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1.
Int J Oral Maxillofac Surg ; 34(1): 94-8, 2005 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-15617976

RESUMO

The clinical, radiographic, and pathological features of a juxtacortical chondrosarcoma of the mandible in a 25-year-old Caucasian woman are presented and the differential diagnostic aspects are discussed. To the best of our knowledge, this rare tumor has not previously been reported in the maxillofacial skeleton. Ten years after surgery there is no evidence of local recurrence or metastatic disease. As the prognosis of juxtacortical chondrosarcoma of the long bones seems to be relatively favorable compared with the usual central chondrosarcoma of similar grade of malignancy, this might also be expected for a similar tumor presentation in the maxillofacial skeleton.


Assuntos
Condrossarcoma/patologia , Neoplasias Mandibulares/patologia , Adulto , Diagnóstico Diferencial , Feminino , Humanos
2.
Int J Oral Maxillofac Surg ; 31(4): 378-82, 2002 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-12361070

RESUMO

In a retrospective analysis of 339 patients, treated with a curative intention for a squamous cell carcinoma of the oral cavity between 1988-1996, the value of a half-yearly routine chest radiograph during the first 2 years of follow-up, was evaluated. Metastatic or primary lung malignancies developed in 18 (5.3%) of the 339 patients in the first 2 years of the follow-up. In 11 (3.2%) patients these malignancies were detected on routine chest radiographs while in 7 (2.0%) patients these were detected on chest radiographs taken because of pulmonary complaints. The mean survival after detection of the pulmonary malignancy was 8 months. All patients died within 21 months, independent of pathology or therapy. No correlation was found between stage, location or differentiation of the primary tumour. As a result of this study it can be concluded that there is no benefit for the patient for a 6-month thoracic radiograph in routine follow-up for patients with oral squamous cell carcinoma. It gives false certainty and burdens the health care system.


Assuntos
Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/secundário , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/secundário , Neoplasias Bucais/patologia , Radiografia Torácica/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/mortalidade , Feminino , Humanos , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Segunda Neoplasia Primária/diagnóstico por imagem , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida , Taxa de Sobrevida , Procedimentos Desnecessários
3.
Int J Radiat Oncol Biol Phys ; 40(5): 1027-32, 1998 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-9539556

RESUMO

PURPOSE: Head and neck oncologists have not reached consensus regarding the role of contemporary imaging techniques in the evaluation of the clinically negative neck in patients with head and neck squamous cell carcinoma (HNSCC). The purpose of the present study was to compare the accuracy of ultrasound with guided fine-needle aspiration biopsy (UGFNAB) and computed tomography (CT) in detecting lymph node metastasis in the clinically negative neck. METHODS AND MATERIALS: Sixty-four neck sides of patients with HNSCC were examined preoperatively by ultrasound/UGFNAB and CT at one of five participating tertiary care medical centers. The findings were correlated with the results of histopathologic examination of the neck specimen. RESULTS: Ultrasound with guided fine-needle aspiration biopsy was characterized by a sensitivity of 48%, specificity of 100%, and overall accuracy of 79%. Three cases had nondiagnostic aspirations using UGFNAB and were excluded. CT demonstrated a sensitivity of 54%, specificity of 92%, and overall accuracy of 77%. UGFNAB detected two additional metastases not visualized on CT, whereas CT detected no metastases not seen on UGFNAB. The results of UGFNAB were similar between the participating centers. CONCLUSIONS: Approximately one half of the clinically occult nodal metastases in our patient group were identified by both CT and UGFNAB. Overall, UGFNAB and CT demonstrated comparable accuracy. The sensitivity of CT was slightly better than UGFNAB, but the latter remained characterized by a superior specificity. The results of CT and UGFNAB did not appear to be supplementary. The choice of imaging modality for staging of the clinically negative neck depends on tumor site, T-stage, and experience and preference of the head and neck oncologist. If CT is required for staging of the primary tumor, additional staging of the neck by UGFNAB does not provide significant additional value.


Assuntos
Biópsia por Agulha/métodos , Neoplasias de Cabeça e Pescoço/patologia , Metástase Linfática/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ultrassonografia de Intervenção , Feminino , Humanos , Masculino , Pescoço , Sensibilidade e Especificidade
4.
Radiology ; 198(3): 819-23, 1996 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-8628877

RESUMO

PURPOSE: To verify the acclaimed accuracy of ultrasound (US) combined with US-guided fine-needle aspiration biopsy (FNAB) in the detection of lymph node metastasis in the neck and to evaluate the interobserver variability. MATERIALS AND METHODS: In a prospective, multicenter study of 185 patients with head and neck squamous cell carcinoma, US (n=238 neck sides) with US-guided FNAB (n=178 neck sides) was used for evaluation of the lymph node status of the neck. Findings were correlated with those of histopathologic examination in 238 neck sides. RESULTS: US with US-guided FNAB had a sensitivity of 77% and a specificity of 100%. Nineteen of 178 aspirations were nondiagnostic. There were no significant differences between the four participating hospitals or the individual sonologists (P>.05). CONCLUSION: Sensitivity of US with US-guided FNAB was slightly lower compared with previous reports. Specificity was similar to previous reports. Interobserver variability appeared to be low. The validity of US with US-guided FNAB is high and warrants widespread use of the procedure for evaluation of the neck.


