Search PubMed⌕ Search

Biomedical subjects

G P Bridger

Publications and source records attributed to G P Bridger.

At least 19 recordsLinked to original sources
PubMed2002

Malignancies of the external auditory canal and temporal bone: a review.

BACKGROUND: Malignancies of the external auditory canal and temporal bone are uncommon. A retrospective review was conducted of a large series treated at the Prince of Wales hospital between 1974 and 1995. METHODS: Retrospective review of 59 cases of ear canal and temporal bone malignancies. These were analysed according to histopathology, disease extent, surgery, margin status and survival. A TNM-type staging system was applied to 51 cases and Kaplan-Meier survival analysis applied to this group. RESULTS: The 5-year cancer-specific survival (CSS) for the series was 54%. For stages 1, 2, 3 and 4 disease, the CSS were 90, 45, 40 and 19%, respectively. Survival was significantly higher where clear surgical margins were achieved (80 vs 35%). CONCLUSIONS: Carcinoma of the external ear canal is rare and, in Australia, is often related to recurrence of periauricular cutaneous malignancy. Surgical extirpation with clear margins provides the best survival.

Adult↗
PubMed2000

Craniofacial resection for paranasal sinus cancers.

BACKGROUND: Combined anterior craniofacial resection (CFR) has been in use for more than 25 years. The advent of the free revascularized tissue transfer flap in l980 permitted safe resection of tumors that had spread beyond the confines of the paranasal sinuses with immediate reconstruction of the sino-orbital cranial defect. The purpose of this study was to examine the outcomes and morbidity of a management policy of primary CFR and postoperative radiotherapy for paranasal sinus cancers infiltrating the skull base over a 21-year period. METHODS: Seventy-three patients with paranasal sinus cancers were treated at the Prince of Wales Hospital between l975 and l996. All were newly diagnosed with the exception of one patient who had received radiotherapy elsewhere 5 years earlier. Only 22% were early lesions and 31% were advanced (more than six sites involved). There were 59 men and 14 women. The mean age was 57 years. All but two patients had a performance status of either 0 or 1. Orbital exenteration was performed in 31 patients. Since l980, all major defects were reconstructed with free tissue transfer flaps. RESULTS: The 5-year cancer-specific survival (CSS) for the 73 patients was 69%, which was unchanged at 10 years. Twenty two patients died from or with their index cancer. An additional 11 patients died from unrelated causes. The actuarial overall survival (OS) at 5 and 10 years was 61% and 48%, respectively. The 5-year recurrence-free rate was 59%. The CSS for the three dominant pathologic conditions were adenocarcinoma 70%, squamous cancer 51%, and olfactory neuroblastoma 84%. The difference was not significant; however, there was a significant difference in OS, with olfactory neuroblastoma having the best prognosis. Orbital involvement, radiologic evidence of skull base erosion, and involvement of the infratemporal fossa were not poor prognostic indicators. Patients with a performance status of 0 had improved OS. There was no operative mortality. CONCLUSIONS: An aggressive policy of combined CFR and postoperative radiotherapy with free-flap reconstruction for large defects gave survival results that were comparable to less-advanced lesions and superior to many other treatment alternatives. There was a high exenteration rate (42%). Squamous cancers were associated with the greatest morbidity and poorest OS.

Adult↗
PubMed2000

Early glottic carcinoma: results of treatment by radiotherapy.

The purpose of the present paper was to review the results of treating early (stages T1-2N0) glottic, squamous cell carcinoma by radiotherapy in the Department of Radiation Oncology, Prince of Wales Hospital, Sydney. A retrospective review was carried out of all patients seen in the department from 1967 to 1994, inclusive. To be eligible, patients had to have newly diagnosed cancer and to have been treated with curative intent by radiotherapy alone. Three hundred and sixty-nine patients satisfied the eligibility requirements. The mean follow-up time was 12.2 years (maximum: 28 years). At 5 years the actuarial local control rate was 80% (84% for stage T1 and 72% for T2). The ultimate local control rate was 96%. The overall survival rates at 5 and 10 years were 73% and 52%, respectively. The risk of nodal recurrence was much higher after persisting disease or local recurrence. Our results confirm the high cure rates achieved with this modality of treatment and are comparable with those reported in the literature.

Carcinoma, Squamous Cell↗
PubMed1992

Hereditary hemorrhagic telangiectasia. A new dermoplasty technique.

A new dermoplasty technique is described that allows both sides of the nasal septum to be covered with a single split-skin graft. This graft is designed with a narrow central dermal band that covers the septal dorsum and can be buried under the alar tissues. Exposure is obtained via a modified external rhinoplasty approach. The operation has been successfully performed on 11 patients, and in nine of them the graft take was complete.

Adolescent↗
PubMed1991

Paranasal sinus cancer.

This is a review of 65 patients with paranasal sinus malignancies who were treated by radical surgery. Most patients received either pre- or postoperative radiotherapy. Twenty-nine tumours arose in the maxillary antrum, seventeen in the ethmoid labyrinth and the remainder from the vestibule, nasal septum, lateral nasal wall and vault. There were 58 epithelial cancers. The 5-year survival rate for patients with adenocarcinoma was 78%, and 70% for antral squamous cell cancer and esthesioneuroblastoma. None of the melanoma patients survived free of disease for 5 years. The 5-year survival rate for the 21 patients undergoing orbital exenteration was 50%, compared with 70% when the eye was spared. Twelve free flap revascularized tissue transfer flaps were used to reconstruct large cranial and sino-orbital defects.

