning in determining extent of disease at several laryngeal levels by comparing preoperative CT scans with corresponding postoperative pathology obtained by serially sectioning laryngeal specimens. We found very good correlation in the inferior larynx and good correlation in the superior larynx. Determination of cartilage invasion proved very difficult, and scanning was unreliable at all levels when severe postradiation reactions were present.

Cricoid Cartilage↗
PubMed1983

Metastatic cancer to the larynx. Diagnosis and management.

A case of metastatic tumor in the larynx following successful treatment of a breast carcinoma and a colon carcinoma is presented. The lesion was visible by indirect laryngoscopy, and computed tomography of the larynx assisted in delineating the extent of the disease. The separation of primary adenocarcinoma of the larynx from metastases is discussed, as is the identification of the origin of a metastasis where two separate primaries have existed. Other reports of cancer metastatsizing to the larynx are reviewed. Tumor spread to the larynx may be asymptomatic or may result in hoarseness, stridor and/or airway obstruction.

Adenocarcinoma↗
PubMed1983

Management of recurrent thyroglossal duct cysts.

In a review of 141 patients with thyroglossal duct cysts between 1961 and 1981, 28 patients were found to have surgical treatment for recurrent cysts and sinuses. Recurrent disease following surgical failure results in a high incidence of fistula formation. In the operative treatment of recurrent disease, all patients had a segment of hyoid bone excised. The dissection was extended to include a core of the base of the tongue in 20 of the 28 patients. There have been no surgical failures in this population of patients treated for recurrent thyroglossal duct cysts. We are currently treating patients with recurrent cysts and sinuses with en bloc anterior neck dissections, a modification of the classic Sistrunk procedure.

Adolescent↗
PubMed1983

Lower alveolar carcinoma. Segmental v marginal resection.

Fifty-three patients were treated for squamous cell carcinoma of the lower alveolar ridge during a 24-year period. Comparison two-year survival rates and no evidence of disease (NED) figures were obtained for segmental and marginal resection of the mandible in these patients for each stage of the disease. Analysis of these two treatment modalities disclosed that marginal resection, especially when combined with radiation, is as effective in controlling disease in stages I and II and, possibly, in stage III. Stage IV carcinomas should be treated by combined segmental therapy. The comparatively high two-year NED rate for marginal resection found in this series suggests that this therapy should be considered as the initial form of therapy in selected patients with stage I and II disease.

Aged↗
PubMed1983

Tongue flap reconstruction of the hypopharynx.

Many different reconstructive procedures are available to the surgeon for restoration of a functioning conduit from the oral cavity to the esophagus. Most procedures require a lengthy single stage or multiple stages to complete reconstruction of the hypopharynx. The base of the tongue is a potential source for variously designed flaps that can be employed to reconstruct the hypopharynx following major resections. Because of proximity and rich vascularization of the tongue base, flaps fashioned from this region have proved to be very expedient and reliable in repair of large defects of the pharynx following subtotal laryngopharyngectomy and supraglottic laryngectomy.

Humans↗
PubMed1983

Sternohyoid myofascial flap reconstruction of the larynx for vertical partial laryngectomy.

Reconstruction of the larynx for vertical partial laryngectomy is of paramount importance in eventual voice and deglutition rehabilitation. Many different methods of laryngeal reconstruction have been tried attesting to the challenge of minimizing hoarseness and aspiration after this type of surgery. During the past decade the scope of partial laryngeal surgery has broadened, mandating more extensive reconstructive procedures in order to acceptably rehabilitate upper aerodigestive function. During the past 6 years the author has employed a superiorly-based sternohyoid myofascial flap to reconstruct the larynx after vertical partial laryngectomy in 31 patients. Swallowing was resumed in all patients without significant aspiration. Although decannulation was delayed in 8 patients, all patients were eventually extubated. Voice quality was considered far superior to other reconstructive methods formerly used by the author.

Humans↗
PubMed1983

Kaposi's sarcoma and community-acquired immune deficiency syndrome.

Kaposi's sarcoma (KS), or idiopathic multiple hemorrhagic sarcoma, has heretofore been considered an indolent disease of the elderly, which also occurs in immunosuppressed hosts. Within the last two years, an epidemic of a community-acquired immune deficiency syndrome (AIDS) and disseminated KS has been reported in various population groups across the United States. The head and neck manifestations of KS in AIDS and our experience at UCLA are reviewed. Of 45 patients with AIDS, 18 (40%) had initial disease in the head and neck region. Most commonly, dermal lesions (44%), oropharyngeal lesions (39%), and cervical lymphadenopathy (33%) were noted. One patient had coexistent lymphoma. Six patients (33%) died of opportunistic infections. Head and neck lesions often herald more extensive disease. Early recognition of AIDS is important for complete patient evaluation as well as for personal safety.

Acquired Immunodeficiency Syndrome↗
PubMed1982

Salivary gland tumors of the lip.

