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Biomedical subjects

R B Sessions

Publications and source records attributed to R B Sessions.

At least 91 records · Page 5Linked to original sources
PubMed1986

A pilot study of cisplatin-vinblastine as the initial treatment of advanced head and neck cancer.

Twenty patients with Stage IV and five patients with Stage III carcinoma of the head and neck were treated with the combination of cisplatin and vinblastine before locoregional therapy. Among 24 patients evaluable for response after chemotherapy, there were four complete responders and 16 partial responders for an overall major response rate of 83%. No complete responses were observed in patients with T4 primary lesions or N3a nodal disease. Toxicity was limited primarily to nausea and vomiting (76%) and myelosuppression (72%). Four patients, all treated at the higher vinblastine dose, required hospitalization for fever associated with neutropenia. Two patients had a transient increase in the serum creatinine clearance to greater than 3 mg/dl. The combination of high-dose cisplatin and frequent vinblastine has significant activity in locally advanced squamous cell carcinoma of the head and neck, has mild and reversible toxicity, and does not require prolonged hospitalizations for continuous intravenous infusions.

Adult↗
PubMed1986

Staple closure of the gullet after laryngectomy: an experimental study.

Traditionally, gullet closure that is done after a laryngectomy has been accomplished with tedious and time-consuming suturing procedures. As an alternative to this, staple closure of the gullet has been growing in acceptance and implementation as a mucosal eversion technique. In this article, we shall present several aspects and considerations of this method of surgical closure.

Animals↗
PubMed1985

Mandibulotomy approach to oropharyngeal tumors.

We have reviewed our experience with 120 selected patients who had pharyngeal tumors resected through a median mandibulotomy approach with paralingual extension (mandibular swing). Clinical findings, technique, and complications are discussed. Results were gratifying in terms of salvage, patient appearance, and function. We believe that this surgical approach, in combination with postoperative radiotherapy when appropriate, offers an attractive alternative to high dose radiotherapy alone in patients with oropharyngeal carcinoma.

Combined Modality Therapy↗
PubMed1985

Intraoperative radiotherapy in patients with recurrent head and neck cancer.

Patients with head and neck cancer who have a relapse of the disease above the clavicles can sometimes be salvaged by additional surgery. However, if all gross tumor cannot be removed during surgery or if the resection margins are unsatisfactory, the likelihood of salvage is remote, especially when postoperative radiotherapy is not feasible due to previous radiotherapy. Between 1979 and 1983, we employed intraoperative brachytherapy for 21 such patients. Sixteen patients had a recurrence after previous surgery and radiotherapy, and 5 after radical radiotherapy. All gross tumor could not be removed in 15 patients, whereas satisfactory margins could not be obtained in 6. In 11 patients, we delivered radiotherapy by a temporary implant of iridium-192 (median dose 4,800 rads in 6 days). In 10 patients, radiotherapy was delivered by a permanent implant of iodine-125 (median activity 13 mCi). Three patients (14 percent) had a relapse within the surgical field, whereas six others (28 percent) had a relapse elsewhere or had development of metastases. Complications developed in four patients (19 percent) and were fatal in one patient. The actuarial disease-free survival rate at 2 years was 55 percent, whereas the rate of local disease control was 81 percent. Our experience suggests that intraoperative brachytherapy can salvage certain high-risk patients with head and neck cancer.

Adult↗
PubMed1985

Head and neck oncology--1985. Reflections on changing times.

The field of head and neck oncology is keeping pace with the dramatic shift in cancer treatment modalities occurring during this period of medical history. Having achieved a level of surgical elegance, the head and neck oncologist has the future to rely upon for more biological methods of management of this disease. Biochemistry, immunology, and virology occupy much of the research interest pertaining to malignancies of these body systems and it is within this research that the answers will probably be found.

Head and Neck Neoplasms↗
PubMed1983

Technical modifications of the medial maxillectomy.

Several technical modifications to the originally described medial maxillectomy are discussed that enhance orbital retraction, nasolacrimal drainage system reconstruction, and orbital content reapproximation to the surrounding bony cage. The application of these techniques simplifies the procedure and enhances the original goal, ie, better visualization of the posterior part of the specimen intended for removal.

Humans↗
PubMed1983

[Complications of rhinoplasty].

Following a consequent outline of his communication, the author subsequently describes his experiences, the possibilities of managing and personal techniques available in case of operative problems or postoperative complications such as bleeding, haematoma, dermal necrosis or scar formation or infection. The nasal physiology and its relation to the operative treatment, and the importance of a thoroughly preoperative evaluation of certain tissue characteristics are discussed. Postoperative skeletal alterations, such as insufficient or excessive removal of humps, cartilages and soft tissues as well as their surgical management are pointed out. Remarks about nasal tip correction conclude the presentation of the subject.

Adolescent↗
PubMed1982

Intra-arterial cisplatin treatment of adenoid cystic carcinoma.

Adenoid cystic carcinoma (ACC) is unique among salivary gland tumors in both its natural history and in its response to nonsurgical treatment methods (ie, radiation and chemotherapy). The chemotherapeutic agent, cisplatin, seems to be unique in its ability to affect ACC. It might be that ACCs of the minor salivary glands are especially vulnerable to the intra-arterial method of administering this drug, because there are accessible feeding vessels to most locations in which these tumors occur. We have treated four patients with advanced ACC with intra-arterial cisplatin. The responses suggest that this method may be a useful adjunct in the management of this tumor both as a preoperative and as a palliative measure.