Actuarial Analysis↗
PubMed1990

Microvascular free flap in hereditary hemorrhagic telangiectasia.

A 69-year-old male patient with hereditary hemorrhagic telangiectasia presented with severe epistaxis requiring repeated transfusions. Both nasal passages were densely populated with these vascular malformations that involved the entire nasal mucosa. A total rhinotomy was performed and all the nasal mucosa and turbinates were excised. Both nasal passages were completely resurfaced with a free radial forearm skin flap. The vascular pedicle was delivered from the nasal passage via the maxillary antrum to anastomose with the facial vessels in the cheek. Following surgery the patient had no further significant epistaxis.

Aged↗
PubMed1989

Anterior craniofacial resection for ethmoid and nasal cancer with free flap reconstruction.

Two surgical approaches were used for nasal and ethmoid cancers involving the anterior skull base. A craniofacial operation with the assistance of a neurosurgeon was employed when the cribriform plate was infiltrated. A frontofacial operation through the frontal sinus was preferred when the cribriform plate was radiologically intact. Thirty patients underwent radical surgery with a minimum three-year follow-up. Thirteen of 16 patients with adenocarcinoma survived. Since 1980, nine patients have had their surgical defects repaired with a revascularized tensor fascia lata muscle and skin flap. The flap is tailored to support the cranial contents, provide muscle bulk for the orbitomaxillectomy cavity, and provide skin for the face, nasal, and palatal surfaces. There were two free flap failures.

Adenocarcinoma↗
PubMed1989

Plunging ranula: literature review and report of three cases.

Three cases of plunging ranula are described and the literature is reviewed. In many cases, a plunging ranula is iatrogenic and follows surgery to an oral ranula. In the cases presented, the cervical swelling was associated with prolongations of sublingual gland into or through the mylohyoid muscle. All patients were cured by partial or total excision of the sublingual gland.

Adult↗
PubMed1986

Surgical closure of septal perforations.

Septal perforations only require treatment when symptoms develop. Two surgical procedures are described for the repair of septal perforations. For defects up to 2 cm, a posterior inverting septal flap composed of mucoperiosteum taken from the bony septum has been successful in seven of eight patients. In two patients with large defects, a two-staged nasolabial skin flap was rotated into the defect and was successful in each case.

Adult↗
PubMed1986

Craniofacial resection for paranasal sinus cancer with free flap repair.

A combined transcranial and facial approach is recommended for antroethmoidal cancers which have invaded the cribriform plate area. This permits a complete enbloc excision of the ethmoid labyrinths. In most patients orbital exenteration was necessary because of tumour invasion. In the facial approach adequate exposure is achieved by mobilizing the entire nasal complex which is swung to the contralateral side. The surgical defect is repaired with a revascularized tensor fascia lata muscle and skin flap. The flap is tailored to support the cranial contents, provide muscle bulk for the orbitomaxillectomy cavity and skin for the face, nasal and palatal surfaces. Postoperative complications are few and most patients received their planned postoperative radiotherapy within a few weeks of the surgery. Since 1980, nine patients have been treated and six of these remain alive and free of disease.

Humans↗
PubMed1985

Vertical partial laryngectomy for glottic carcinoma.

Vertical partial laryngectomy is recommended as primary treatment for selected T2 glottic cancers. Some irradiation failures are also suitable but the indications are more restricted. A careful assessment of the cancer is mandatory. Of 12 patients undergoing primary surgery, no patient has died from their disease. Five of seven irradiation failures were salvaged by vertical partial laryngectomy.

Carcinoma↗
PubMed1985

Pharyngocutaneous fistulae following laryngectomy.

This retrospective analysis of 100 patients revealed a postoperative pharyngocutaneous fistula rate of 15.3% following total laryngectomy, and 21.4% following partial pharyngolaryngectomy. All fistulae were benign. None resulted in mortality. The most significant risk factor for the development of fistulae is prior radiotherapy, especially high dose (greater than 5000 rads). Other factors include postoperative haemoglobin less than 12.0 g/dl, pyriform sinus tumour, and larger tumour size. Both the prior administration of radiotherapy and the site of the fistula opening most influence management problems.

Adult↗
PubMed1983

Postlaryngectomy voice reconstruction.

A simple one staged technique for voice reconstruction after total laryngectomy is described. A section of posterior tracheal wall is preserved and converted into a tracheo-oesophageal shunt. Results in nine patients are described.

Esophagus↗
PubMed1981

Split rib graft for alar collapse.

Alar collapse may be developmental and can occur after trauma or tip rhinoplasty. This condition is often seen in elderly persons. Autogenous split costal bone that was grafted to the nasal bones proved effective in the treatment of alar collapse in three patients. This method changes the weakened alar wall into a noncollapsible extension of the nasal bones. Nasal inspiratory airflow was substantially increased after surgery.

Humans↗
PubMed1980

Radical surgery for ethmoid cancer.

Radical surgery followed by radiotherapy offers the best chance of cure for ethmoid cancer. In operations on 15 patients with ethmoid cancer, intracranial spread was found in five instances. In every patient, a craniofacial ethmoidectomy was performed. Two approaches are recommended. If there is radiologic or clinical evidence of intracranial spread, a frontal craniotomy and lateral rhinotomy approach is employed. With the help of the neurosurgeon, the overlying dura can be resected with the anterior cranial floor. When the cribriform plate appears intact, the resection is accomplished via a lateral rhinotomy and transfrontal sinus approach to the anterior cranial fossa. These techniques were used in 15 patients. Nine are free of recurrence after an observation time of two to seven years.

Adenocarcinoma↗