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Biomedical subjects

C T Yarington

Publications and source records attributed to C T Yarington.

At least 19 recordsLinked to original sources
PubMed1998

Malignant melanoma of the head and neck: effect of treatment on survival.

This study compared outcomes for intermediate-thickness (1.5 to 3.99 mm) head and neck melanomas treated with or without elective lymph node dissection (ELND). The records of all head and neck melanomas treated at Virginia Mason Medical Center from 1974 through 1995 were reviewed and analyzed for outcome by stage and elective or therapeutic lymph node dissection. One hundred seventy-four patients with head and neck melanomas were treated in the study period, of which only 25% had intermediate-thickness lesions. Of 38 clinically node-negative patients with intermediate-thickness lesions followed more than 3 years, 10 underwent ELND, yielding two positive dissections (20%). The rate of distant metastases and the mortality rate were 44% and 35% lower in patients undergoing ELND compared with stage II patients who did not undergo ELND, but the difference did not achieve statistical significance (P = 0.12 and 0.21, respectively). The role of ELND in head and neck melanoma is uncertain. This retrospective study is limited by the small number of intermediate-thickness lesions, yet there appears to be a survival advantage to ELND in head and neck melanoma, even in negative dissections. Conventional histologic stains miss micrometastases detected by immunohistological and polymerase chain techniques. Removal of such micrometastases may explain the improved outcome. A multicenter prospective trial in head and neck melanomas, incorporating the latest techniques of sentinel node biopsy and immunohistological staining of node specimens, is needed to clarify definitive therapy for this increasingly common diagnosis.

Case-Control Studies↗
PubMed1993

Parotid cancer: treatment and results.

The records of 74 consecutive patients with primary parotid malignancy were reviewed. The age and sex incidence was comparable to that described in previous studies; we observed a high incidence of adenocarcinoma not reported by other investigators. Stage at the time of examination and histologic grade of tumor were independent statistically significant predictors of clinical outcome. Long survival with low grade disease and late recurrence were common. Radiation therapy has been shown to increase survival in a number of studies; however, it had no demonstrable benefit in our series. Parotid cancer should be managed aggressively and early surgery is indicated for all parotid neoplasms. Neck dissection is indicated for clinically positive nodes and high grade cancers; radiation therapy is indicated for high grade cancers and residual disease.

Actuarial Analysis↗
PubMed1989

The tracheoesophageal diversion and laryngotracheal separation procedures for treatment of intractable aspiration.

Intractable aspiration is a severe and often fatal complication in patients with impaired protective function of the larynx. This problem is usually a result of central nervous system disorders such as cerebrovascular accident, trauma, neoplasms, or degenerative disease. Surgical separation of the upper respiratory tract from the digestive tract can prevent recurrent contamination of the respiratory system in these patients. Two such procedures are the tracheoesophageal diversion procedure and a modification of this operation, the laryngotracheal separation procedure. The Virginia Mason Medical Center experience with these procedures, their indications, technique, and outcome are presented. In addition, cases of successful surgical reversal of the diversion procedures are discussed.

Adult↗
PubMed1988

Submandibular gland excision.

A review of 107 submandibular gland excisions was made to determine the relative frequency of neoplastic versus non-neoplastic disease. The results show a preponderance of non-neoplastic pathology. Benign tumors were found in 6% of glands, primary glandular and metastatic carcinoma in 3%. Timely treatment of a submandibular gland mass is indicated due to the relatively aggressive behavior of malignancies originating in this location.

Adult↗
PubMed1987

Extrameningeal meningiomas of the infratemporal fossa: diagnosis and treatment.

A presentation of two recently treated extrameningeal meningiomas of the infratemporal fossa will be augmented by a review of the literature on this subject. These tumors are quite rare, insidious in their presentation, and, as a benign tumor, require consideration of surgical treatment which causes the least possible functional disability. The natural history of these lesions and the surgical approach which has proved most successful in our hands will be discussed in some detail.

Aged↗
PubMed1986

Vagal body tumors: diagnosis and treatment.

