Neck Service Research Articles

Factors influencing the safety of carotid ligation

The experience of the Head and Neck Service at Memorial Sloan-Kettering Cancer Center from 1954 through 1966 is reviewed. One hundred and fifty-one patients were subjected to ligation of the common and/or internal carotid arteries. Four patients required bilateral ligation. Sixty-four elective and ninety-one nonelective ligations (eighty-seven patients) were performed. Elective ligation proved to be twice as safe as nonelective ligation. Those patients exhibiting brain damage and death were most commonly those in whom shock developed. Oozing should be considered a highly significant sign which may frequently herald carotid blowout. By judicious election, the patient may be spared the dangerous as well as frightening experience of spontaneous carotid hemorrhage.

Future of Head and Neck Surgery: A Combined Head and Neck Service: An Ecumenical Approach

I WISH to express my appreciation for the privilege of giving the first annual Herbert H. Harris lecture at Baylor University College of Medicine. The fact that this annual lecture in his name has been established is a testimonial of the high esteem his former associates and residents have for him. The subject of my talk is the "Future of Otolaryngology and Head and Neck Surgery." Otolaryngology is a very broad specialty. It is part surgical and part medical. In its surgical aspects it includes minor procedures which are frequently performed, eg, tonsillectomy, adenoidectomy, submucus resection of the nasal septum; procedures which are rare, eg, hypophysectomy and cervical esophagectomy; and procedures which overlap other areas, eg, radical resections for cancer of paranasal sinuses, requiring the combined intranasal and intracranial approach, and mediastinal tracheostomy. To make matters more complicated, there are procedures which other specialties hold sacrosanct to their own fields,

Non-Epidermoid Cancer of the Larynx

From the Head and Neck Service and Department of Pathology, Memorial Hospital for Cancer and Allied Discases, New York, New York 10021

Malignant Melanoma of the Mouth

PRIMARY malignant melanoma of the oral cavity occurs rarely. General Incidence.—In this study, malignant melanoma of the oral cavity represented 1.7% of all the cases of melanoma recorded in the Head and Neck Service of the Associacao Paulista de Combate ao Cancer. From 1953 to 1965 seven cases were studied. The commonest site was the palate (four cases). The specific anatomical incidence of melanoma in the oral cavity is shown in Table 1. Age, Sex, and Race.—Primary malignant melanoma of the mouth occurs chiefly in the more advanced decades of life.1,2The incidence before 30 years of age is low. The youngest patient was 36 years old, and the oldest one was 66. Table 2 demonstrates the incidence according to age, sex, and race. There is no significant difference between sexes

Squamous cell carcinoma of the scalp

Two patients recently treated on the Head and Neck Service of Memorial Hospital gave the impression that squamous cell carcinoma of the scalp is more aggressive than that arising elsewhere, and was more difficult to treat successfully. This was not substantiated by a review of the available literature. Accordingly, this review was initiated to evaluate the experience with this type of cancer. Thirty-seven patients were found to have squamous cell carcinoma of the scalp from 1932 through 1960. The presenting symptoms, admission findings, method of treatment, and end results were recorded. The five year definitive survival rate was 75 per cent. Surgery was the method of treatment in 95 per cent of the patients. Local recurrence was infrequent and the development of cervical metastases was the primary cause of failure to effect control of cancer.

Electrocardiographic changes typical for central nervous system disease after right radical neck dissection

Study Objective: To determine if acquired long QT syndrome following right or left, radical or modified, neck dissections result in malignant arrhythmias or deaths.Design: Prospective study.Setting: Inpatient head and neck service of the Massachusetts Eye and Ear Infirmary.Patients: 69 patients who underwent extensive neck surgery, without congenital long QT syndrome, medications known to prolong the QT interval, preoperative ventricular arrhythmias, or electrolyte abnormalities.Interventions: None.Measurements and Main Results: Preoperative and postoperative electrolytes were evaluated. Preoperative and postoperative electrocardiograms and QT intervals were evaluated. Continuous intraoperative and 10- to 12-hour postoperative monitoring of lead II or V5 were evaluated. Twenty-six patients (Group 1) underwent either right radical neck dissection or modified right radical neck dissection, 25 patients (Group 2) underwent either left radical neck dissection or modified left neck dissection, and 18 patients (Group 3) underwent extensive neck surgery without radical or modified neck dissection. Postoperatively, 38 patients (19 Group 1, 11 Group 2, and 8 Group 3 patients) developed a QT interval corrected for heart rate (QTc) of greater than 440 milliseconds. Repeated measures analysis of variance, comparing preoperative and postoperative QTc showed a statistically significant preoperative to postoperative change, but no significant difference among the three groups. No malignant arrhythmias or deaths were recorded in any of the three groups.Conclusions: Acquired long QT syndrome following radical neck dissection, without congenital, metabolic, or pharmacologic disturbance, is unlikely to trigger malignant arrhythmias, as previously reported for right radical neck dissection.

Reconstruction of the cervical esophagus after total pharyngolaryngectomy: A modified Wookey operation.

Head and Neck Service of the Surgical Division of the Montefiore Hospital and Medical Center, Bronx, New York

A catheter for parotid sialography.