Aged↗
PubMed1982

Morphologic and histochemical characteristics of laryngeal muscle.

Laryngeal muscle (LM) is highly specialized for phonation and sphincter activity. We queried whether this specialization is reflected in the structure of LM. We examined, using histochemical techniques, the structure of five LM from three men who died suddenly and who had no evidence of laryngeal disease. Compared with nonlaryngeal skeletal muscle, our specimens demonstrated moderate fibrosis, rounding of fibers, basophilia, and ragged red fibers that were shown to be mitochondria. In general, LM fibers are smaller, have more variability in size, and contain a greater percentage of histochemically type 1 fibers than limb skeletal muscles. These differences suggest that theories of motor control derived from studies of limb skeletal muscles may not apply to LM.

Adenosine Triphosphatases↗
PubMed1982

Nasal dermal sinuses--new concepts and explanations.

Utilizing a series of 13 consecutive patients with nasal dermal sinus-cyst (NDSC) as a basis for study, this area of embryopathology was re-examined in light of the known and also the speculative knowledge available. Four of these patients had NDSC that involved the intracranial cavity and these served as a basis for correlating preoperative radiologic findings with what was actually found at the time of surgery. In so doing, we have been able to show that the pathogenesis of these lesions is consistent and the predictability of their intracranial involvement is based on this consistency. The repeated penetration through the prenasal space and into the foramen cecum is accompanied by a characteristic deformity of the base of the skull that is entirely recognizable radiographically. A protocol of findings has been developed, therefore, that allows the surgeon to be forewarned regarding the depths to which NDSC extends, and as such to design the surgical procedure to fit the lesion. The more basic findings for this study relate to the demonstration in human embryos of an anatomic reason why intracranial dermal cysts grow in the manner in which they do, i.e., in the substance of the falx cerebri; and even more basically, with additional human embryo studies we have been able to demonstrate a neuroectodermal pathway through the prenasal space, thus definitively confirming previous speculated embryomorphologic information. By corroborating the placement of the dermal displacement in the prenasal space, we have speculated that the NDSC is often but one disorder in a spectrum of aberrations which involves not only dermal and neural displacement, but also cranial floor deformities.

Adolescent↗
PubMed1982

Computed tomography of the major salivary glands.

Forty-eight patients with proven disease of the salivary glands were evaluated by computed tomography (CT). Twenty-seven patients had salivary gland neoplasm and all were identified by CT. Fifteen benign tumors appeared as discrete, sharply marginated, high-density masses embedded in an otherwise normal gland. All 15 were correctly identified as benign by CT. There were 12 malignant tumors; 10 were invasive and presented as poorly defined, relatively dense lesions which obliterated and/or transgressed adjacent fat and fascial planes. Two malignant tumors presented as discrete masses and were incorrectly considered to be benign by CT. Twenty-one patients with inflammatory disease of the salivary glands were studied. A variety of patterns were noted, the most common a relatively diffuse, irregular area of increased density in an enlarged gland. Salivary duct calculi, diffuse sialectasis, and enlarged lymph nodes were well demonstrated. Differentiation between focal and inflammatory disease and malignant neoplasm was difficult. Computed tomography may be augmented by coincident sialography, although it is seldom necessary.

Adolescent↗
PubMed1980

Myospherulosis: a preventable iatrogenic nasal and paranasal entity.

We discuss a disorder that, although at first considered of possible fungal origin, now is known to be due to an alteration of erythrocytes induced by petrolatum-based antibiotic ointment. In this country, the structures of myospherulosis have been seen most often in tissues from the nose and paranasal sinuses following surgery in this region. Our studies show that both components of the vehicle of a commonly used tetracycline antibiotic ointment, lanolin and petrolatum, either separately or together, produce the structures of myospherulosis in vitro. It is recommended that a nonpetrolatum-based substance be used in nasal packing for purposes of hemostasis.

Adult↗
PubMed1977

En bloc ethmoidectomy and medial maxillectomy.

A method is described which enables the surgeon to gain necessary visual access for en bloc removal of certain tumors of the nasoethmoid area. A "medial maxillectomy" has been performed on ten patients, three of whom underwent combined craniofacial surgery for extensive neoplasms. The procedure is especially suitable for those tumors in which piecemeal or "shelling out" techniques are not desirable, and in which one desires to preserve the eye, palate, and facial appearance.

Adenocarcinoma↗
PubMed1977

Inverted papilloma of the lacrimal sac, the paranasal sinuses and the cervical region.

A 22-year-old woman presented with a lacrimal sac mass which on biopsy was an inverted papilloma. Two years later an ipsilateral cervical mass was removed, which contained inverted papilloma with a histologically typical pattern. Subsequently, the patient had a medial maxillectomy and remains well 5 years later. The cervical mass may represent inverted papilloma arising in a branchial cleft cyst or it may be a metastasis of benign papilloma to a regional lymph node. This is the second such case reported and the first with substantial followup.

Adult↗