Assuntos
Biópsia por Agulha , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/secundário , Neoplasias de Cabeça e Pescoço/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/diagnóstico , Feminino , Humanos , Metástase Linfática/diagnóstico , Metástase Linfática/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pescoço , Variações Dependentes do Observador , Palpação , Estudos Prospectivos , Sensibilidade e Especificidade , Ultrassonografia
5.
Cancer ; 75(11): 2656-62, 1995 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-7743466

RESUMO

BACKGROUND: In the frame of a nationwide study of oropharyngeal carcinoma in the Netherlands (1986-1990), the current International Union Against Cancer 1992/American Joint Committee on Cancer 1988 staging system was evaluated with respect to patient distribution and prognostic value. METHODS: Data related to epidemiology, treatment and survival from 640 patients referred for primary treatment were analyzed. Staging was first evaluated in a proportional-hazard regression analysis controlled for these data. Next, all possible combinations of T, N, and M were tested in a stepwise backward elimination model until all remaining indicator variables had a P value of less than 0.05. New stages were defined, based on the coefficients of the remaining indicator variables. RESULTS: The revised stages revealed two advantages compared with the UICC 1992/AJCC 1988 version: a more balanced distribution of patients (31% in Stage I, 31% in Stage II, 18% in Stage III, 14% in Stage IV, and 5% unknown in the revised staging system versus 7% in Stage I, 17% in Stage II, 24% in Stage III, 50% in Stage IV, and 2% unknown in the UICC 1992/AJCC 1988 staging system), and an improved prognostic discrimination for the disease specific survival (5-year results in the revised staging were 67% in Stage I, 42% in Stage II, 28% in Stage III, and 11% in Stage IV, versus 68% in Stage I, 64% in Stage II, 44% in Stage III and 27% in Stage IV in UICC 1992/AJCC 1988). CONCLUSION: Improvements in the current staging system in patient distribution in the stages in prognostic discrimination is feasible by regrouping the T, N, and M but without redefining the categories themselves.


Assuntos
Carcinoma de Células Escamosas/patologia , Carcinoma/patologia , Estadiamento de Neoplasias/métodos , Neoplasias Orofaríngeas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma/mortalidade , Carcinoma de Células Escamosas/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Neoplasias Orofaríngeas/mortalidade , Prognóstico , Análise de Sobrevida
7.
J Craniomaxillofac Surg ; 18(6): 237-42, 1990 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-2212019

RESUMO

The cutaneous sensibility of 13 pectoralis major cutaneous island flaps has been investigated retrospectively. Although in raising the pectoralis major myocutaneous island flap sensory denervation of the skin is produced, after a mean follow-up period of 29 months (range 5 to 71 months), 68% of the cutaneous portion of the flap revealed sensibility to touch, suggesting a reinnervation from the surrounding intact oral mucosa or skin. The rate of reinnervation was found to be related to the sensibility present in the surrounding tissue.


Assuntos
Neoplasias Faciais/cirurgia , Mucosa Bucal/inervação , Neoplasias Bucais/cirurgia , Músculos Peitorais/transplante , Sensação/fisiologia , Pele/inervação , Retalhos Cirúrgicos , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/fisiologia , Doenças do Sistema Nervoso/etiologia , Músculos Peitorais/inervação , Fenômenos Fisiológicos da Pele , Transplante de Pele/métodos , Cicatrização
8.
Int J Oral Maxillofac Surg ; 18(2): 99-103, 1989 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-2501417

