1/182. Infiltrating lipoma of the head and neck: a report of one pediatric case.Infiltrating lipomas are rare benign tumors. Several cases have previously been reported in the oral cavity but only three cases have been reported to date in children. We report a case of a 7-year-old child with an infiltrating lipoma of the neck and a posterior extension to the fourth and fifth cervical roots and the vertebral artery. The absence of any neurological signs, negative clinical and radiological examination results, as well as, the surgical risk of total removal and high rate of recurrence suggested a period of watchful waiting. After 5 years, the patient's clinical and radiological characteristics remain stable. A review of the literature regarding this pathology in the head and neck area, in both children and adults is also presented.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
2/182. head and neck reconstruction using lateral thigh free flap: flap design.Eleven lateral thigh free flaps were used in head and neck reconstruction, transferred on the basis of the second perforator as well as the third perforator of the profunda femoris artery. The lateral thigh free flap was useful and reliable in head and neck reconstruction and was versatile in flap design. Due to the wide cutaneous territory of the lateral thigh flap, the skin island could be designed freely in the lateral thigh region. Careful patient selection is mandatory for good results. The pinch test and an understanding of the variety of subcutaneous thicknesses in the lateral thigh region are helpful in designing a skin island of adequate thickness. Other considerations in flap design are discussed.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
3/182. Hereditary paraganglioma.head and neck paraganglioma is a rare tumour, especially in its familial form. We report a case of a multifocal head and neck paraganglioma in a young man with a family history of cervical tumours. At the age of 24, exploration of a left cervical swelling disclosed jugulotympanic and carotid body paragangliomas. Surgical removal of both tumours was performed. Two years later, a right carotid body as well as vagal paragangliomas were discovered. Follow-up at age 30 demonstrated relapse of the bilateral cervical paragangliomas, but also aortopulmonary and mesogastric paragangliomas. Cervical paragangliomas were also detected in the patient's sister and daughter, but not in his father. Furthermore, the proband's paternal grandmother and a maternal great-uncle had a history of 'neck scar'. This family history is suggestive of an autosomal dominant pattern of inheritance with maternal genomic imprinting. Genetic analysis of paraganglioma kindreds showed linkage with two different loci: 11q13.1 and 11q22.3-q23. Further knowledge of the genes involved could provide early diagnosis and accurate genetic counselling in affected families. Thorough familial investigation is consequently mandatory in all head and neck paragangliomas, especially in younger patients with multiple localizations, as surgical removal is safer at an early stage.- - - - - - - - - - ranking = 209.73805683235keywords = carotid (Clic here for more details about this article) |
4/182. Management of incidentally discovered cervical paragangliomas: report of two cases and review of current issues.Paragangliomas of the head and neck are uncommon neoplasms arising from the extra-adrenal paraganglia and include carotid body and glomus vagale tumors. These lesions may be discovered incidentally by imaging studies performed to evaluate carotid atherosclerotic occlusive disease. Incidental paragangliomas of the head and neck may be smaller than those discovered due to symptoms. Although surgical resection remains the definitive treatment for head and neck paragangliomas, important issues of management arise when such lesions are discovered. Two recent cases are reported. epidemiology, pathophysiology, diagnostic evaluation, and issues of management of head and neck paragangliomas are discussed.- - - - - - - - - - ranking = 209.73805683235keywords = carotid (Clic here for more details about this article) |
5/182. Primary melanocytic schwannoma of cervical sympathetic chain.BACKGROUND: Primary melanocytic schwannoma arising from the cervical sympathetic chain is a rare pigmented nerve sheath tumor. Two cases are presented from an academic medical center. patients and methods patients were initially seen with an enlarging neck mass associated with sympathetic nervous system dysfunction. radiography demonstrated a mass located posterior to the carotid sheath. Primary therapy consisted of surgical excision and postoperative radiation therapy. RESULTS: The tumors were found to be melanocytic schwannomas arising from the cervical sympathetic chain. The pathologic characteristics of this neoplasm are reviewed. One patient remained disease free for 12 years after treatment, whereas 1 patient died as a result of local recurrence and distant metastases. CONCLUSIONS: Melanocytic schwannoma of the cervical sympathetic chain is a rare nerve sheath tumor of the head and neck that may be misdiagnosed as malignant melanoma. The clinical behavior of this neoplasm is variable. Preoperative neurologic findings, anatomic location, electron microscopy, and immunohistochemistry findings help to establish the diagnosis, and electron microscopy may have a role in distinguishing between benign and malignant lesions. Complete surgical excision is the treatment of choice.- - - - - - - - - - ranking = 104.86902841618keywords = carotid (Clic here for more details about this article) |
