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Biomedical subjects

E L Applebaum

Publications and source records attributed to E L Applebaum.

At least 55 records · Page 3Linked to original sources
PubMed1984

Congenital sensorineural hearing loss.

The ears of 47 selected patients with congenital sensorineural hearing loss were examined with complex-motion tomography. The patients were divided into 3 general categories: those with a recognized syndrome, those with sensorineural hearing loss unrelated to any known syndrome, and those with microtia. A great variety of inner ear anomalies was detected, but rarely were these characteristic of a particular clinical entity. The most common finding was the Mondini malformation or one of its variants. Isolated dysplasia of the internal auditory canal or the vestibular aqueduct may be responsible for sensorineural hearing loss in some patients. Patients with microtia may also have severe inner ear abnormalities despite the fact that the outer and inner ears develop embryologically from completely separate systems.

Adolescent↗
PubMed1984

Growth of human squamous head and neck cancer in vitro.

This study was undertaken to define the cloning efficiency of squamous head and neck (H/N) cancer in soft agar. Twenty squamous cell carcinomas of H/N origin were mechanically dissociated and cultured in the human tumor clonogenic assay ( HTSCA ). No growth was observed. Nine ascites specimens from separate patients with ovarian cancer were cultured during the same time period, and six grew, all with more than 30 colonies per plate. Thirty-one additional H/N specimens were enzymatically dissociated and cultured in the HTSCA . Again, no growth was observed. Sixteen of these enzymatically dissociated specimens were simultaneously cultured in identical media without agar. Five specimens grew. We conclude that squamous carcinoma of H/N requires anchorage and fibroblast support for successful growth in culture. Suspension in semisolid media is less effective than liquid tissue culture systems for in vitro growth of this tumor type.

Carcinoma, Squamous Cell↗
PubMed1983

Patterns of cancer recurrence in the postoperatively irradiated neck.

Data from 92 patients with stage III or IV squamous cell carcinoma of the head and neck treated with surgery and planned postoperative radiotherapy were analyzed to determine the incidence and patterns of tumor recurrence. Overall, recurrent tumor in the cervical region developed in 19 patients (21%). Of these, eight were in the neck alone and 11 in both the neck and the primary site. All recurrences were in the ipsilateral cervical region and none in the contralateral neck. The presence of two or more metastatic nodes at the time of surgery correlated with tumor recurrence and decreased survival. Extracapsular tumor spread increased the recurrence rate. Our data suggest that postoperative radiotherapy decreases ipsilateral cervical tumor recurrence in only those patients with more than two metastatic lymph nodes, and contralateral neck recurrence in all patients.

Carcinoma, Squamous Cell↗
PubMed1983

Postoperative radiotherapy for persistent tumor at the surgical margin in head and neck cancers.

Seventy-two patients with a carcinoma of the head and neck, who were treated with surgery and postoperative irradiation, were reviewed to determine the local recurrence rates and survival in patients with inadequate surgical margins. Tumor recurrence rate was 31% for patients with microscopic tumors at resection margins and 50% for those with macroscopic tumor. Actuarial 3-year survival for these patients was 71% and 43%, respectively. All 4 patients who were irradiated later than 6 weeks after surgery developed recurrent malignancy despite the resection margins being free of tumor. Excluding these patients the 3-year survival for R0 patients was similar to that of R1 patients. It is concluded that postoperative irradiation is effective in patients with tumor at the surgical margins. It is suggested that the time interval between surgery and radiation therapy be limited to less than 6 weeks. Radiation dose prescriptions for various clinical situations are discussed.

Carcinoma, Squamous Cell↗
PubMed1983

Computed tomography of the middle ear in the evaluation of cholesteatomas and other soft-tissue masses: comparison with pluridirectional tomography.

Computed tomographic (CT) scans and tomograms of 60 patients with various soft-tissue masses of the middle ear, including 30 with cholesteatomas, were studied. CT produced excellent images of middle ear soft-tissue masses and appears to be the diagnostic method of choice for cholesteatomas, glomus tympanicum tumors, and other soft-tissue masses. In one patient CT demonstrated pneumolabyrinth resulting from postsurgical fracture of the footplate of the stapes. Pneumolabyrinth is a newly reported CT finding in stapes footplate fracture.

Adolescent↗
PubMed1983

Cancer of the glottis: prognostic factors in radiation therapy.

The authors conducted a multivariate analysis of the prognostic factors in 96 patients with early glottic cancer treated by radiation therapy. Of these, 73 had T1 and 23 had T2 tumor. The primary tumor was controlled in 82% of T1 and 74% of T2 lesions. Actuarial five-year survival rates were 87% for T1 and 74% for T2. Carcinoma of the anterior commissure associated with bilateral vocal cord involvement, subglottic tumor extension, persistent or recurrent laryngeal edema, and impaired cord mobility was found to adversely influence the prognosis. The data suggest that irradiation is the treatment of choice for glottic cancer limited to the vocal cords or with minimal extension to the anterior commissure or supraglottic larynx.

Carcinoma, Squamous Cell↗
PubMed1982

Lipoma of the nasopharynx.

A 49-year-old woman had a histologically proved lipoma of the nasopharynx. Though the tumor almost filled the inferior portion of the nasopharynx, the patient has no other otolaryngologic findings except mild sensorineural hearing loss. To our knowledge, this is the first report of a nasopharyngeal lipoma in an adult. The lesion was histologically typical of lipomas occurring elsewhere in the body.

Female↗
PubMed1982

Radiation therapy for subclinical carcinoma in cervical lymph nodes.