RESUMO

In a study of 213 patients with oral cancer, we investigated the incidence and prognosis of lung malignancies in patients offered a yearly chest radiography in the follow-up. Three conclusions can be drawn. (1) Metastatic or primary lung cancer was diagnosed in 22 (10.3%) patients. The 2-year actuarial incidence rate of lung cancer following cancer of the oral cavity is 13%. No new lung cancers were detected after 2 years follow-up. This suggests that after this period, yearly chest radiography may be superfluous for the early detection of lung cancer. (2) The survival rate of patients with a lung malignancy following cancer of the oral cavity is poor (1-year = 25%). The survival rate of patients detected by the yearly chest radiography without symptoms is higher than for patients detected after symptoms (p = 0.006). It is not clear to what extent this different survival rate is biased by lead-time and selection of patients with a favourable prognosis. A randomized study would be required to assess whether patients with oral cancer do benefit from the yearly chest radiography compared with no regular chest radiography. (3) Of 22 patients with lung cancer, 13 (59%) were detected by chest radiography without symptoms. In the first year following oral cancer, 11 patients were diagnosed with lung cancer. Only 4 of these 11 patients (36%) were detected by chest radiography in an asymptomatic stage. The detection of patients with lung cancer in an asymptomatic stage may be increased by more frequent chest radiography examinations in the 1st year following oral cancer.


Assuntos
Carcinoma de Células Escamosas/terapia , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Bucais/terapia , Neoplasias Primárias Múltiplas/epidemiologia , Radiografia Torácica , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/secundário , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de Tempo
9.
Ned Tijdschr Tandheelkd ; 96(4): 137-40, 1989 Apr.
Artigo em Holandês | MEDLINE | ID: mdl-2622509

RESUMO

An overview is presented of the premalignant lesions and conditions of the oral mucosa. The dentist can play an important role in the detection of these lesions, thereby reducing the chance of premalignant transformation.


Assuntos
Doenças da Boca , Mucosa Bucal/patologia , Lesões Pré-Cancerosas , Humanos , Leucoplasia Oral
10.
Acta Chir Belg ; 87(1): 1-5, 1987.
Artigo em Inglês | MEDLINE | ID: mdl-3577555

RESUMO

In a retrospective study 101 patients who underwent surgery for a parotid mass were evaluated. The different diagnostic modalities (sialography, ultrasound, needle biopsy and frozen section) are described and discussed. Eighty-one tumors proved to be benign, of which 56 patients had a pleiomorphic adenoma, ten of them had a recurrent pleiomorphic adenoma, all after an enucleation, which again proved to be an inadequate operation for a parotid mass. The 20 malignant parotid tumors had a poor clinical outcome. Of the 18 patients with a malignant primary parotid tumor three showed a local recurrence and five metastatic disease within five years. The morbidity of parotid surgery is mainly due to post-operative facial nerve weakness (30%), which is mostly reversible, and the Frey syndrome (10%).


Assuntos
Adenoma/diagnóstico , Neoplasias Parotídeas/diagnóstico , Adenoma/cirurgia , Paralisia Facial/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Parotídeas/cirurgia , Complicações Pós-Operatórias/etiologia , Prognóstico , Recidiva , Estudos Retrospectivos
11.
Laryngoscope ; 96(5): 564-7, 1986 May.
Artigo em Inglês | MEDLINE | ID: mdl-3702572

RESUMO

The platysma myocutaneous island flap has demonstrated high versatility and reliability when used to close defects in the oral cavity in a series of ten patients. The surgical technique for this one-stage reconstructive procedure is described. The advantages and disadvantages of this flap, the results, and complications are discussed.


Assuntos
Boca/cirurgia , Retalhos Cirúrgicos , Adulto , Idoso , Carcinoma de Células Escamosas/cirurgia , Feminino , Humanos , Masculino , Métodos , Pessoa de Meia-Idade , Soalho Bucal , Neoplasias Bucais/cirurgia
12.
J Maxillofac Surg ; 14(2): 103-7, 1986 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-3009673

RESUMO

Malignant fibrous histiocytoma (MFH) can occur as a rare mesenchymal neoplasm of the deep structures of the head and neck region. An unusual case of MFH of the tongue is described in a 61-year-old male. The primary tumour measured 90 X 50 X 30 mm. Treatment consisted of hemiglossectomy in continuity with a supra-omohyoidal neck dissection. The patient has been free from disease for 2 years. The tongue as a primary site of MFH has not been reported to date. The literature of oral manifestations and treatment of this neoplasm is reviewed.


Assuntos
Histiocitoma Fibroso Benigno/cirurgia , Neoplasias da Língua/cirurgia , Glossectomia , Histiocitoma Fibroso Benigno/patologia , Histiocitoma Fibroso Benigno/ultraestrutura , Humanos , Masculino , Pessoa de Meia-Idade , Esvaziamento Cervical , Neoplasias da Língua/patologia , Neoplasias da Língua/ultraestrutura
15.
J Maxillofac Surg ; 12(6): 255-61, 1984 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-6596365

RESUMO

Of 407 patients with facial fractures who were operated on at the Department of Oral and Maxillo-Facial Surgery, University Hospital, Nijmegen, over a 3-year period, 23 had a fracture in the nasofrontal region with or without extension to the base of the skull. The problems and results of the treatment of these fractures are presented, with special reference to the management of the frontal sinus lesions, the lacrimal system, and the reconstruction of the nasal skeleton and canthal attachments. The postoperative complications and sequellae are discussed. Most prominent features are ocular problems and unsatisfactory nasal contour. Conclusions which could contribute to the proper therapeutic management are drawn.


