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Biomedical subjects

M S Persky

Publications and source records attributed to M S Persky.

33 records · Page 2Linked to original sources
PubMed1988

Trans-septal sphenoidotomy approach for cystic lesions of the clivus.

Destructive lesions of the clivus produce symptoms related to adjacent anatomic structures. Radiographic evaluation of a patient presenting with cranial neuropathies revealed a cystic lesion of the clivus, and surgical and histologic findings established a diagnosis consistent with a mucocele. There have been no previous reports in the literature describing a primary mucocele of the clivus. Appropriate treatment for these fluid-filled structures is marsupialization or exteriorization into the sphenoid sinus. A trans-septal sphenoidal approach was used in this case and is advocated as an effective means of managing cystic lesions in this area.

Adult↗
PubMed1986

Congenital vascular lesions of the head and neck.

There is no universally acceptable classification or method of treating congenital vascular lesions of the head and neck. An historical perspective, the hemodynamics of arteriovenous fistulas, and the various modalities of treatment are presented. The importance of superselective angiography in studying these lesions is emphasized. Embolization represents a major advance in the treatment of these patients and cooperation between head and neck surgeon and the vascular radiologist is encouraged. The evaluation and treatment of 66 patients with congenital head and neck vascular lesions are presented. The rationale for various types of treatment is reviewed.

Adult↗
PubMed1985

Cricopharyngeal myotomy: a review of surgical results in patients with cricopharyngeal achalasia of neurogenic origin.

Cricopharyngeal myotomy is an effective procedure for the treatment of swallowing disorders due to dysfunction of the upper esophageal sphincter and pharyngeal musculature. Eight patients with documented pharyngeal and sphincteric dysfunction have undergone myotomies with significant improvement in swallowing associated with restoration of oral feeding without aspiration in 5, while 3 patients have not improved. The preoperative work-up and evaluation is discussed as well as criteria that may identify those patients most likely to benefit from this treatment.

Aged↗
PubMed1985

Internal jugular vein thrombosis.

Internal jugular vein thrombosis is a vascular disorder that is easily overlooked or misdiagnosed. It occurs in a variety of clinical settings which disrupt normal blood flow through the internal jugular vein. Intravenous drug abusers represent a high risk group in this study. Diagnosis is readily made by computed tomography. Seven patients are presented, with discussion of the pathogenesis, clinical findings, radiologic features, potential complications, and treatment rationale.

Adult↗
PubMed1984

Combined treatment of head and neck vascular masses with preoperative embolization.

Recent advances with aggressive vascular radiologic techniques have altered the methods of treatment of head and neck vascular malformations. High resolution CT scanning and superselective angiography with subtraction technique is now capable of defining the extent of these lesions and demonstrating blood flow dynamics. Careful joint evaluation by the vascular radiologist and the head and neck surgeon is necessary for the proper treatment of these patients. Preoperative embolization of these lesions effectively reduces intraoperative blood loss and provides for better exposure in those patients ultimately undergoing resection of these masses. Careful selection of those cases that are amenable to total or subtotal excision, with adherence to specific criteria and goals, usually produces gratifying results. We present five patients who have undergone combined treatment of their head and neck vascular lesions. Our treatment protocol is reviewed and emphasis is placed on the integral part that the vascular radiologist assumes in the treatment of these patients.

Adult↗
PubMed1984

Carbon dioxide laser treatment of oral florid papillomatosis.

Oral florid papillomatosis is an uncommon condition that has been treated with various forms of therapy in the past. This lesion is considered to be premalignant by most authors, and surgical therapy has ranged from local excision to radical resection. A case of oral florid papillomatosis involving the entire hard palate and extending over the superior alveolar ridge into the buccal-gingival sulcus is presented. This patient was successfully treated by a two-stage carbon dioxide (CO2) laser excision with excellent functional results and minimal morbidity.

Carbon Dioxide↗
PubMed1983

Platysma myocutaneous flap for intraoral defects.

