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Chemosurgery by Mohs' fresh-tissue technique lends itself readily to plastic repair of the defects. The advantages and disadvantages of this approach and the various techniques that have been used successfully are discussed.
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The mechanics of repairing round and oval wounds by O to Z-plasty and some personal modifications and uses in special circumstances and locations are described. Several schematics and photographs illustrate the technique and clinical results.
Reasons for surgical ablation of giant hairy pigmented nevi are stated and surgical techniques of ablation are illustrated and described in a representative case on the face.
A retrospective clinical and radiographic analysis of 20 patients with orbital venous malformations was performed. The malformations were fed by other veins rather than arteries. They may nearly always be demonstrated by orbital or jugular phlebography, though occasionally they will fill only following direct puncture. There appeared to be varied etiologies. A few were related to trauma or to other causes of increased intraorbital pressure. There is an association with periorbital hemangiomas suggesting developmental or congenital origin.
An infant with a congenital giant hairy nevus causing occlusion of the visual axis of the right eye is presented. The nevus was removed at the early age of three weeks because of concern that the child would develop deprivation amblyopia. Since such nevi can undergo malignant changes, early removal may be justified for that reason alone.
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The results of long experience with many methods of reconstructive surgery following destruction of various splanchnocranial structures are presented. Emphasis is placed on the usefulness of cooperation between the oncological and plastic surgeon. Fifteen cases are illustrated. In many of these, endoarterial infusion of chemical antiblastics was first employed. Since tumours may vary considerably in site and histological type, as well in the biotype, age and sex of the patient, and since a variety of radical and reconstructive techniques exist for individual or associated use, therapeutical programmes cannot be put forward with any degree of confidence, but must obviously be determined by the surgeon's personal experience.
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In a sample of patients with pseudotumors and benign and malignant tumors of the orofacial region there has repeatedly been investigated, after radical surgery, the cell reaction to autologous tumor tissue applied at indicated time intervals on a small skin lesion. The prognostically favorable picture of a cellular-type hypersensitivity reaction with massive participation of lymphoid cells and basophil granulocytes was only found in some basaliomas and leukoplakias. Conversely, spinocellular carcinomas are, irrespective of localization, characterized by areactivity.
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The authors communicate the results of their experiences with 96 basaliomes. 62.5% of patients were men. The mean age was 62 +/- 1.38 years. Basaliomes were most frequent on certain sections of the face: 49 were situated in the ear region, 19 in the eye region and 24 on the nose. We observed only one basliome on the upper lip, and five others in the temporal and occipital region. 26 out of 96 patients were already treated outside, some of them even several times, before coming for our treatment. Our best results were obtained by surgical operation and this for of the following reasons: 1. Results are as good as with other methods. 2. Better cosmetic results were obtained by methods of plastic surgery. 3. Costs are reduced because of short treatment. Therefore most basaliomes were operated (77 = 80.2%). In 17 cases combination with radiotherapy was necessary because of the importance of the tumor. Two patients were only radiated because they refused surgical treatment. We observed relapse in 11 cases, 4 of them were reoperated, 6 were reoperated and radiated and one of them was only radiated. So we obtained on overall cure-rate of 98.9%. Because of high frequency of basaliomes on nose, ears and eyes certain surgical procedures related by us showed good results and didn't need hospitalisation of the patients. We recommend to hospitalise patients with angular basaliomes of the eye always, because they often have a deep extension, and the defects created by operations are difficult to be treated by plastic surgery. We think that our methods of therapy could be taken as an example.
Report of a case of Ota's naevus fuscocaeruleus ophtalmomaxillaris in an african child. The authors are not aware of a previous report of this deformity in Africa (South of the Sahara). They review the clinical and histological features of this naevus and describe in this case a pigmentary infiltration of corneal stroma.
In two infants hospitalized at the ages of three and one-half months and 11 months because of epileptic seizures, the diagnosis of tuberous sclerosis was reached upon the basis of retinal astrocytomas found in the fundus examination. It is recommended that indirect ophthalmoscopy be performed in all infants and young children referred with signs possibly related to this disease.