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Biomedical subjects

E Abemayor

Publications and source records attributed to E Abemayor.

67 records · Page 4Linked to original sources
PubMedDate not supplied

Hibernomas of the head and neck.

Hibernomas are rare tumors derived from brown adipose tissue, a specialized form of fat tissue found in hibernating and nonhibernating animals. Only a minority of reported hibernomas have occurred in the head and neck region. This report describes two cases of cervical hibernomas, one of which was preoperatively diagnosed by the use of fine-needle aspiration biopsy. The clinical and pathologic characteristics of this neoplasm are reviewed. In general, hibernomas are slow-growing tumors with inconclusive evidence for the existence of a malignant variant. A review of the literature supports the conclusion that excision, sparing vital structures, appears to be curative.

Adipose Tissue, Brown↗
PubMedDate not supplied

Endolymphatic hydrops after fenestration: a temporal bone study with implications on the function of the utriculo-endolymphatic valve.

A temporal bone specimen demonstrating endolymphatic hydrops 13 years after fenestration of the lateral semicircular canal is presented. Fibro-osseous tissue extending from the lateral semicircular canal and reaching the vestibule produced fixation of the membranous wall of the utricle to the bony wall. Fixation and retraction of the utricule appears to have resulted in a permanently open utriculo-endolymphatic valve leaflet. Similar findings of fibro-osseous changes arising from the area of the crus commune and an open valve were found in a Meniere's disease specimen. The implications of these findings on the function of the valve are discussed.

Aged↗
PubMedDate not supplied

Tonsillectomy under local anesthesia: a safe and effective alternative.

Tonsillectomy using local anesthesia (local tonsillectomy) is a safe and effective alternative to general anesthesia in the healthy cooperative teenage or adult patient. This retrospective analysis involved 64 local tonsillectomies performed over the past 7 years in a minor operating room using only local anesthesia with intravenous sedation. Operations were performed by residents in training as well as by experienced head and neck surgeons. Blood loss, morbidity, complications, and patient satisfaction were reviewed and compared with tonsillectomies done under general anesthesia. The average blood loss was 42 mL in the local tonsillectomy group with no cases of postoperative hemorrhage, compared with 198 mL in the general anesthesia group with two cases of postoperative hemorrhage. There was one major complication related to postoperative antibiotic use in the local anesthesia group, and follow-up interviews revealed that patients were satisfied with the procedure and would recommend and choose local anesthesia again. We conclude that local tonsillectomies have high patient acceptance and are associated with minimal morbidity and complications. Furthermore, they are cost-effective.

Adolescent↗
PubMedDate not supplied

Tricholemmal cysts of the head and neck.

PURPOSE: Tricholemmal cysts, sometimes termed pilomatrixomas, are benign skin neoplasms. This study was undertaken to evaluate the clinical experience with management of pilomatrixomas at a large, referral-based university hospital. PATIENTS AND METHODS: The records of patients treated at the UCLA Medical Center were reviewed retrospectively. Patients treated during the years 1966 to 1991 inclusive were reviewed for details of the clinical course. All pathology slides were confirmed histologically. RESULTS: Pilomatrixoma was confirmed in 53 patients. Of these, 29 patients (55%) had pilomatrixoma isolated to the head and neck region. All were treated with surgical excision. One patient (3%) experienced recurrence due to inadequate initial excision. Subsequent re-excision resulted in a cure. CONCLUSION: Tricholemmal cysts present as solitary, painless, slow-growing cutaneous nodules often resulting in discoloration of the overlying skin. Simple excision cures this benign neoplasm, and recurrences are rare. Fine-needle aspiration biopsy may aid in the diagnostic workup.

Adolescent↗
PubMedDate not supplied

The role of radiation therapy in the treatment of head and neck cutaneous melanoma.

INTRODUCTION: This study was undertaken to elucidate the efficacy of external beam irradiation in the treatment of head and neck malignant melanoma, in comparison with the efficacy of surgical excision and the efficacy of surgical excision combined with external beam irradiation. MATERIALS AND METHODS: A retrospective chart review of all patients seen at the Department of Radiation Oncology at the University of California at Los Angeles Medical Center with the diagnosis of head and neck melanoma from 1973 to 1992 was conducted. Using chi 2 analysis, survival rates were examined for patients treated with excision alone, irradiation alone, and both excision and irradiation. RESULTS: Patients were treated with primary excision (96%), salvage excision for recurrent or residual disease (47%), primary irradiation (9%), post-surgical-planned irradiation (22%), adjuvant chemotherapy (45%), and adjuvant immunotherapy (36%). The overall survival rate for the entire group was 29%. For patients with recurrent or regional disease, survival rates were 37% for those treated with excision in combination with irradiation, 20% for those treated with irradiation alone, and 19% for those treated with excision. Whereas the differences among groups were not statistically significant, the biologic implication is that external beam irradiation is effective in controlling regional disease, since the tumors treated with irradiation alone or excision in combination with irradiation were larger and more aggressive than those treated with excision alone. CONCLUSION: External beam irradiation is of benefit in treating patients with melanoma who are ineligible for salvage surgery or as an adjunctive modality in situations where the risk of recurrence is high.

