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At least 703 records · Page 39Linked to original sources
PubMed1993

Basaloid squamous cell carcinoma of floor of mouth.

BACKGROUND: Only five cases of basaloid squamous cell carcinoma (BSCC), a rare tumor of head and neck, have been reported to involve the floor of mouth. METHODS: Clinicopathologic and immunohistochemical features of eight BSCC of floor of mouth were studied to evaluate the significance of the basaloid features. RESULTS: Five patients were male and three were female. Their mean age was 52 years (range, 39-59). At presentation, one patient was diagnosed with Stage II disease, four were diagnosed with Stage III disease, and three were diagnosed with Stage IV disease. Aside from typical squamous differentiation, each patient had a component of basaloid cells arranged in irregular nests, cords, or pseudoglandular spaces with a brisk mitotic rate, myxoid stroma, and marked tendency for perineural invasion. A panel of immunostains yielded the following results: keratin, +8/8; carcinoembryonic antigen, +3/8; and S-100, chromogranin, and neuron-specific enolase were negative. Mucin stains were negative in all cases. Ultrastructural characterization of three BSCC revealed squamous differentiation of the basaloid cells and a peculiar basal membrane-like material in between them. No neurosecretory granules were present. Seven patients underwent surgery; six of them were also treated with postoperative radiation therapy. In two cases, chemotherapy was added at recurrence. One nonresectable patient received radiation and chemotherapy. At the last follow-up, five patients were dead of disease within 13 months from the diagnosis. One patient died of an unknown cause. Two patients were still alive at the time of this report, 4 and 2 months after treatment. Seven patients had recurrent disease. The authors compared these data with a control group of patients with conventional squamous cell carcinoma (SCC). CONCLUSIONS: The authors' results indicate that BSCC of floor of mouth is an aggressive variant of SCC and is prognostically worse than the conventional SCC, regardless of the grade of the latter.

Adult↗
PubMed1975

Species differences in mechanosensory projections from the mouth to the ventrobasal thalamus.

To determine whether the largely ipsilateral, inverted representation of mouth parts in the ventrobasal thalamus of sheep was unique to that species or an expansion of a general mammalian pattern, the corresponding thalamic projections were mapped electrophysiologically in a selected series of mammals (oppossums, agoutis, squirrel monkeys, cats, raccoons, and sheep) representing major branches of evolution among therian mammals. In mapping, tungsten microelectrodes were used to record multi-unit discharges in the thalamus in response to mechanical stimulation of oral surfaces. The pattern of projections seen in sheep is not a general mammalian pattern; there is extensive variability among mammals in the laterality and internal orgainzation of the projections from the mouth. In spite of the great variability, the results suggest an hypothesis concerning phylogenetic trends: descendants of palaeoryctoid insectivores (cats, raccoons, and sheep in our sample) have extensive ipsilateral projections from the mouth, in other therian mammals (opossums, agoutis, and squirrel monkeys in our sample) the ipsilateral component is small or absent.

Animals↗
PubMed1984

The incidence of occult metastases for cancer of the oral tongue and floor of the mouth: treatment rationale.

One hundred thirty-six surgical cases of squamous cell carcinoma of the oral tongue and floor of the mouth at the Emory University Hospitals were reviewed for the incidence of occult metastases. Thirty-five percent of the T1 T2 lesions of the anterior tongue had occult metastases. The figure was 31.5% for similarly staged lesions of the floor of the mouth. The presence of regional metastases resulted in a 2-year determinate survival rate of 37% and 32% for patients with oral tongue and floor of the mouth lesions, respectively. The poor prognosis in the study for delayed cervical metastases and the high incidence of occult cervical metastases have led the authors to propose a more aggressive therapy for the clinically negative necks in these two sites of squamous cell carcinoma of the oral cavity.

Adolescent↗
PubMed1992

Marginal mandibulectomy for carcinoma of the floor of the mouth.