Radiotherapy alone was used to treat 187 patients with a head and neck cancer and clinically uninvolved lymph nodes. Delayed lymph node metastases developed in 35 (19%) patients, and concomitant tumor at the primary site was present in 90% of them. In two (1%) of the 187 patients, delayed metastases developed in the irradiated nodes with the primary tumor controlled; both of these patients received a radiation dose of less than 5,000 rad. Metastases in supraclavicular and posterior cervical regions occurred in 4% of the patients; and these sites were not included in the original radiation fields. The following conclusions were reached: (1) a radiation dose of 5,000 rad or more can eradicate 99% of the subclinical carcinomas in lymph nodes; (2) whole-neck irradiation is not indicated in patients with N0 stage tumor; and (3) surgical resection of primary tumors alone, without added neck dissection, may be adequate if postoperative radiation therapy is planned.

Carcinoma, Squamous Cell↗
PubMed1982

Fluorescein kinetics in perilymph and blood: a fluorophotometric study.

A modified slit lamp fluorophotometer was used to determine fluorescein concentration changes in the perilymph, cerebrospinal fluid and blood of chinchillas after intravenous injection of 0.2 ml of fluorescein sodium. This new technique provides a means of determining quantitative changes of fluorescein concentration in the perilymph without the need to withdraw fluid samples through the round window membrane of cochlear wall. Fluorescein was observed to enter the perilymph between 1 and 2 minutes after injection, and it reached its peak concentration in the mean time of 23 minutes. The mean peak concentration was 4.20 X 10-6 g/ml. Both increasing and decreasing fluorescein concentration changes in the perilymph followed an exponential time course. Although the observations of cerebrospinal fluid fluorescence were thought to represent a composite of the fluorescence of the cerebrospinal fluid itself and the underlying brain stem blood vessels, the peak fluorescence did not exceed that observed in the perilymph. These observations support the view that most of the perilymph is produced in the cochlea by ultrafiltration from the cochlear blood vessels. The slit lamp fluorophotometer appears to be a satisfactory means of recording fluorescein concentration changes in the perilymph without disturbing the cochlear physiology by penetrating the labyrinth to obtain fluid samples.

Animals↗
PubMed1982

Lymphoepithelioma of the nasopharynx.

There is uncertainty as to whether the clinical behavior of nasopharyngeal lymphoepithelioma differs from that of squamous cell carcinoma of the nasopharynx. To determine if significant differences existed, we have studied 39 patients with nasopharyngeal lymphoepithelioma and compared their data with 50 nasopharyngeal squamous cell carcinoma patients. In contrast to squamous cell carcinoma, lymphoepithelioma occurred at a younger age, presented as smaller primary tumors, and manifested more extensive cervical lymph node involvement. When analyzed by T stage, N stage, or overall stage groups, the 5-year actuarial survivals were better in the lymphoepithelioa patients. Late tumor recurrences (beyond 4 years) were seen in the lymphoepithelioma patients, whereas all of the recurrences in the squamous cell carcinoma group occurred within 4 years. Tumor recurrences were more common in the cervical lymph nodes in the lymphoepithelioma group and in the primary site of the squamous cell carcinoma group.

Actuarial Analysis↗
PubMed1981

Complications of postoperative and preoperative radiation therapy in head and neck cancers. A comparative study.

The complications of planned postoperative irradiation in 60 consecutive patients treated between 1975 and 1979 are compared with those seen in 92 patients treated with preoperative irradiation between 1968 and 1974. The overall rate of complications requiring additional hospitalization was 15% (nine patients) in the postoperative radiotherapy group as compared with 54% (50 patients) in the preoperative radiotherapy group. A statistically significant increase in acute complications was noted in the latter group (46 vs three, 50% vs 5%). Delayed complications occurred with similar frequency in both groups. The three-year survival was comparable between similar patients of each group treated with either of the two modalities. We favor postoperative irradiation because of decreased acute complications and comparable survival. Modifications of the treatment technique are suggested to minimize the overall rate of complications.

Head and Neck Neoplasms↗
PubMed1980

Carcinoma of the floor of the mouth.

Sixty-six patients were treated for squamous cell carcinoma of the floor of the mouth during an 11-year period. Determinate three-year survival rates were 53%, 46%, 43%, and 33% for stages I through IV, consecutively. Analysis of treatment modalities showed that composite resection combined with radiation therapy resulted in higher cure rates than irradiation or wide local excision alone. The relatively low cure rates associated with the early cancers in this series suggest that more aggressive surgical therapy is warranted for small lesions.

Adult↗
PubMed1979

Heterotopic salivary tissue in the neck.

Six cases of heterotopic salivary gland tissue in the anterolateral neck are presented with a review of their clinical and histopathologic characteristics. Neoplastic transformation, fistulization, and isolated rests represent a spectrum of these uncommon lesions. The embryologic derivation of salivary tissue and close association with the branchial apparatus are discussed. The significance of salivary carcinoma presenting in the neck is reinterpreted in light of the embryogenesis of these heterotopias.

Child↗
PubMed1979

Human laryngeal reinnervation: the Northwestern experience.

Recent publications have reported impressive success with laryngeal reinnervation utilizing a nerve-muscle pedicle. This innovative surgical procedure is claimed to be useful for unilateral and bilateral vocal cord paralysis. Although the surgical results reported by Tucker have been good, they have lacked corroboration from other centers. We have performed six laryngeal reinnervation procedures at Northwestern University Medical School. Four patients presented with bilateral vocal cord paralysis and two patients with unilateral paralysis. All six operations were successful in restoring vocal cord function. The technique, problems, and results are discussed. Our experience supports the initial reports of success with this new operation.

Aged↗