Assuntos
Ossos Faciais/lesões , Fraturas Cranianas/cirurgia , Adolescente , Adulto , Idoso , Criança , Feminino , Seguimentos , Fixação Interna de Fraturas , Fraturas Expostas/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Fraturas Orbitárias/cirurgia , Complicações Pós-Operatórias/etiologia
17.
Neth J Surg ; 35(1): 1-7, 1983 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-6843863

RESUMO

Defects in the bucco-pharyngeal cavity after tumor resection were closed with pectoralis major myocutaneous island flaps in ten consecutive patients. The skin element consisted of an island which was transposed on a muscular pedicle containing the vascular stalk. The advantages and disadvantages of the method and the results and complications in the treated patients are discussed. When the defects mentioned require pedicled skin flaps, the pectoralis major island flap is preferred.


Assuntos
Neoplasias Bucais/cirurgia , Retalhos Cirúrgicos , Idoso , Carcinoma de Células Escamosas/cirurgia , Bochecha , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Músculos Peitorais , Neoplasias Faríngeas/cirurgia
18.
Acta Pathol Microbiol Scand A ; 87A(3): 185-92, 1979 May.
Artigo em Inglês | MEDLINE | ID: mdl-463564

RESUMO

The effect of cyclophosphamide on the healing of open cutaneous wounds was studied in rats. Following intraperitoneal injections of 25 mg/kg body weight every second day for 9 days, only about 7% of the wounds were completely covered by epithelium after 15 days, whereas in the control animals 60% of the wounds were completely epithelialized. Measurements of wound diameters in circular skin wounds revealed unhealed wound areas in the drug treated animals which were significantly larger than those of the control animals. Cyclophosphamide was found to reduce the occurrence of H3-labelled cells in the granulation tissue when evaluated after 11 days. At 15 days there was no difference in the labelling frequency between treated and control animals, indicating reversal of the drug effect.


Assuntos
Ciclofosfamida/farmacologia , Cicatrização/efeitos dos fármacos , Animais , Autorradiografia , Divisão Celular/efeitos dos fármacos , Ciclofosfamida/administração & dosagem , Relação Dose-Resposta a Droga , Epitélio/efeitos dos fármacos , Vida Livre de Germes , Tecido de Granulação/efeitos dos fármacos , Masculino , Ratos , Pele/efeitos dos fármacos , Fatores de Tempo
19.
Eur J Clin Pharmacol ; 8(3-4): 209-16, 1975 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-786680

RESUMO

It was considered that double-blind crossover studies of therapeutic efficacy after acute injury could well be done in patients who required surgical removal of impacted wisdom teeth from both sides of the lower jaw. In the present trial 24 healthy patients received either placebo or ibuprofen (Brufen: 400 mg three times daily), a non-steroidal anti-inflammatory agent, for 5 days commencing the day before surgery. Treatments were given on the two occasions when impacted wisdom teeth were to be removed from one side or other of the lower jaw. A number of objective and subjective parameters were recorded for paired comparison of the post-operative courses, including swelling, trismus and pain. A mechanical device which allows simple and accurate measurement of cheek swelling is described. On the 1st, 3rd and 5th post-operative days in the ibuprofen group the measured swelling averaged 93, 89 and 82%, respectively, of that in the placebo group; the corresponding alpha-values were 0.35, 0.06 and 0.07. Patients with less swelling after ibuprofen were not always those with a high serum concentration of the drug. Ibuprofen significantly reduced pain on the day of the operation. This may at least partly account for less trismus and the preference of the patients for their post-operative courses with ibuprofen. Examination of various haematological parameters did not reveal any significant difference between the two operations. Subjective scores indicated that neither wound-healing nor bleeding was affected by ibuprofen, nor were any side effects detected.


Assuntos
Ibuprofeno/uso terapêutico , Inflamação/tratamento farmacológico , Dente Molar , Fenilpropionatos/uso terapêutico , Extração Dentária , Dente Impactado/cirurgia , Adolescente , Adulto , Ensaios Clínicos como Assunto , Avaliação de Medicamentos , Edema , Feminino , Hemostasia/efeitos dos fármacos , Humanos , Ibuprofeno/efeitos adversos , Ibuprofeno/sangue , Masculino , Mandíbula/cirurgia , Dente Molar/cirurgia , Dor Pós-Operatória/tratamento farmacológico , Trismo
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