The UCLA experience with minor salivary gland tumors of the lip is presented and contrasted with that of the literature. The incidence of benign to malignant tumors of the lip does not follow the inverse relationship stated in the axiom that the smaller the salivary gland the greater the probability that a developing tumor will be malignant. Benign tumors represent over 80% of all salivary gland tumors of the lip. There is no preponderant malignant tumor for the lip. Adenoid cystic carcinoma, mucoepidermoid carcinoma, and adenocarcinoma occur with almost equal frequency. Because of the indolent nature of these tumors, excellent survival rates can be achieved with wide local excision with few recurrences, if the tumors are adequately treated when first seen.

Adenocarcinoma↗
PubMed1981

Management of cervical thorium dioxide granulomas.

Thorium dioxide (Thorotrast) was used extensively in the United States from the 1930s through the 1950s for contrast radiography, including cerebral angiography. Its use was discontinued after the pathologic consequences of tumor formation and local fibrotic reaction (thorium dioxide granuloma) were recognized. The latency period for the development of these consequences is 20 to 30 years and, thus, has not expired. Radical surgical excision in an attempt to remove cervical thorium dioxide granulomas and their ionizing radiation has been advocated previously. A case prompted reconsideration of this management. Total surgical removal does not seem possible and is extremely hazardous in those cases with a patent carotid artery adjacent to the cervical granuloma. More cases should be expected, and each case should be approached individually as to benefits and risks of attempted surgical removal of the granuloma. Radical surgery is not always the treatment of choice.

Adult↗
PubMed1981

Aerodigestive dysfunction secondary to thyroid tumors.

Although most thyroid tumors first manifest clinically by a neck mass, several patients with thyroid tumor have been treated whose initial complaint was a disturbance of the respiratory and digestive tracts. Because this association is not well recognized, the diagnosis of a thyroid tumor can be delayed, or even missed until the tumor grows much larger causing other symptoms. A series of 269 patients with thyroid tumors seen at UCLA from 1979-1980 was reviewed. Approximately 16% of these patients sought treatment because of aerodigestive dysfunction such as dyspnea, dysphagia, hoarseness, throat discomfort and hemoptysis. Such symptoms often indicate malignancy of substernal extension of tumor. The management of these tumors is discussed.

Deglutition Disorders↗
PubMed1980

Adenoid cystic carcinoma of the nose, paranasal sinuses, and palate.

A retrospective study was performed on 18 cases of adenoid cystic carcinoma involving the nose, paranasal sinuses, or palate. The most common symptoms seen initially were referable to a mass or epistaxis. Surgery was the only form of therapy associated with long survival, although the addition of postoperative radiation therapy appears to prolong survival. All recurrences were first noted in the primary area. Factors that correlated best with surgical were clear surgical margins and absence of cranial nerve involvement.

Adolescent↗
PubMed1980

Inverting papillomas of the nose and paranasal sinuses.

Inverting papilloma of the nose and paranasal sinuses can sometimes be very difficult to distinguish from other nasal tumors, and the confusion ranges from allergic nasal polyposis to carcinoma. They are also certainly characterized by multiple recurrence, particularly after limited operations. The experience with 34 cases seen at UCLA over the past two decades is analyzed and a philosophy of treatment is outlined. We favor wide local excision which generally necessitates a lateral rhinotomy and medial maxillectomy. The operative approach will be described in detail.

Female↗
PubMed1980

Antral-ethmoidal decompression of the orbit in Graves' disease: ten-year experience.

The orbital manifestations of Graves' disease usually comprise the most distressing component of this inadequately understood disease entity. Patients with optic neuropathy, exposure keratopathy, or disfiguring proptosis can be helped considerably by decompression of the swollen orbital tissues into the maxillary and sinus cavities. Experience with 104 patients personally operated by the senior author and analyzed by chart review and patient questionnaire indicates that antral-ethmoidal decompression is a successful form of therapy, generally free of serious complications. It is now employed earlier in the course of Graves' ophtholmopathy than in the past.

Female↗
PubMed1979

Nasolacrimal obstruction after maxillary sinus and rhinoplastic surgery.

Transient nasolacrimal obstruction is a common complication of maxillary sinus, as well as rhinoplastic surgery. Permanent epiphora, however, is unusual. This communication describes 11 patients with surgical injury to the lacrimal drainage system, which necessitated dacryocystorhinostomy for correction. Seven of these cases occurred subsequent to nasoantral window procedures, three occurred after rhinoplasty, and one resulted from a partial maxillectomy. It has been shown that the two areas most vulnerable to inadvertent surgical injury are the nasolacrimal sac, located just beneath the medial canthal ligament, and the ductal ostium in the inferior meatus. We discuss the relevant anatomy of the nasolacrimal apparatus, in addition to surgical methods for avoiding injury to the system. We also describe the currently applied techniques for diagnosing and managing lacrimal obstruction and review the literature.

Adult↗