The use of myocutaneous flaps has resulted in improved methods for reconstruction involving the head and neck area. The platysma myocutaneous flap offers an excellent alternative for reconstructing appropriate oral cavity defects resulting from tumor ablation. It has certain advantages over other local or distant pedicled flaps and has been proved to be a reliable alternative for single-stage repair of these defects. The technique of this flap is described and a review of its use in six cases, including complications, is discussed.

Carcinoma, Squamous Cell↗
PubMed1983

Infiltrating lipoma of the sternocleidomastoid muscle.

Infiltrating lipomata are unusual benign tumors that have been rarely associated with the head and neck areas. We present the only known documented case of an infiltrating lipoma of the sternocleidomastoid muscle. The literature is reviewed and the characteristics of these lesions are discussed. The head and neck surgeon should include these interesting tumors in the differential diagnosis of head and neck masses and be aware that, because of a known propensity for recurrence, total surgical excision is the treatment of choice.

Adult↗
PubMedDate not supplied

Computed tomography of the clinically negative neck.

Members of the New York Head and Neck Society conducted a multi-institutional review correlating preoperative computed tomography (CT) of the neck with postoperative pathology in 59 patients with squamous cell carcinoma of the oral cavity, pharynx, and larynx, without palpable lymphadenopathy. All underwent CT followed by surgery that included partial or complete cervical lymphadenectomy. Sixteen (28%) patients had occult cervical metastases including 6 (17%) of 36 patients with "early stage" (T1 and T2) primary tumors and 10 (44%) of 23 patients with "advanced" (T3 or T4) lesions. There was agreement of CT scan findings with presence or absence of metastatic disease in 41 (69%) of 59 studies, with sensitivity 38%, and with specificity 81%. Findings of central lucency and nodal confluence were highly reliable indicators of malignancy, whereas nodal size bore a less direct relationship. Intravenous contrast medium was useful for anatomical delineation, but not for identification of malignancy. Review of films by a single radiologist did not produce greater diagnostic accuracy than the original interpretations. The authors conclude that while it is not possible to identify all instances of cervical node involvement, employment of CT in addition to physical examination and prognostication based on primary tumor stage will facilitate appropriate selection of patients for elective treatment of the neck.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Squamous cell carcinoma of the oral cavity and oropharynx in young adults.

Studies of squamous cell carcinoma of the oral cavity and oropharynx in young adults differ as to whether younger patients resemble the general population of head and neck cancer patients. A retrospective study was performed on 23 patients (40 years old or younger) with oral and oropharyngeal carcinoma at New York University Medical Center between 1961 and 1984. Patients with oropharyngeal cancer resembled the general population of head and neck cancer patients. In contrast, oral cavity carcinoma occurred more frequently in women under the age of 35 and lacked the usual etiologic factors of tobacco and alcohol abuse. Survival correlated best with the TNM stage of disease at initial presentation. Patients with Stage I and II lesions had an excellent response to surgical treatment alone and a high 5-year survival rate. Patients with advanced Stage III and IV disease had a poor survival rate with single modality treatment. We recommend surgery and radiotherapy in patients with advanced disease.

Adult↗
PubMedDate not supplied

Olfactory groove meningioma with paranasal sinus and nasal cavity extension: a combined approach.

A 58-year-old man had an enlarging right fronto-orbital mass. A biopsy specimen of a right nasal cavity tumor was reported as meningioma. Preoperative evaluation including skull roentgenograms, tomograms of the paranasal sinuses, brain scan, computerized axial tomography, and carotid angiography substantiated a large subfrontal mass with paranasal sinus and orbital extension. A combined approach through a right frontal craniotomy and right lateral rhinotomy was used for a complete removal of this tumor. A review of the literature is contained herein.

Bone Neoplasms↗
PubMedDate not supplied

Combined therapy vs curative radiation in the treatment of pyriform sinus carcinoma.

An attempt has been made to compare the long-term results using preoperative radiation and surgery with radiation therapy alone in the treatment of squamous cell carcinoma of the pyriform sinus. There is a 33% survival for the combined therapy group and a 6% survival for the curative radiation group. Large primary lesions and the presence of cervical adenopathy portend a grave prognosis. The various surgical procedures used are presented with the extent of the primary lesion as the determining factor.

Aged↗