Resection of primary tumors of the floor of the mouth mandates consideration of the management of the mandible which may be either involved by direct invasion or by close proximity. Segmental mandibulectomy can usually be performed when the tumor is either massive or directly invading the mandible. However, the cosmetic and functional results of segmental mandibulectomy are unsatisfactory. Whenever the tumor is close to the mandible or adherent to the periosteum, consideration should be given to marginal mandibulectomy. Over a period of 8 years, we have treated 65 patients with carcinoma of the floor of the mouth. Of these, 22 underwent marginal mandibulectomy. The number of patients staged T1, T2, and T3 were 4, 13, and 5, respectively. Most had oblique marginal mandibulectomy including the resection of the upper rim and medial cortex of the mandible. Vertical or horizontal mandibulectomy was rarely used. In each patient the preoperative workup included dental X-rays, panoramic films, and computerized tomography (CT) scan of the head and neck. The decision as to the extent of mandibulectomy was made primarily based on the clinical judgement. Seven patients underwent marginal mandibulectomy through the open mouth. However, in the remaining 15 patients, the cheek flap approach was utilized. The defect following marginal mandibulectomy was reconstructed either with split thickness skin graft, tongue flap, or myocutaneous flap. Small defects were left open to heal by granulation and secondary intention. Split thickness skin grafts healed very well over the surface of resected mandibles. Good local tumor control was achieved at the primary site and the functional and cosmetic results were excellent.

Adult↗
PubMed2003

Complex oncologic reconstruction of a mandibular and floor of mouth defect with a fibula free flap in an achondroplastic patient.

The fibular free flap is seen as one of the foremost technical options in mandibular reconstruction, especially in those defects where long bone is required. Cases with squamous-cell carcinoma of the floor of the mouth with mandibular spread and subsequent segmentary mandibular removal are the cornerstone examples. A case of squamous-cell carcinoma of the whole floor of the mouth with mandibular invasion is reported. Radical resection of the floor of the mouth and bilateral mandibular horizontal ramus was performed, with a bony defect extending from angle to angle. The patient revealed an achondroplastic condition, with remarkable dwarfism and long-bone morphological alterations, that minimized the potential fibular length to transfer. A microsurgical reconstruction with an osteocutaneous fibular free flap was undertaken. The flap design was technically compromised by the forward bowing of the fibula and the ossification of the interosseous membrane. Specific intraoperative strategies for dealing with anatomic variations are discussed. The fibular free flap is an excellent technique for mandibular reconstruction. Morphological deviations can modify the design of the flap. Achondroplasia is not a deterrent in successful use of the free fibula flap for reconstruction of the head and neck in adequately selected cases.

Achondroplasia↗
PubMed2003

[Mouth dryness and burning sensation of the oral mucosa: causes and possibilities for treatment].

Both sets of complaints, mouth dryness and a burning sensation of the oral mucosa, can have a variety of causes. Local and regional as well as systemic causes can be responsible for burning mouth syndrome. Diseases of the oral mucosa can have genetic, inflammatory, or neoplastic origins. Autoimmune diseases and allergies as well as different afflictions relating to internal medicine can be accompanied by a burning sensation in the oral mucosa. Neurological and psychiatric illnesses must be clarified during interdisciplinary diagnostics in order to identify idiopathic forms. The causes of mouth dryness are similarly complex. In addition to inadequate fluid intake, particularly in elderly patients, drug side effects or systemic diseases are frequently also responsible. Treatment is directed at the underlying disease; in ambiguous cases, symptomatic therapy can provide relief for medical complaints.

Burning Mouth Syndrome↗
PubMed2006

[The "ancient schwannoma". A rare tumor of the mouth floor].

"Ancient schwannomas" of the mouth floor are rare, benign neoplasms derived from the nerve sheath of peripheral nerves. They show many degenerative changes such as necrosis and vascular thrombosis. Ancient schwannomas show histopathological features, such as degenerative changes and atypical nuclei, and may easily be confused with malignant neoplasms. B-scan sonography for the mouth floor and MRT imaging may be helpful in differential diagnosis. Here, we report on a patient with ancient schwannoma of the floor of the mouth.

Biomarkers, Tumor↗
PubMed1987

The association between burning mouth syndrome and psychosocial disorders.

Twenty-five patients with a diagnosis of nonorganic burning mouth syndrome were matched for age and sex with twenty-five patients with organically based painful disorders of the mouth. All patients were interviewed by a psychiatrist and completed the General Health Questionnaire to screen for psychiatric disorders. A diagnosis of psychiatric disorder based on clinical examination findings was made in 44% (11/25) of the patients with burning mouth syndrome and in 16% (4/25) of the controls.

