Cases reported "Head and Neck Neoplasms"

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1/1565. rhabdomyoma of the hypopharynx and larynx. Report of two cases and a review of the literature.

    Two cases of extracardiac rhabdomyoma are reported in a 54-year-old man with unexplained difficulty in breathing and in a 39-year-old man with a prolonged history of hoarseness. attention is drawn to the necessity of doing hypopharyngo-and laryngoscopy in such cases. One tumour was found in the left vallecula in the hypopharynx and the other on the left vocal cord. The literature and the histological findings in 53 cases are reviewed. It appears that this rare tumour is most frequently found in muscles derived from the pharyngeal arches. A total of 40 cases have been diagnosed during the last decade, and this increase is likely to continue in the future. It may turn out that extra-cardiac rhabdomyoma is not so rare as was first presumed.
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ranking = 1
keywords = muscle
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2/1565. Fatal cardiac ischaemia associated with prolonged desflurane anaesthesia and administration of exogenous catecholamines.

    PURPOSE: Four cardiac ischaemic events are reported during and after prolonged anaesthesia with desflurane. CLINICAL FEATURES: We have evaluated desflurane in 21 consecutive patients undergoing advanced head and neck reconstructive surgery. Four deaths occurred which were associated with cardiac ischaemic syndromes either during or immediately after operation. All patients in the study received a similar anaesthetic. This comprised induction with propofol and maintenance with alfentanil and desflurane in oxygen-enriched air. Inotropic support (either dopamine or dobutamine in low dose, 5 micrograms.kg.min-1) was provided as part of the anaesthetic technique in all patients. Critical cardiovascular incidents were observed in each of the four patients during surgery. These were either sudden bradycardia or tachycardia associated with ST-segment electrocardiographic changes. The four patients who died had a documented past history of coronary heart disease and were classified American Society of Anesthesiologists (ASA) II or III. One patient (#2) did not survive anaesthesia and surgery and the three others died on the first, second and twelfth postoperative days. Enzyme increases (CK/CK-MB) were available in three patients and confirmed myocardial ischaemia. CONCLUSION: These cases represent an unexpected increase in the immediate postoperative mortality for these types of patients and this anaesthetic sequence.
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ranking = 1423.9725473091
keywords = neck
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3/1565. E.N.T. manifestations of Von Recklinghausen's disease.

    Von Recklinghausen's disease (VRD) is a neurocutaneous, systemic disease characterized by CNS tumors and disorders, cafe-au-lait spots, generalized cutaneous neurofibromata, skeletal deformities, and somatic and endocrine abnormalities. It is an autosomal dominant, hereditary disorder found in approximately 1:2500 to 3300 births. There are many manifestations of this disease in the head and neck region of interest to the otolaryngologist. case reports of three patients with multiple ENT involvements are detailed. A review of the literature is presented with a brief discussion of diagnosis and treatment. The most common intracranial tumor in the adult is the acoustic neuroma, usually bilateral, while in the child it is the astrocytoma. A defect in the sphenoid bone is common and may produce temporal lobe herniation into the orbit causing pulsatile exophthalmos. Involvement of the facial bones usually causes radiolucent defects secondary to neurofibromata within nerve pathways, and a variety of asymmetrical changes, especially within the mandible. "elephantiasis" of the face is a hypertrophy of the soft tissues overlying a neurofibroma, often quite extensive and disfiguring. Laryngeal and neck involvement may compromise the airway and early and repeated surgical intervention is required. The over-all malignancy rate approaches 30%, indicating that the patient with VRD may be predisposed to developing a malignancy. There appears to be an increased surgical risk in these patients, with some demonstrating abnormal responses to neuromuscular blockade.
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ranking = 2847.9450946182
keywords = neck
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4/1565. Management of secondary soft-tissue deficits following microsurgical head and neck reconstruction by means of another free flap.

