Claude Beauvillain de Montreuil

Prognostic factors for T1–T2 squamous cell carcinomas of the mobile tongue: A retrospective cohort study

The aim of this study was to identify factors predicting poor prognosis at the time of early oral tongue carcinoma diagnosis.

Removal of ethmoidal malignant tumors by the isolated paralateronasal approach with resection of the cribriform plate and the dura mater.

OBJECTIVE A series of ethmoidal tumors was resected by an entirely extracranial approach through a lateral rhinotomy incision, with partial maxillectomy and removal of the cribriform plate and dura mater from below. METHODS Thirty-four consecutive patients (32 male, 2 female; mean age 64 years, range 45-78) with malignant tumors of the ethmoid sinus were operated by this technique between July 1998 and February 2002. All had complete tumor resection, including the cribriform plate and the dura mater. Excision was performed en bloc 23 times (68%). Although cerebral involvement was encountered in four cases (T4 IC), this technique was adequate for tumor resection, together with corticectomy when necessary. The method used for tumor resection and rebuilding of the anterior skull base is described in detail. RESULTS There were no immediate postoperative deaths. One patient developed pneumococcal meningitis with cerebrospinal fluid leakage as a result of a technical error and required further surgery. Four patients presented a confusion syndrome that regressed during the hospital stay, 2 complained of transient diplopia, and 4 had hematoma of the abdominal wall. Mean follow-up of 10.4 months (1-41 months) is still too short to reach definitive conclusions about oncologic results. CONCLUSIONS This approach is particularly suitable for removal of tumors in contact with or invading the cribriform plate. Tumor resection is as extensive as with the traditional mixed approach, but does not require the frontal lobes to be drawn aside.

Results after u-shaped pectoralis major myocutaneous flap reconstruction of circumferential pharyngeal defects†‡

To evaluate surgical, functional, carcinologic results after circumferential pharyngolaryngectomy and reconstruction with U‐shaped pectoralis major myocutaneous flap.

Relevance of Both Individual Risk Factors and Occupational Exposure in Cancer Survival Studies: The Example of Intestinal Type Sinonasal Adenocarcinoma

Wood dust is a well‐established risk factor for intestinal type sinonasal adenocarcinoma. The 5‐year overall survival has varied from 20% to 80% according T1‐T4 stages; 5‐year survival according to histologic subtype has varied from 20% to 50%.

Results after U-shaped Pectoralis Major Myocutaneous Flap Reconstruction of Circumferential Pharyngeal Defects

Objectives: Evaluate surgical, functional, carcinologic results after circumferential pharyngolaryngectomy and reconstruction with U-shaped pectoralis major myocutaneous flap. Methods: Forty-one patients in a retrospective case series spanning a 6-year period. Results: General and local complications occurred in 10% and 22% of patients respectively, without early death. Swallowing and vocal functions were satisfactory for 82% and 43% of patients respectively, despite 39% of neopharynx stricture and 22% of pharyngocutaneous fistula. With a 20-month mean follow-up, cancer recurrence was present in 58% of patients. The overall survival rate was 29% at 3 years. Conclusions: This flap is simple, reliable, and allows adequate reconstruction of the hypopharynx. However, the neopharynx stricture rate is high and the quality of voice rehabilitation is poor when compared with free flaps. This procedure, which is an option for the reconstruction of circumferential pharyngeal defects, must be considered in selected cases.