ABSTRACT
OBJECTIVES: Our aim was to investigate the metastasis behavior and its prognostic Factor for Survival, with our clinical data. MATERIALS AND METHODS: This retrospective study included 29 Caucasians, with a squamous cell carcinoma of the skin in the head and neck region, at our tertiary clinic between 2004 and 2016. All Patients received a Tumorresection and Neckdissection. We used either Ultrasound or Computer-Tomography (conventional or PET-CT) for our preoperative Staging and the Follow-up. The Patients were classified according to metastatic behavior and the corresponding survival rates were determined. RESULTS: We found 11 patients with cervical metastases, 4 patients with parotideal metastases, 5 patients had Metastasis in both locations. In 9 patients a prophylactic neck dissection was performed. A loco regional tumor recurrence occurred in a total of 24â % of the cases, these cases were all associated with cervical metastasis. The 5-year survival rate in these cases was 71â %; in contrast, it was 100â % when parotideal metastasis alone occurred. In the group with prophylactic neck dissection, one case was diagnosed with occult metastases. CONCLUSIONS: Cervical metastasis is associated with a poorer prognosis compared to parotideal metastasis. The survival rate after surgical therapy and, if necessary, additional adjuvant radiotherapy is generally good (79â %). The role of prophylactic neck dissection in cN0 with corresponding risk factors, has not been conclusively clarified.
Subject(s)
Carcinoma, Squamous Cell , Neoplasm Recurrence, Local , Skin Neoplasms , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/diagnostic imaging , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/therapy , Female , Humans , Male , Neck Dissection , Neoplasm Recurrence, Local/diagnostic imaging , Neoplasm Recurrence, Local/mortality , Neoplasm Recurrence, Local/therapy , Prognosis , Retrospective Studies , Skin Neoplasms/diagnostic imaging , Skin Neoplasms/mortality , Skin Neoplasms/pathology , Skin Neoplasms/therapyABSTRACT
OBJECTIVE: Among other difficulties, achieving a stable position of a total ossicular replacement prosthesis (TORP) is demanding because of a limited view on the TORP-footplate interface and individual angles between the footplate and tympanic membrane. The Kurz Omega Connector aims at a simplified insertion of the TORP. The performance of total ossicular reconstruction using the Omega Connector was evaluated. STUDY DESIGN: Prospective cohort study and experimental measurements with a fresh human temporal bone. SETTING: Tertiary referral center. PATIENTS: Seventeen consecutive patients receiving total ossicular reconstruction were included. Historical control group composed of 36 patients. INTERVENTIONS: Total ossicular reconstruction using the Omega Connector. MAIN OUTCOME MEASURES: (a) Handling of the TORP and Omega Connector intraoperatively, (b) functional short-term results compared with a historical control group, (c) sound transmission properties with 3 different connective positions between the TORP and the Omega Connector. RESULTS: Placing the Omega Connector on the footplate and coupling the Omega Connector to the TORP was straightforward in 65% of cases. A stable final position of the TORP was obtained in 88% of cases. Mean (SD) preoperative and postoperative air-bone gaps were 36.00 (11.05) and 25.29 (12.25) dB and were almost identical with those in the historical control group (p = 0.9). In the experimental measurements, functional outcomes with "partial connection" showed almost the same results as those with "full connection." CONCLUSION: The Omega Connector provides easy handling of the TORP. The short-term functional results were comparable to those achieved previously without the Omega Connector. The temporal bone measurement supports tolerance in connective position between the TORP and the Omega Connector.