This presentation includes a report of four vagal body tumors bringing the total number in the English literature to approximately 80. The diagnosis and treatment of this lesion, its familial incidence and the propensity for multiple secreting or nonsecreting chemodectomas, and appropriate clinical and pathologic studies required will be reviewed in some detail. Appropriate differential diagnostic features will be illustrated by comparison of these tumors with other primary vagal tumors from our experience such as neurofibromas, neurilemmomas, and cystic degeneration of neurilemmomas.

Adult↗
PubMed1985

Synchronous parotid tumors of different histological types in association with metastasizing hypopharyngeal carcinoma.

At operation for metastasizing carcinoma of the piriform sinus a patient was found to have two separate parotid tumors, one a pleomorphic adenoma and the other a papillary cystadenoma lymphomatosum (Warthin's tumor). These tumors presented as palpable masses on the same side as a lymph node involved with carcinoma. Synchronous parotid tumors of different types are rare; previous reports in the literature show that this combination of pleomorphic adenoma and Warthin's tumor is the most common. We have found no previous report of multiple parotid neoplasms in a patient with coexistent squamous carcinoma of the head and neck.

Adenolymphoma↗
PubMed1985

Aspergillosis of the maxillary sinuses in otherwise healthy patients.

There is an increasing number of reports of fungal infections of the nose and paranasal sinuses, due in part to increasing recognition of this condition in both healthy and immunologically depressed patients. Three cases of aspergillosis of the maxillary sinus are presented, one of which demonstrates bone destruction in an otherwise healthy individual. In diagnosing aspergillosis sinusitis it is important to submit material for microscopic examination, as cultures are often negative for fungus. Treatment consists of surgery to establish good aeration and drainage with the addition of antifungal drugs in selected cases.

Aged↗
PubMed1985

Medical readiness.

Explore the source record for details and available documents.

Disaster Planning↗
PubMed1984

Tumors of the salivary glands. Comparison of frozen-section diagnosis with final pathologic diagnosis.

Of the 256 cases of salivary gland tumors subjected to frozen-section diagnosis, the error rate in diagnosis for malignant disease was one of four cases, and in benign disease, it was one of ten cases. Six of the 52 malignant tumors were erroneously labeled as benign, while four of the 204 benign tumors were diagnosed as malignant neoplasms. The occurrence of concurrent benign and malignant disease, nonneoplastic alterations of salivary gland tissue, and sampling errors militated against total reliance on frozen-section diagnosis in the management of salivary gland neoplasms.

Child↗
PubMed1984

Olfactory neuroblastoma. Chemotherapy and radiotherapy for extensive disease.

A patient with olfactory neuroblastoma had extensive involvement of the nasopharynx, sinuses and orbit, and cervical metastasis. After surgical biopsy and excision of metastatic disease, she was treated with chemotherapy: three cycles of high-dose cisplatin (100 mg/sq m) and infusion of fluorouracil (1 g/sq m/day for five days). Subsequent treatment included definitive radiation therapy followed by three additional cycles of chemotherapy. The patient is free of disease three years after initiating therapy. This case report demonstrates the potential efficacy of planned combined modality therapy, including early chemotherapy in the control of locally advanced, unresectable olfactory neuroblastoma.

Cisplatin↗
PubMed1983

Tongue flaps: repair of oral and pharyngeal defects after resection for cancer.

During the past 15 years, well over 100 major tongue flaps have been used in reconstruction in patients with head and neck cancer at the Mayo Clinic and the Mason Clinic. Although the trend at the present time is toward utilization of smaller flaps of local tissue, as described elsewhere, in an effort to achieve primary closure with the least possible functional disability, the tongue flap still retains its initial advantages of providing tissue bulk and volume, dependable vascularity, and considerable versatility in design and application. While the use of myocutaneous flaps and other single stage methods of repair is becoming ever more popular, the tongue flap should not be discarded or forgotten as a significant tool for use by the head and neck cancer surgeon.

Humans↗