Adult↗
PubMed1994

Prognosis in mouth cancer: tumour factors.

524 patients with histologically proven squamous cell carcinoma of the oral cavity who were previously untreated are studied for prognostic factors. There were various associations between T stage and site; T2 being more common in buccal cancer, T1 in tongue cancer, T4 in floor of mouth tumours and T2 in the roof of the mouth. Floor of mouth cancer tended to be more frequently associated with positive cervical lymph nodes than were other sites (45%). Well-differentiated tumours tended not to be associated with nodal disease (66%). Small tumours tended not to be associated with nodal metastases whereas large ones were. Univariate analysis of observed survival showed that well differentiated tumours had a slightly better survival than poorly-differentiated tumours (a difference of 8%). Survival fell with increasing T stage and with increasing pT stage. Positive resection margins and advanced pT stage in particular had a dismal prognosis. Survival also fell with increasing N stage and with increasing pathological N stage and extranodal rupture adversely affected prognosis. When the data were analysed by Cox's multivariate regression only two factors were found to be significant. These were T stage and N stage. Both were highly significant predictors of survival; survival falling with increasing stage.

Aged↗
PubMed2005

[Use of nasolabial flap for mouth floor reconstruction].

SUBJECT: Oral cavity cancers represent 30% of the cephalic extremity tumors. Their resection requires in the majority of the cases a reconstruction by soft tissue. The reconstruction must be simple by bringing some reliable, hairless, thin, resistant tissue to radiation therapy, with a limited morbidity and an acceptable scar ransom. PURPOSE: The purpose of our study is to define the place and the limits of nasolabial flap in the reconstruction of the anterior floor of the mouth after tumoral resection compared to the other surgical and microsurgical techniques. MATERIAL AND METHOD: We retrospectively studied patients with oral cancerous lesions of the anterior floor of the mouth reconstructed by nasolabial flap between 1997 and 2002. The patients benefited from a surgical resection of the tumor by respecting the safety margins, with an immediate reconstruction allowing the restoring of the oral functions. We tried to describe the limits of this flap and discussed its modalities of vascularization. RESULTS: Fifty-three flap procedures were performed on 47 patients; forty-one have received a unilateral and 6 a bilateral nasolabial flap. The majority of tumors were squamous cell carcinomas (50 cases). The average age of patients were 64.8 years (45-78 years) with 40 men (75%) and 13 women (25%). A radical neck lymph nodes dissection with facial artery ligation was realized for 21 patients (15 ipsilateral and 3 bilateral) without affecting the outcome. As complications, we noted one complete necrosis and two partial necrosis of the flap, two postoperative wound complications with dehiscence as well as a massive local recurrence of initial tumor in one patient. CONCLUSION: The nasolabial flap represents a simple functional and morphological option to other pedicled or microsurgically anastomosed flaps for the reconstruction of intermediate-sized mouth floor defects.

Aged↗
PubMed2002

Epidemiological basis useful for the control of foot-and-mouth disease.

Although known for many years, foot-and-mouth disease is still able to represent a real threat to many farming economies in the world. The recent 2001 Western European epizootics linked to O PanAsia virus strain can illustrate the fact that many questions are still unanswered in the field of foot-and-mouth epidemiology. It also demonstrates that the increase in international trade, including livestock, animal products and animal food, means an increase in the probability of transmitting, through the same way, some animal diseases, foot-and-mouth included. In our economies, a rapid identification of the virus and a fast elimination of infected, contaminated and even some contact animals are still the key factors to react in front of such a disease.

Animal Husbandry↗
PubMed1994

The burning mouth syndrome: lack of a role for contact urticaria and contact dermatitis.

