ABSTRACT
Carotid artery rupture ranks as the most dreaded among the head and neck surgery complications. Despite the well-documented risk of cerebral ischemia, operative carotid ligation has been the traditional management of last resort for carotid artery rupture. Over the past several years, however, the technique of endovascular occlusion of blood vessels has demonstated considerable promise in the management of carotid artery rupture. With the help of endovascular balloon occlusion, the authors managed a case of carotid artery rupture developed after the radiation therapy of laryngeal carcinoma and the salvage laryngectomy with neck dissection. Embolization on the right carotid artery was performed with detachable balloons and spiral coils after the carotid artery occlusion test. The patient did not show any complications of neurological function. The pharyngocutaneous fistula and skin defects were reconstructed with the use of pectoralis muscuocutaneous flap.
Subject(s)
Humans , Balloon Occlusion , Blood Vessels , Brain Ischemia , Carotid Arteries , Fistula , Head , Health Resorts , Laryngectomy , Ligation , Neck , Neck Dissection , Rupture , SkinABSTRACT
BACKGROUND AND OBJECTIVES: Cigarette smoking and alcohol consumption are well known risk factors of laryngeal squamous cell carcinoma. Recently, attention has been focused on other risk factors such as human papillomavirus (HPV). The presence of HPV genome in the tumor has been reported to correlate with poor patient outcome. The integration of viral genome into the host DNA is believed to be helped by alcohol and cigarette smoking. This study attempted to evaluate the incidence of HPV in laryngeal cancer with regard to its stage and recurrence. MATERIALS AND METHODS: The authors examined the incidence of HPV in 61 cases of laryngeal cancers (34 supraglottic cancers, 26 glottic cancers, 1 subglottic cancer). The histologic type of tumor in all cases was squamous cell carcinoma. There were 8 patients in the stage 1, 26 patients in the stage 2, 14 patients in the stage 3 and stage 4. Recurrence of the disease during follow-up periods occurred in 12 patients (19.6%). Polymerase chain reaction (PCR) was performed using the consensus primers for HPV on the formalin-fixed, paraffin-embedded archival tissue. For cases with amplified products corresponding to the HPV genome, a dot blot hybridization was performed for typing the different HPV types. RESULTS: The HPV genome was identified in 5 cases (8%) of laryngeal squamous cell carcinomas by using PCR. In recurrent laryngeal cancer group, detection rate of HPV DNA was significantly greater than in the non-recurrent group (p<0.05). The dot blot hybridization showed only one case to be the HPV type 31. The other cases (4 cases) could not be typed using the dot blot hybridization. CONCLUSION: We can only say that the possible role of HPV in the carcinogenesis of larynx cancer is not yet resolved.
Subject(s)
Humans , Alcohol Drinking , Carcinogenesis , Carcinoma, Squamous Cell , Consensus , DNA , Follow-Up Studies , Genome , Genome, Viral , Incidence , Laryngeal Neoplasms , Papillomavirus Infections , Polymerase Chain Reaction , Recurrence , Risk Factors , SmokingABSTRACT
BACKGROUND: Head and neck cancer(HNC) is the sixth most common cancer worldwide. Squamous cell carcinoma(SCC) accounts for 85-90% of all HNC. However, its biologic behavior has little been known yet. OBJECTIVES: In the present investigation, Eight of nine cell lines, which were developed and characterized in Asan Medical Center of University of Ulsan, were tested for tumor formation and histology in nude mice. MATERIALS AND METHODS: Explant cultures of fresh tumor tissue were used to develop new permanent tumor cell lines. Five-to ten million-cells were injected subcutaneously into 3-to 6-week-old male nude mice and the formation of tumors was evaluated after 3 to 8 weeks. RESULTS: Eight cell lines(AMC-HN-1, -2, -3, -4, -5, -6, -7 and -9) produced progressively growing tumor, and were noticed remarkable similarity of the histologic feature to original tumor. Well formed keratin pearls were present both in the original tumor and the tumor produced by the AMC-HN-3 and -7 cell lines. AMC-HN-2 and -6 grew in well formed infiltrating cords with a prominent stromal network exactly like that in the original tumor. The undifferentiated carcinoma from AMC-HN-9 has the same histologic and immunohistochemical pattern. CONCLUSION: The histologic similarity between original tumors and AMC-HN cell lines are representative that cell lines are promised to be good in vitro models for study of HNC biology.
Subject(s)
Animals , Humans , Male , Mice , Biology , Carcinoma , Cell Line , Cell Line, Tumor , Head , Heterografts , Mice, Nude , NeckABSTRACT
INTRODUCTION: Nasopharyngeal angiofibroma is a rare histologically benign tumor which occurs almost exclusively in adolescent boys. The morbidity and mortality associated with this tumor are related to its prominent vascularity and its propensity for aggresive local growth. MATERIALS AND METHOD: From November 1990 through February 1996, 8 patients with a diagnosis of nasopharyngeal angiofibroma were managed at Asan Medical Center. For the devasculation of the tumor before the surgery, preoperative arterial embolization was performed on 6 patients. RESULTS: The main tumor supplying vessel was ipsilateral internal maxillary artery in all cases. According to Chandler classfication(Table 1), stage II was 4 cases and stage III was 4 cases. Operative procedures were midfacial degloving approach(4 cases), transpalatal approach(1 case), transantral approach(1 case), combined approach(1 case: Caldwell-Luc op & endoscopic op), medial maxillectomy(1 case). There were no treatment-related deaths and no major surgical complications.