6/182. Thorotrast-induced haemangioendothelial sarcoma--a lesson from the past.Complications following a carotid arteriogram done in 1947 with Thorotrast are described in a 47-year-old man who subsequently died from them in 1970. They included a local cervical granuloma with associated haemangioendothelial sarcoma, chromosome changes characteristic of radiation damage and widespread haemangioendothelial sarcomatous deposits in brain, lung, liver, probably arising from multicentric primary sites in the bone marrow. A survey of the use of Thorotrast as a contrast medium in australia and new zealand showed that its use was extremely limited. The prinicpal complications seen have been two cervical granulomas and one hepatoma.- - - - - - - - - - ranking = 104.86902841618keywords = carotid (Clic here for more details about this article) |
7/182. Fourth branchial cyst presenting with neonatal respiratory distress.Fourth branchial cysts are quite rare. A neonate with a left lateral neck mass and respiratory distress was found to have a fourth branchial cyst, which was diagnosed with computed tomography and endoscopy. The characteristic computed tomography findings included an air-containing neck cyst, which was located at the anteromedial site of the common carotid artery with mediastinal extension. Endoscopic examination revealed an internal opening at the apex of the pyriform sinus, communicating with the cyst. Total excision of the cyst was performed, and the specimen, which showed ciliated columnar epithelium with a subepithelial lymphoid infiltrate, thyroid follicles, and thymic tissue, histologically confirmed the diagnosis.- - - - - - - - - - ranking = 139.56351796961keywords = carotid, carotid artery, artery (Clic here for more details about this article) |
8/182. Free anterolateral thigh flap for reconstruction of head and neck defects following cancer ablation.Thirty-seven consecutive free anterolateral thigh flaps in 36 patients were transferred for reconstruction of head and neck defects following cancer ablation between January of 1997 and June of 1998. The success rate was 97 percent (36 of 37), with one flap lost due to a twisted perforator. The anatomic variations and length of the vascular pedicle were investigated to obtain better knowledge of anatomy and to avoid several surgical pitfalls when it is used for head and neck reconstruction. The cutaneous perforators were always found and presented as musculocutaneous or septocutaneous perforators in this series of 37 anterolateral thigh flaps. They were classified into four types according to the perforator derivation and the direction in which it traversed the vastus lateralis muscle. In type I, vertical musculocutaneous perforators from the descending branch of the lateral circumflex femoral artery were found in 56.8 percent of cases (21 of 37), and they were 4.83 /- 2.04 cm in length. In type II, horizontal musculocutaneous perforators from the transverse branch of the lateral circumflex femoral artery were found in 27.0 percent of cases (10 of 37), and they were 6.77 /- 3.48 cm in length. In type III, vertical septocutaneous perforators from the descending branch of the lateral circumflex femoral artery were found in 10.8 percent of cases (4 of 37), and they were 3.60 /- 1.47 cm in length. In type IV, horizontal septocutaneous perforators from the transverse branch of the lateral circumflex femoral artery were found in 5.4 percent of cases (2 of 37). They were 7.75 /- 1.06 cm in length. The average length of vascular pedicle was 12.01 /- 1.50 cm, and the arterial diameter was around 2.0 to 2.5 mm; two accompanying veins varied from 1.8 to 3.0 mm and were suitable for anastomosis with the neck vessels. Reconstruction of one-layer defect, external skin or intraoral lining, was carried out in 18 cases, through-and-through defect in 17 cases, and composite mandibular defect in two cases. With increasing knowledge of anatomy and refinements of surgical technique, the anterolateral thigh flap can be harvested safely to reconstruct complicated defects of head and neck following cancer ablation with only minimal donor-site morbidity.- - - - - - - - - - ranking = 4keywords = artery (Clic here for more details about this article) |
9/182. A case of jugular foramen chordoma with extension to the neck: CT and MR findings.We describe a case of jugular foramen chordoma with extracranial extension into the carotid, parapharyngeal, and perivertebral spaces through the jugular foramen. Although this type of extension is unusual, the differential diagnosis of head and neck tumors includes unusual extension of chordoma as well as extension of meningioma and neurinoma from the posterior skull base.- - - - - - - - - - ranking = 104.86902841618keywords = carotid (Clic here for more details about this article) |
10/182. Endovascular treatment of a pseudoaneurysm of a recipient external carotid artery following radiation and free tissue transfer.Radical resection and reconstruction after preoperative radiation has become routine treatment for patients with certain types and stages of head and neck cancers. When microvascular flap reconstruction is required, the recipient vessels have been subjected to radiation, making them more thrombogenic and friable, thus increasing the risks of postoperative complications. The authors report a patient who received preoperative radiation therapy for rhabdomyosarcoma of the infratemporal fossa and who underwent a radical resection and free rectus musculocutaneous flap reconstruction. The free flap covered the base of the brain from the nasopharynx and closed an intraoral defect. The donor artery was anastomosed end to side to the external carotid artery stump. The patient developed a pseudoaneurysm of the external carotid artery stump 1 month postoperatively, which was treated with endovascular coil embolization without loss of the flap. Percutaneous transcatheter endovascular treatment of pseudoaneurysms that develop after free tissue transfer in head and neck reconstruction has not been reported previously. One month after surgery, endovascular occlusion of the main arterial supply to the flap did not compromise its viability because of collateral revascularization from the peripheral tissue bed, despite the patient's history of radiation.- - - - - - - - - - ranking = 838.38110781768keywords = carotid, carotid artery, artery (Clic here for more details about this article) |
| | Next -> |