Biomedical subjects
Publications and source records attributed to T D Briant.
A case of inverted ductal papilloma arising in a major salivary gland is reported. To the best of the authors' knowledge, no similar case could be found in the literature. Histologic appearance and cytologic origin of this neoplasm, unique at this site, are discussed.
The clinical presentation of sphenoid sinus mucocele is usually dependent on the degree of involvement of adjacent structures. Since extension can be in any direction, there is a wide spectrum of symptomatology and clinical diagnosis can be difficult. Five cases of sphenoid sinus mucocele, four of which were demonstrated by computed tomography (CT), are presented. CT with its multiplanar display capability, is the diagnostic procedure of choice. It not only demonstrates the extent of the lesions non-invasively, but its ability to demonstrate bony expansion and destruction as well as density and enhancement pattern, will obviate the need for tomography. It has the greatest potential for differentiating other sphenoid and parasellar lesions.
The patient with an abnormal voice has variously been investigated by laryngologists and speech pathologists, the diagnosis being based on visualization of the larynx and the sound of the voice. With the advent of phoniatric surgery, for example augmentation of the vocal cord and recurrent nerve section for spastic dysphonia, more objective means of quantifying abnormalities and results became pressing. Investigation of dysphonia where obvious lesions of the vocal cords were absent required further laboratory methods. The advent of microprocessors and fiberoptic endoscopy allows research methods to be applied clinically with better ability to diagnose and document patients with voice disorders. This paper outlines the experience of a voice laboratory and tries to assess the relevance of laboratory tests to clinical practice.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Osteogenic sarcoma of the mandible is a rare tumor and exhibits differences in age of onset, symptomatology, radiological appearance, and prognosis when compared to similar tumors in other location. While the prospects for cure remain poor, aggressive therapy can result in higher survival rates than are achieved for tumors in other sites. Seven cases of mandibular osteogenic sarcoma are presented and aspects of diagnosis and treatment are discussed.
A case of aberrant internal carotid artery, passing through the middle ear, is presented and the literature is reviewed, including modes of presentation and etiologic theory. The need for adequate pre-operative radiologic investigation in any suspected vascular lesion of the middle ear is stressed.
Between 1948 and 1975, we have seen 48 patients with nasopharyngeal angiofibroma. Radiotherapy is the treatment of choice for most patients. A dose of 3,000 rads in three weeks leads to thrombosis, fibrosis, and tumor regression, although a latent period up to two years may elapse before final disappearance. Coronal tomography demonstrated tumor extension into the accessory air sinuses in 26 of 29 patients examined. Radiation controlled the tumor both clinically and radiologically from two to 20 years in 28 (80%) of 35 patients treated for the first time. Ten patients, initially treated by surgery, underwent irradiation for recurrence, and in seven the tumor was controlled. Overall, ten (22%) of 45 tumors were not controlled by the first course of radiotherapy; seven of these were controlled by a second course and three were treated by surgery. Hormonal study results on 12 patients were normal.
Great advances in the field of reconstructive head and neck surgery have been made in the last 20 years, and although the nape of neck flap has not been used as frequently as the deltopectoral flap or the forehead flap, its contribution in this field has been significant. This paper discusses the flap's history, anatomical basis, and clinical applications. Advantages, disadvantages, and complications are discussed and the flap's role in modern head and neck reconstructive surgery is examined.
The clinical records of 69 patients who had Teflon injection of the vocal cord are reviewed. The indications for treatment, methodology and results of therapy are discussed. The histological findings in three serially sectioned autopsy larynges which had been injected with Teflon paste during life are also presented. Special attention is given to the distribution of Teflon and to the local tissue reaction. The findings are discussed in conjunction with the current concepts regarding the use of this therapeutic modality.
Computerized tomography has revolutionized the investigation of head and neck tumors and so rapid are the advances in this field, reviews are often outdated at time of publication. Several cases are presented to demonstrate the value of computerized tomography in investigation of lesions involving the paranasal sinuses, nasopharynx, and soft tissues of the neck.
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Over the past 10 years, numerous reports on click evoked brain stem responses have appeared in both the general otolaryngologic and the audiologic literature. Equipment is now commercially available, is relatively simple to operate, and permits the routine recording of these potentials. The technique is especially useful in the objective establishment of hearing thresholds in the newborn and in adult subjects and appears to be more reliable than the cortical evoked response (AEP). Other uses and applications of the technique, as in the detection of brain stem lesions and acoustic tumors, in coma and brain death, are discussed.
A number of cases are presented illustrating the value of computed tomography in the investigation of mass lesions involving the paranasal sinuses, nasopharynx, and soft tissues of the neck. Rapid advances in CT technology now underway will alter our approach to the investigation of certain diseases in these locations.
A control rate of approximately 80% has been obtained in 45 cases of juvenile nasopharyngeal angiofibroma treated by a single moderate dose of radiotherapy at the Princess Margaret Hospital, Toronto. The remaining patients ultimately achieved control generally after further irradiation. Immediate side-effects of the treatment have been minimal, and no late complications have been observed. In 2-20 years' follow-up, no irradiation-induced tumors have been found. Superiority of irradiation in these cases over surgery is emphasized, as well as the importance of using sophisticated techniques to limit the volume of tissues irradiated and protect vulnerable radiosenstitive structures. Because tumor regression can be expected to continue for many months after treatment has been completed, a policy of observation following radiotherapy is recommended.
Juvenile nasopharyngeal angiofibromas produce radiographic changes which are sufficiently characteristic to render a diagnosis without resorting to biopsy. Computed tomography is also of value, particularly in following the response of these tumors to therapeutic irreadiation.
A patient with sphenoid sinus mucocele presented with destruction of the clivus and a pre-pontine mass mimicking a chordoma of the clivus.