Head & neck
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Completion cervical lymphadenectomy is usually performed after excisional biopsy of nodal metastases from melanoma. Radiation (XRT) might be effective for some patients in lieu of formal lymph node dissection. ⋯ The results of this study suggest that selected patients may receive regional XRT after local excision of nodal disease from melanoma in lieu of formal lymph node dissection.
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The maxillary swing procedure has been used as an anterolateral approach to expose the nasopharynx, the central skull base, and its vicinity. The reported incidence of postoperative palatal fistula has ranged from 20% to 25%. The oronasal incompetence especially associated with a large fistula has adversely affected normal speech, eating, and swallowing functions. We describe a modified palatal incision to reduce the incidence of palatal fistula associated with the maxillary swing procedure. ⋯ The modified palatal incision as described has effectively prevented palatal fistula formation after the maxillary swing procedure.
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Cranionasal resection was first described in 1997 for the surgical resection of olfactory neuroblastoma. The endoscopic transnasal approach is used in cranionasal resection to replace the more invasive craniofacial resection. It has the advantages of avoiding the facial wound and its associated pain, swelling, and scar. The authors have routinely practiced cranionasal resection since 1996 for resection of all anterior skull base tumors in which the resultant skull base bony defect is limited to the nasal and sinus roof. The aim of this study was to review the results of cranionasal resection for olfactory neuroblastoma. ⋯ Cranionasal resection is a safe and adequate procedure. Postoperative radiotherapy is not necessary after clear resection of Kadesh A and B tumors.
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Esophageal perforation is an uncommon but known complication of esophageal dilation. Abscess after esophageal tear is rare, especially in the spinal epidural space. This is one case report of such an abscess. ⋯ Early diagnosis with a gadolinium-enhanced MRI and aggressive surgical treatment are keys to successful management with a good functional outcome after this unfortunate complication.
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Mucosa-associated lymphoid tissue (MALT) lymphoma is usually associated with a chronic inflammatory disease from which lymphoid tissue of MALT type arises as a prerequisite for lymphoma proliferation. No well-characterized chronic inflammatory process has been identified in the larynx. ⋯ We may assume that chronic laryngitis could be a precursor to MALT lymphoma. This case is the first one to our knowledge of a primary MALT lymphoma of the larynx treated with conservative management combining surgical excision, reflux therapy, and eradication of gastric H. pylori infection.