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Biomedical subjects

T C Calcaterra

Publications and source records attributed to T C Calcaterra.

At least 109 records · Page 6Linked to original sources

The coexistence of parathyroid adenoma and thyroid carcinoma.

Not well-known and inadequately understood is the high incidence of conexistent parathyroid adenoma and nonmedullary thyroid carcinoma. In a series of 144 patients with parathyroid adenoma, 11 (8%) were found to have concurrent thyroid carcinoma. Although similar to other multiple endocrine tumor syndromes, these two tumors have no common embryologic cell origin. The most likely explanation for this apparent relationship is the specific oncogenic effect of hypercalcemia on the thyroid gland.

Adenocarcinoma↗

Epidermoid carcinoma of the palate.

A retrospective study was made of 80 cases of epidermoid carcinoma of the palate that were treated at the UCLA Center for the Health Sciences between 1955 and 1977. Tumor size larger than 3 cm, extension to neighboring structures, and contralateral, bilateral, and "fixed" lymph node metastases substantially decreased survival. The presence of ipsilateral nodes and the modality of treatment used (surgery or irradiation) did not appear to affect the outcome. Three-year cure rates for all cases was 40%. Ninety percent of recurrences took place during the first two years after treatment, and additional cancers developed in the upper aerodigestive tract of 20% of the patients.

Adult↗

Recovery of eighth nerve function after cerebellopontine angle surgery.

Retrocochlear lesions cause typical patterns of hearing loss as detailed in special audiometric tests. Such losses, however, may be temporary deficits. Indeed, return to near normalcy following severely depressed auditory function is documented in this article. Conservative surgery on lesions influencing eighth nerve function should be considered. This is not to say that neoplasia can be partially removed, but rather that when tumors can be resected while preserving the cochlear nerve, this should be done inasmuch as good hearing levels may be restored.

Auditory Threshold↗

The value of sialography in the diagnosis of parotid tumors. A clinicopathological correlation.

The importance of sialography in the diagnostic evaluation of the condition of a patient with a parotid mass remains uncertain; some proponents advise use of sialography routinely, while others believe it to be worthless. To help resolve these conflicting opinions, a retrospective study of 40 patients was carried out that compared sialographical interpretations with respective surgical-histological findings. The results of this study show that generally reliable information, which may serve to influence therapeutic decisions concerning these patients, can be gleaned from sialography.

Humans↗

The role of computed tomography in the management of cancer of the larynx.

Computed tomography (CT) offers a unique method of displaying the anatomy of laryngeal cancer. Asymmetrical contours of the thyroid cartilages have been found as a normal variant. Marked asymmetry may indicate buckling of the cartilage which could contribute to acute airway obstruction following radiation therapy. A low-density, soft-tissue plane medial to the thyroid cartilages may prove valuable in evaluating cartilaginous involvement with tumor. Computed tomography should make a significant contribution to more accurate planning of radiation therapy portals by showing the relationship of lymphatic spread to the primary tumors.

Humans↗

Cerebrospinal rhinorrhea: extracranial surgical repair.

Cerebrospinal rhinorrhea is an uncommon complication of head trauma or of diverse types of intracranial diseases. Because of the risk of meningitis, this condition warrants immediate attention. If the leak fails to stop spontaneously in a short time, the precise site of the leak must be ascertained and surgical repair attempted. For the past 50 years craniotomy has been the principal operative approach; however, this method carries the risk of significant morbidity and protracted hospital stays, as well as a disappointing incidence of persistent leak. During the past decade extracranial operations for dural repair have been devised, and experience in the management of patients by a variety of such procedures illustrates the success of these operations.

Cerebrospinal Fluid Rhinorrhea↗

The lip-splitting approach to resection of oropharyngeal cancer.

Adequate margins are of primary importance in a composite resection of oropharyngeal carcinomas. Secondary considerations include the functional status and cosmetic result of the patient after the operation. A series of 6 patients demonstrate that, in selected cases, a lip-splitting approach to increase exposure while ensuring adequate margins may be undertaken without undue fear of functional impairment or cosmetic deformity. The ultimate result will depend on proper placement of the incisions and careful reapproximation of tissue.

Aged↗

Ischemic paralysis of the facial nerve: a possible etiologic factor in Bell's palsy.

Numerous causes of peripheral facial nerve paralyses have been described; however, none has satisfactorily explained the genesis of the most common type of paralysis, Bell's palsy. Two patients undergoing an experimental embolization of vascular intracranial tumors suffered a total peripheral facial nerve paralysis when occlusion of the middle meningeal artery had been accomplished. It is speculated that this paralysis resulted from ischemia of the horizontal portion of the facial nerve, an observation that has not previously been described and that might be applicable as well to the etiology of Bell's palsy.

Adult↗

Prosthetic rehabilitation of large midfacial defects.

Advanced tumors of the midfacial region often require removal of the nose, upper lip, portions of the maxilla, and other adjacent structures. When the resultant defects do not lend themselves to surgical reconstruction, prosthetic appliances may be used successfully to restore the functions of speech and swallowing to near-normal levels. The degree of success depends upon the nature of the previous treatment, the existing surgical defect, and the adaptability of the patient. The most important anatomical consideration is the form and amount of the remaining maxilla. Recent advances in the development of the polyurethanes have resulted in lighter, more flexible, and, therefore, better tolerated prostheses. Close cooperation between the surgeon and the prosthodontist is necessary if successful rehabilitation of these patients is to be achieved.

Aged↗

Pseudomonas meningitis complicating head and neck surgery.

Three patients, each of whom had Pseudomonas meningitis as a sequela of an extensive head and neck operation, have been treated successfully. All three patients had cerebrospinal fluid leaks, and operative management of this complication is discussed. Antibiotic management included the parenteral administration of the recently developed drugs gentamicin, carbenicillin, and intrathecal gentamicin. Since extensive head and neck operations are being performed, with increasing frequency and since infectious complications are inevitable, it is mandatory that the otolaryngologist be familiar with current methods of managing these potentially lethal conditions.

Carbenicillin↗

Current adjuncts for surgery of the sphenoid sinus and pituitary gland.

Surgical intervention in the region of the sphenoid sinus pituitary gland requires extreme precision because of enveloping vital structures. The rhinologic approach to the pituitary gland, once abandoned due to limited visibility and the risk of meningitis, has experienced a renaissance as a result of recent medical and technical advances. Antibiotics have almost eliminated the risk of meningitis, and the operating microscope and televised radiofluoroscope now provide sufficient illumination, magnification, and orientation that injury to nearby structures can be avoided. A mid-line rhinologic approach provides ample exposure and further minimizes operative hazards.

Fluoroscopy↗