BACKGROUND: The burning mouth syndrome is poorly understood and mainly affects postmenopausal women. Dental allergens have seldom explained the burning. OBJECTIVE: Eight patients (seven women, one man) (mean age 62.5 years) who wore dentures and had the burning mouth syndrome were investigated to determine whether contact urticaria, allergic contact dermatitis, or pressure urticaria played a role. Only patients who had minimal to no erythema of the mucosa were included. METHODS: A complete blood cell count, fasting chemistry profile, and potassium hydroxide examination and cultures for Candida and dermatophytes were obtained. Contact urticaria and patch testing with control substances were performed with a panel of 25 potential denture allergens. RESULTS: Complete blood cell counts and fasting chemistry profiles were normal. One positive Candida culture was found, but no improvement in the symptoms was noted after treatment. All patients tested positive to histamine and to at least two of the nonimmunologic urticaria controls. No patient had a positive urticarial reaction to the potential dental allergens. Two patients with nonimmunologic urticaria to cinnamic aldehyde improved with avoidance. All patch tests were negative. In the six patients tested for pressure urticaria, the results were negative. CONCLUSION: We cannot indict contact dermatitis, contact urticaria, or pressure urticaria as a cause of the burning mouth syndrome in the denture-wearing patient who has a normal-appearing mucosa. The burning symptoms in this syndrome may be secondary to a simple frictional phenomenon of the denture on the mucosa.

Blood Cell Count↗
PubMed2002

Brachytherapy for T1-T2 floor-of-the-mouth cancers: the Gustave-Roussy Institute experience.

PURPOSE: In a retrospective analysis, we evaluated the Gustave-Roussy Institute's experience of locoregional control, survival, and complications of low-dose rate brachytherapy for carcinoma of the floor of the mouth. METHODS AND MATERIALS: Between 1970 and 1985, 160 patients with previously untreated carcinoma of the floor of the mouth received interstitial brachytherapy as definitive treatment. Of the 160 patients, 79 (49%) had T1 and 81 (51%) had T2 lesions, and 127 (79%) had N0 and 33 (21%) had N1; 84% of tumors arose from the anterior floor of the mouth. Brachytherapy was performed with 192Ir wires, according to the Paris system rules, followed by neck dissection (T2 or N1) or follow-up (T1N0). RESULTS: With a follow-up period of 9-19 years, the observed survival rates were 89% at 2 years and 76% at 5 years, and the local control rates were 93% in T1 and 88% in T2 tumors. A low rate of distant metastases was noticed (5%); 31% of patients developed a second primary cancer. Severe mucosal necrosis was observed in <10% of patients. Any grade of bone necrosis was seen in 18% of cases (only 2.5% had G3 necrosis). This complication occurred more frequently in patients with poor dental status and in those treated without dental protection during implantation (p <0.001). CONCLUSION: Radical brachytherapy offers excellent local control (89%) and an acceptable rate of complications (<10% severe necrosis) that may be significantly decreased with dental care and the use of protective devices. The high incidence of second malignancies remains a major concern in these patients.

Analysis of Variance↗
PubMed1991

Nasolabial flap for the reconstruction of defects of the floor of the mouth.

Nasolabial flaps can be used for local reconstruction of moderate defects of the anterior oronasal structures. In a 10-year period 59 flaps were used in 43 patients to cover defects of the nose, lip and anterior structures of the oral cavity (floor of mouth, tongue, alveolar process). The fate of 26 of the flaps used for reconstruction of defects of the floor of the mouth in 16 patients, were reviewed. All flaps, 6 uni- and 10 bilateral, were inferiorly based. Dehiscence, which occurred twice, and loss of one flap were the main complications. The indications and the technique are discussed. The nasolabial flap is a good alternative for the reconstruction of moderate defects of the floor of the mouth, especially in older patients and even after high doses of preoperative radiotherapy.

Aged↗
PubMed2000

Mouth protection in sport in Scotland--a review.

The oral health strategy for Scotland, which was published in 1995, recommends that dentists promote the use of mouth protection in sport to reduce the risk of injury. There is compulsory mouthguard use in some sports including ice-hockey, fencing, boxing, lacrosse and some forms of autocycling. In cricket, face protection appears to be compulsory for batsmen only. The use of mouth protection in the martial arts is compulsory at international level but, in the UK, the rule does not seem to be always enforced at club level. Players of contact sports, such as rugby and hockey, are considered to be more at risk of dentoalveolar injury and the governing bodies of these sports recommend that players at all levels wear mouth protection but have not made it mandatory.

Adolescent↗
PubMed2000

Factors affecting survival for floor-of-mouth carcinoma.