    Secondary soft-tissue deficits may develop following a microsurgical reconstruction in the head and neck region because of inadequate planning or chronic effects of radiotherapy. Although most cases could be managed with alternative methods, free flaps might be necessary in difficult cases. Herein are described 11 cases of microsurgical head and neck reconstruction in which secondary soft-tissue deficits required transfer of another soft-tissue free flap. All patients had malignant tumors treated with surgical resection, and their defects were reconstructed with free flaps. Seven patients received either preoperative or postoperative adjunctive radiotherapy. These patients gradually developed signs and symptoms of soft-tissue deficiency in the reconstructed area, and a soft-tissue free flap transfer was required for treatment within an average of 21.5 months of their initial reconstruction. Five rectus abdominis, one rectus femoris, one latissimus dorsi, one tensor fasciae latae myocutaneous, one radial forearm, one medial arm, and one dorsalis pedis flap were used for this purpose. All flaps survived completely. The average follow-up time was 32 months. Significant improvement was achieved in all cases, and no further major surgical procedures were required. Secondary soft-tissue deficits that could not be predicted or prevented during the initial microsurgical reconstruction may be treated successfully by a subsequent free soft-tissue transfer in selected cases.
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ranking = 8543.8352838546
keywords = neck
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5/1565. Fourth branchial arch sinus: clinical presentation, diagnostic workup, and surgical treatment.

    OBJECTIVES/HYPOTHESIS: Abnormalities of the fourth branchial arch are much less common than those of the second arch and present in a different manner. The authors report their experience with five cases of fourth arch sinuses. methods: Retrospective chart review of patients at a tertiary care center. RESULTS: All patients presented in the first or second decade of life, and all but one had left-sided neck involvement. Four patients presented with recurrent low neck inflammatory episodes, and one with respiratory compromise. Diagnostic studies performed included ultrasound, computed tomography (CT) scan, barium swallow, magnetic resonance imaging, and fine-needle aspiration. barium contrast studies and CT scan were the most useful in demonstrating a fourth arch sinus tract preoperatively. Surgical treatment with an emphasis on complete exposure of the recurrent laryngeal nerve and exposure of the lateral piriform sinus to facilitate complete sinus tract excision was successful in all patients. CONCLUSION: The clinical history of recurrent low neck inflammatory episodes in young patients, especially on the left side, should raise the suspicion of this entity. Investigation using barium swallow in combination with CT scanning is useful. Excision of the sinus tract taking care not to injure the recurrent laryngeal nerve is curative.
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ranking = 4271.9176419273
keywords = neck
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6/1565. Midline posterior cervical cystic hygroma.

    Cystic hygromas are among the most common congenital neck masses. They have a predilection for the left posterior triangle and manifest early in life. Although various locations of cystic hygromas are found in the literature, we believe our case of a 9-month-old girl represents the first reported occurrence of a posterior cervical midline cystic hygroma.
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ranking = 1423.9725473091
keywords = neck
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7/1565. Plexiform schwannoma of the neck extending deeply to the mediastinum.

    We describe a 42-year-old man who had tumors occupying the right deep neck through the upper part of the mediastinum. The right vocal cord was fixed and bulgings of the pharyngeal and tracheal wall were observed. At surgery, the masses were subtotally removed as much as possible. Histological examination revealed that they were schwannomas. The postoperative course was uneventful, except for the presence of hoarseness.
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ranking = 7119.8627365455
keywords = neck
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8/1565. Camouflage in head and neck region--a non-invasive option for skin lesions.

    The technique of camouflage, a non-invasive procedure to correct flaws in the texture and colour of the facial skin, is presented. The acceptance and use of camouflaging by 52 patients with different diagnoses are presented. The advantages of camouflaging are discussed in comparison to medical tattooing.
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ranking = 5695.8901892364
keywords = neck
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9/1565. Cervical teratoma.

    Cervical teratomas are rare tumors in an unusual location. A neck mass in a newborn was excised when it enlarged disproportionately; histologically, it was a teratoma. Teratomas may occur because of an alteration in sterol chemistry; conception in this case occurred while the mother was ingesting estrogens. Retinal tissue, an unusual finding, was present in this teratoma. Symptoms in cervical teratomas are secondary to interference with deglutition and respiration. Treatment is surgical excision.
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ranking = 1423.9725473091
keywords = neck
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10/1565. The sternomastoid "tumor" of infancy.

    The sternomastoid "tumor" of infancy is a firm, fibrous mass, appearing at two to three weeks of age. It may or may not be associated with torticollis. Generally, the "tumor" initially grows, then stabilizes, and in about half the cases recedes spontaneously after a few months. It may leave a residual torticollis or may be associated with a facial or cranial asymmetry of a delayed torticollis. The etiology is unknown, a direct cause and effect relationship to birth trauma has been largely disproved although approximately half these children are products of breech deliveries. The treatment is controversial. Approximately half of these "tumors" will resolve spontaneously without sequelae. Progressive torticollis or development of facial asymmetry are considered indications for surgery. The purpose of this report is to acquaint the head and neck surgeon with this entity which may confront him for diagnosis and treatment.
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ranking = 1423.9725473091
keywords = neck
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