Chi-Square Distribution↗
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Angiolymphoid hyperplasia with eosinophilia and vascular tumors of the head and neck.

PURPOSE: The clinicopathologic distinctions between angiolymphoid hyperplasia with eosinophilia (AHE) and vascular tumors are controversial. Some investigators believe that AHE is a variant of hemangioma, whereas others state that it is an inflammatory phenomenon. To better delineate the clinicopathologic entity of AHE and investigate the efficacy of various treatment regimens, we undertook a retrospective analysis of AHE and compared it with other angiomatous lesions treated at a tertiary referral center. MATERIALS AND METHODS: We reviewed the histopathologic features of hemangioma, AHE, and angiosarcoma of the head and neck seen in 46 cases at University of California Los Angeles (UCLA) Medical Center between 1950 and 1992. Lesions were evaluated for presence of lymphoid and eosinophilic infiltration, type of endothelial cell, and pattern of vascular proliferation. Patient charts were also reviewed for clinical history and outcome. RESULTS: The typical findings of AHE were present in 13 cases of conventional hemangioma and angiosarcoma. The clinical data of 8 AHE patients were also reviewed and a benign outcome was observed. CONCLUSION: We propose that AHE represents an angiomatous neoplasm similar to the hemangioma but characterized by a marked reactive appearance. AHE may comprise part of a spectrum of vascular tumors with differences between lesions depending in part on host-mediated inflammatory and immune responses.

Adult↗
PubMedDate not supplied

Computer coregistration of positron emission tomography and magnetic resonance images in head and neck cancer.

PURPOSE: Early experience has shown that positron-emission tomography (PET) is a useful technique for the detection of occult squamous cell carcinoma of the head and neck. Although highly sensitive, PET lacks definition of anatomic detail and therefore does not localize pathology precisely. To circumvent this limitation, a computerized coregistration technique has been developed at the University of California-Los Angeles to correlate PET and magnetic resonance images (MRI). This method allows accurate, precise anatomic localization of areas of heightened glucose metabolism, including subclinical tumors. MATERIALS AND METHODS: The technique uses a coregistration computer program that precisely superimposes the PET scan with the corresponding MRI image. RESULTS: Two cases are presented in which PET-MRI coregistration was used to anatomically define the areas of heightened glucose metabolism. Large tumors were selected because the precision of the method can be verified. CONCLUSION: The coregistration technique is a valuable addition to PET imaging, particularly in its ability to anatomically localize PET findings. The most important application of this technique is to facilitate the biopsy of subclinical lesions identified on PET.

Aged↗
PubMedDate not supplied

Endoscopic diagnosis of sarcoidosis in a patient presenting with bilateral exophthalmos and pansinusitis.

Sarcoidosis is a chronic granulomatous disease of unknown etiology. Otolaryngologic and ophthalmologic manifestations occur in 15 to 55% of afflicted individuals, respectively. Neck masses, parotid enlargement, and facial nerve palsy are the most common presenting otolaryngologic complaints, while lacrimal gland enlargement, uveitis, and upper eyelid masses often call the attention of the ophthalmologist. Biopsy reveals non-caseating granulomas, while the angiotensin converting enzyme (ACE) level may be elevated. We report an unusual case of a patient who presented with severe bilateral exophthalmos as the sole initial complaint. A prior workup included a negative conjunctival biopsy. On magnetic resonance imaging (MRI) and computed tomography (CT), the patient had pansinusitis. Endoscopic ethmoidectomies with tissue analysis revealed sarcoidosis. Further evaluation revealed no evidence of systemic disease, and all symptoms resolved with a course of oral steroids. Thus, nasal endoscopy and biopsy of affected paranasal sinus mucosa may prove a useful adjunct to the diagnosis of sarcoidosis, particularly in atypical cases.

Adult↗
PubMedDate not supplied

Predictors of long-term smoking cessation in head and neck cancer patients.

Cigarette smoking is a major risk factor for head and neck cancer, and individuals who continue to smoke past diagnosis and treatment are at elevated risk for further disease. In a randomized controlled trial, a state of the art provider-delivered smoking cessation intervention was compared to a usual care advice control condition. The intervention consisted of surgeon- or dentist-delivered advice to stop smoking, a contracted quit date, tailored written materials, and booster advice sessions. Subjects were 186 patients with newly diagnosed first primary squamous cell carcinomas of the upper aerodigestive tract who had smoked cigarettes within the past year. At randomization, 88.2% of subjects were current smokers. At 12-month follow-up, 70.2% of subjects completing the trial (n = 114) were continuous abstainers; among baseline smokers alone the continuous abstinence (CA) rate was 64.6%. The cotinine validation rate at 12 months was 89.6%. Modeling techniques were utilized in order to derive expected CA rates, which included noncompleter subjects (n = 72). The CA rate expected at 1 year for the entire patient population was 64.2%, and for smokers alone the expected CA rate was 59.4%. Logistic regression analysis carried out on baseline smokers identified predictors of 12-month CA status. These included medical treatment, stage of change, age, nicotine dependence, and race. The intervention effect was not significant, although the sign of the effect was positive. Based on these findings, we recommend systematic brief advice to stop smoking for head and neck cancer patients, with a stepped care approach for patients less able to quit.

Carcinoma, Squamous Cell↗