OBJECTIVES: The treatment of extensive floor-of-mouth carcinoma has remained a challenging problem for head and neck surgeons. We have reviewed our experience in the surgical management of floor-of-mouth cancer in an attempt to identify factors influencing survival. METHODS: A total of 144 patients with cancer involving the floor of the mouth were treated between March 1988 and November 1995. A retrospective chart review was conducted that captured information including clinical staging, therapeutic modalities, pathologic findings, and patient follow-up. Factors affecting survival were assessed by nonparametric analysis and analysis of variance. RESULTS: There was no statistical significance for the effects of vascular invasion (P = 0.4019), lymphatic invasion (P = 0.3430), bone invasion (P = 0.1548), or positive margins (P = 0.1113) on survival. Extranodal extension and recurrent disease were strongly suggestive of influencing survival but were not statistically significant (P = 0.0650 and P = 0.0504, respectively). Nodal disease significantly affected survival (P = 0.0138) but did not affect recurrence (P = 0.451). CONCLUSION: Mean survival for this cohort was 30.6 months. Positive node status significantly affected mean overall survival in this series, whereas extracapsular disease did not. These data suggest that aggressive surgical management of neck disease is mandated to maximize survival.

Adult↗
PubMed2000

Analysis of treatment results for floor-of-mouth cancer.

OBJECTIVE: This study reports the results of treating floor-of-mouth cancer with five different treatment modalities with long-term follow-up. STUDY DESIGN: Retrospective study of 280 patients with floor-of-mouth cancer treated in the Department of Otolaryngology-Head and Neck Surgery at Washington University Medical School (St. Louis, MO) from 1960 to 1994. METHODS: Patients with biopsy-proven squamous cell carcinoma of the floor of mouth who were previously untreated were treated with curative intent by one of five modalities and were all eligible for 5-year follow-up. The treatment modalities included local resection alone, composite resection alone (with neck dissection), radiation therapy alone, local resection with radiation therapy, and composite resection with radiation therapy. Multiple diagnostic, treatment, and follow-up parameters were studied using standard statistical analysis to determine statistical significance. RESULTS: The overall 5-year disease-specific survival (DSS) was 56% with death due to tumor in 44% of patients. The 5-year cumulative disease-specific survival (CDSS) was 0.61 (Kaplan-Meier probability) with a mean of 8.3 years and a median of 9.7 years. The DSS by treatment modality included local resection (76%), composite resection (63%), radiation therapy (43%), local resection with radiation therapy (61%), and composite resection with radiation therapy (55%). Overall, there was no significant difference in DSS by treatment modality. Recurrence at the primary site (41%) was the most common site of treatment failure. Nineteen percent of patients had recurrence in the neck. Eighty-eight percent of initial recurrences occurred within 60 months after the onset of treatment. Metastasis to a distant site occurred in 30% of patients. Twenty percent of these patients had second primary cancers, and 53% of these patients died of their second primary cancers. CONCLUSIONS: Significantly improved 5-year DSS was seen in the patients with clear margins, early clinical tumor stage, and negative nodes. Significantly decreased 5-year survival was seen in the patients with involved margins, advanced clinical tumor stage, positive nodes, and tumor recurrence. Patients with no clinically positive nodes (cNO) can be observed safely for regional nodal disease and subsequent positive nodes can be treated as they occur with no adverse affect on survival. Because of high recurrence rates at the primary site and neck, and an increased rate of both distant metastasis and the development of second primary cancers, patients should be monitored closely for a minimum of at least 5 years.

Adolescent↗
PubMed1976

[Approach and reconstruction in the operative treatment of tumors of the tongue, epiglottis, floor of the mouth and pharynx].

This paper explains a new way of a temporary splitting of the lower jaw and the reconstruction of the tongue and the floor of the mouth. The described way of the temporary splitting of the lower jaw allows to maintain the nerve and results in better suppositions for the reposition and osteosynthesis. For the reconstruction of the tongue and the floor of the mouth, an island flap is reommended. The flap consists of the musculus sternocleidomastoideus, pedicled inferiorly in its cranial part of the skin. The skin taking extends over the insertion of the muscle up to the beginning of the hairy part. With this flap it is possible to cover even large defects in the floor of the mouth and its taking does scarcely bother the patient. Thus, in many cases the flap gives the suppositions to maintain the lower jaw.

Epiglottis↗