[Neck skin-muscular flap use in cases of expanded operations on the occasion of malignant neoplasms of maxillo-facial region].

Comparative analysis of the results of different flaps, cut out on side surface of the neck for plastic cover of extensive defects of maxillo-facial region (MFR) formed after malignant tumors ablation, use was carried out. Reconstructive plastic operations were performed in 84 patients: displacement of neck skin-facial flap on the stem in 54 (64.1%) patients, use of neck skin-muscle flap (SMF) in 20 (23.8%) patients, use of improved method of skin-muscle transplant forming from only medial part of nodding muscle in 10 (12.1%) patients. Good cosmetic and functional results were received in 62 (73.8%) observations. Use of complex SMF after surgical interventions in cases of malignant tumors in MFR let reduce the number of postoperative complications and provide earlier rehabilitation of this heavy group of patients.

[Immediate and long-term results of plastic reconstruction of soft tissues of the head and neck in areas previously treated with surgery for tumor and radiation injury].

The efficiency was studied of vascularized tissue complexes in 346 cancer patients with extensive facial injuries to the head and neck who had undergone combined treatment. Free microsurgical autotransplantation was carried out in 7 (2%) patients, deltapectoral graft--151 (44%), sternocleidomastoid myocutaneous flap--39 (11%), pectoralis major flap--10 (3%), bi- and tri-lobed flap--55 (16%), temporal musculoperiosteal flap--25 (7%), cheek flap--24 (6.9%), thoraco-dorsal axillary flap--24 (6.9%), frontal flap--6 (1.7%), free-flap transfer--5 (1.5%). Although most vascularized tissue complexes were placed in previously irradiated areas, primary engraftment was reported in 249 (72%) patients, while peripheral or partial necrosis in distal part of flap- in 97 (28%). Good cosmetic and functional results were obtained in 298 (86%) patients who considered themselves cured.

Californium-252 interstitial implants in carcinoma of the tongue.

A clinical study using 252Cf sources in brachytherapy of tumors began in the Research Institute of Medical Radiology of the Academy of Medical Sciences of the USSR in 1973. 252Cf afterloading cells were utilized by the method of simple afterloading. Dosimetry and radiation protection of medical personnel were developed. To substantiate optimal therapeutic doses of 252Cf neutrons, a correlation of dose, time, and treatment volume factors with clinical results of 252Cf interstitial implants in carcinoma of the tongue for 47 patients with a minimum follow-up period of 1 year was studied. Forty-nine interstitial implants have been performed. Seventeen patients received 252Cf implants alone (Group I), 17 other patients received 252Cf implants in combination with external radiation (Group II), and 15 patients were treated with interstitial implants for recurrent or residual tumors (Group III). Complete regression of carcinoma of the tongue was obtained in 48 patients (98%). Recurrences occurred in 1 patient (6%) in Group I, 6 patients (35%) in Group II, and 5 patients (33%) in Group III. Thirteen patients (27%) developed radiation necrosis. The therapeutic dose of neutron radiation from 252Cf sources in interstitial radiotherapy of primary tongue carcinomas (Group I) was found to be 7 to 9 Gy. Optimal therapeutic neutron dose in combined interstitial and external radiotherapy of primary tumors (Group II) was 5 to 6 Gy with an external radiation dose of 40 Gy. For recurrent and residual tumors (Group III), favorable results were obtained with tumor doses of 6.5 to 7 Gy.

[Radiation ulcers after Cf-252 treatment of patients with cancer of the tongue]. / Luchevye iazvy posle terapii istochnikami 252Cf bol'nykh rakom iazyka.

A study was made of the frequency, clinical appearance and therapeutic methods of radiation injuries in 12 out of 57 patients who were treated for cancer of the tongue using interstitial therapy with 252Cf. The most frequent radiation injuries were observed in patients (6 out of 18, i.e. 34%) who were treated for recurrent and residual tumors after previous radiotherapeutic courses as compared to the treatment of primary malignant lesions in 6 out 39 (15%) patients. The clinical picture of radiation injuries of the tongue presented an ulcer of various sizes. A clinical classification of radiation injuries of the tongue was developed depending on the degree of the manifestations. Among causative factors the most important role is played by an absorbed tumor dose which when exceeding 9 Gy in patients with primary tumors and 8 Gy in patients with recurrent and residual tumors, resulted in radiation injuries. The development of radiation injuries is also influenced by poor hygiene and the oral cavity, and such harmful habits as smoking and alcohol consumption. Conservative therapeutic measures made it possible to achieve a complete epithelization of ulcers.