Thomas C. Calcaterra

Postirradiation sarcoma of the head and neck

Background. With improvement in survival after cancer treatment, it is becoming increasingly important to study treatment‐related morbidity and mortality. Sarcoma can develop in the irradiated field after radiation therapy. The authors performed a study to estimate the risk, and compared the risk of sarcoma after radiation therapy with that of other treatment modalities used against cancer.

Leiomyosarcoma of the head and neck: A review of the literature and report of two cases

Two cases of leiomyosarcoma involving structures of the head and neck area are added to the 29 cases recorded in the English literature since 1950. Review of the diagnosis, histological appearance, behavior and management of the tumor suggests that wide local excision is the therapy of choice.

Laryngeal dysplasia. A clinicopathologic study

Background. Histologic changes that may predict irreversible neoplastic transformation remain poorly defined for lesions of the larynx. To date, more than 20 schemes for the classification of laryngeal dysplasia have been proposed, yet no one system has gained wide acceptance. This has led to considerable confusion in defining the pathogenesis of this process and controversy in selecting the optimal management strategy of patients with premalignant changes of the larynx.

Pseudomonas meningitis complicating head and neck surgery.

Three patients, each of whom had Pseudomonas meningitis as a sequela of an extensive head and neck operation, have been treated successfully. All three patients had cerebrospinal fluid leaks, and operative management of this complication is discussed. Antibiotic management included the parenteral administration of the recently developed drugs gentamicin, car‐benicillin, and intrathecal gentamicin. Since extensive head and neck operations are being performed with increasing frequency and since infectious complications are inevitable, it is mandatory that the otolaryngologist be familiar with current methods of managing these potentially lethal conditions.

Aerodigestive dysfunction secondary to thyroid tumors

Although most thyroid tumors first manifest clinically by a neck mass, several patients with thyroid tumor have been treated whose initial complaint was a disturbance of the respiratory and digestive tracts. Because this association is not well recognized, the diagnosis of a thyroid tumor can be delayed, or even missed until the tumor grows much larger causing other symptoms.

Normal variations in size and neoplastic changes of skull foramina

Operability of head and neck cancers is usually limited by extension to the base of the skull. Intracranial extension occurs by tumor growth along the perineurium of cranial nerves and along blood vessels or by direct bone erosion. Skull involvement usually is determined by radiologic evidence of destruction or enlargement of skull foramina.

Current adjuncts for surgery of the sphenoid sinus and pituitary gland

Surgical intervention in the region of the sphenoid sinus pituitary gland requires extreme precision because of enveloping vital structures. The rhinologic approach to the pituitary gland, once abandoned due to limited visibility and the risk of meningitis, has experienced a renaissance as a result of recent medical and technical advances. Antibiotics have almost eliminated the risk of meningitis, and the operating microscope and televised radiofluoroscope now provide sufficient illumination, magnification, and orientation that injury to nearby structures can be avoided. A mid‐line rhinologic approach provides ample exposure and further minimizes operative hazards.