Acta oto-laryngologica
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The endoscopic approaches developed for the treatment of the chordomas according to the different clival location provide the possibility for more complete tumor resection with maximal preservation of anatomic structures and reduction of the overall incidence of complications. ⋯ Seven gross total, four subtotal, and one partial resection were achieved after surgery. At 6 months to 3 years follow-up, eight patients were recurrence-free and two patients had unchanged residual tumor. One patient with recurrent chordoma underwent second surgery and subsequent intensity modulated radiation therapy (IMRT). The other patient with a recurrent chordoma died 1 year postoperation.
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Acta oto-laryngologica · Jan 2009
Metastasis to the submandibular gland in oral cavity squamous cell carcinomas: pathologic analysis.
This study demonstrates that the incidence of submandibular gland metastasis in oral cavity squamous cell carcinoma (SCC) is extremely rare and its involvement is through direct extension from a primary lesion. Therefore, if the primary lesion of the oral cavity carcinoma is not in close proximity and hence does not provide suspicion of direct extension, it may be safe to preserve the submandibular gland. ⋯ In all, 44 cases (21.9%) were found to show ipsilateral level I metastasis on pathologic examination. Only two cases (1%) had carcinoma involvement in the submandibular gland. Both these two cases had direct extension from a primary lesion (retromolar trigone and floor of mouth) and no submandibular glands showed pathologic evidence of isolated metastasis or local extension of metastatic lymph nodes.
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Acta oto-laryngologica · Jan 2009
Severe deep neck space infections and mediastinitis of odontogenic origin: clinical relevance and implications for diagnosis and treatment.
Early diagnosis and aggressive antimicrobial and surgical treatment are essential to successfully treat extensive cervico-mediastinal abscesses of odontogenic origin. Patient management should be performed by experienced clinicians well trained in managing possible complications. We recommend close clinical and radiological postoperative follow-up investigations with early surgical re-intervention if necessary. ⋯ The submandibular space was the most frequently encountered location of deep neck space infections. Mediastinitis was found in five patients. The most frequent causative bacteria were Streptococcus and Bacteroides species. All patients underwent intravenous antibiotic treatment and surgical therapy. Mediastinotomy was inevitable in five cases and thoracotomy in one case. All patients survived.