VARIOUS techniques for the cannulation of Stensen's duct in the performance of parotid sialography have been utilized. The majority rely on dilatation of Stensen's duct with lacrimal duct dilators prior to definitive cannulation. Few, if any, find the necessity for the application of topical or local anesthesia. Einstein and Perzik¹utilize a short blunt needle (20-23 French) attached to a syringe (Luerlock) for cannulation of the dilated duct and instillation of radiopaque solution. After injection, the needle is removed before roentgenograms are taken. Ross and Castro²utilize a blunt silver needle for the same purpose. Others, including the Head and Neck Service at the Los Angeles Veterans Administration Hospital, insert polyethylene tubing which is taped to the face in the examining room. The patient is then transported to the radiology department for instillation and films. All of the above techniques have their place and usually yield good

Value of preoperative x-ray therapy as an adjunct to radical neck dissection

In 1960, the Head and Neck Service and the Department of Radiation Therapy of the Memorial Hospital Center, New York, N. Y., instituted a controlled clinical study to determine the value of preoperative irradiation in the prevention of recurrence after radical neck dissection. To avoid a significant delay in surgery as well as complications, a tissue dose of 2,000 rads to the subcutaneous tissues of the neck was chosen. This was given by 5 treatments, each of 400 R in air, on five successive treatment days immediately preceding the operation. All therapy was administered through one large lateral field which covered the whole neck and included the primary except when it was in the maxilla, the palate, or the nasopharynx. The Allis-Chambers betatron was employed, with an electron beam of 18 Mev maximum energy. Patients born on an odd day received preoperative radiation, while those born on an even day did not, thus constituting a control group. It was agreed at the outset of the study that the patients in ...

Value of preoperative x-ray therapy as an adjunct to radical neck dissection.

In 1960, the Head and Neck Service and the Department of Radiation Therapy of the Memorial Hospital Center, New York, N. Y., instituted a controlled clinical study to determine the value of preoperative irradiation in the prevention of recurrence after radical neck dissection. To avoid a significant delay in surgery as well as complications, a tissue dose of 2,000 rads to the subcutaneous tissues of the neck was chosen. This was given by 5 treatments, each of 400 R in air, on five successive treatment days immediately preceding the operation. All therapy was administered through one large lateral field which covered the whole neck and included the primary except when it was in the maxilla, the palate, or the nasopharynx. The Allis-Chambers betatron was employed, with an electron beam of 18 Mev maximum energy. Patients born on an odd day received preoperative radiation, while those born on an even day did not, thus constituting a control group. It was agreed at the outset of the study that the patients in ...

Cancer of the cheek (mucosa).

CancerVolume 18, Issue 11 p. 1392-1398 ArticleFree Access Cancer of the cheek (mucosa) P. H. O'Brien M.D., P. H. O'Brien M.D. Head and Neck Service of Memorial Center, New York, N.Y. 10021 Senior Clinical Trainee, U.S. Public Health Service, Senior Resident Surgeon, Memorial Hospital, New York, N.Y.Search for more papers by this authorD. Catlin M.D., Corresponding Author D. Catlin M.D. Head and Neck Service of Memorial Center, New York, N.Y. 10021444 East 68th Street, New York, N.Y. 10021===Search for more papers by this author P. H. O'Brien M.D., P. H. O'Brien M.D. Head and Neck Service of Memorial Center, New York, N.Y. 10021 Senior Clinical Trainee, U.S. Public Health Service, Senior Resident Surgeon, Memorial Hospital, New York, N.Y.Search for more papers by this authorD. Catlin M.D., Corresponding Author D. Catlin M.D. Head and Neck Service of Memorial Center, New York, N.Y. 10021444 East 68th Street, New York, N.Y. 10021===Search for more papers by this author First published: November 1965 https://doi.org/10.1002/1097-0142(196511)18:11<1392::AID-CNCR2820181103>3.0.CO;2-ECitations: 30 AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat References 1 Burswanger, R. H., and Stenstroni, K. W.: Carcima of the cheek. Radiology 44: 213, 1945. 2 Catlin, D.: Radiation treatment of cancer of the touth. Am. J. Roentgen. 85: 448, 1961. 3 Fletcher, G. H., and MacComb, W. S.: Radiation therapy in the Management of Cancers of the Oral cavity and Oropharynx. Springfield, Ill., Charles C thomas, 1962. 4 Frazell, E. L., and Lucas, J. C.: Cancer of the tongue. Cancer 15: 1085, 1962. 5 Jackson, H. S., and New, G. B.: Carcinoma of buccal mucosa. Surg. Gynec. Obstet. 9: 232, 1950. 6 Leffall, L. D., and White, J. D.: Cancer of the oral cavities in Negroes. Surg. Gynec. Obstet. 120: 70, 1965. 7 Martin, C. L.: Weak radium needle technic in carcinoma of the cheek. Am. J. Roentgen. 43: 226, 1961. 8 Martin, H. E.: Surgery of Head and Neck Tumors. New York, Paul B. Hoeber, Inc., 1957. 9 Martin, H. E., and Pfleuger, O. H.: Cancer of the cheek (buccal mucosa). A. M. A. Arch. Surg. 30: 721, 1935. 10 Moore, C.: Smoking and mouth and throat cancer. Am. J. Surg. 108: 565, 1964. 11 Richards, G. E., and Ash, C. L.: Radiation therapy of carcinoma of the buccal mucosa. In Treatment of Cancer and Allied Diseases, vol. 3, Pack and Ariel, eds. New York, Paul B. Hoeber, Inc., 1959; chap. 7. 12 Stecker, R. H., Devine, K. D., and Harrison, E. G.: Verrucose “Snuff Dipper's” carcinoma of oral cavity. JAMA 189: 144, 1964. Citing Literature Volume18, Issue11November 1965Pages 1392-1398 ReferencesRelatedInformation

PAPILLARY CARCINOMA OF THE THYROID. A CLINICAL AND PATHOLOGICAL STUDY OF 70 FATAL CASES.

CancerVolume 17, Issue 8 p. 1035-1044 ArticleFree Access Papillary carcinoma of the thyroid. A clinical and pathological study of 70 fatal cases H. Randall Tollefsen M.D., H. Randall Tollefsen M.D. Head and Neck Service, Department of Surgery, and Department of Pathology, Memorial Hospital for Cancer and Allied Diseases and the James Ewing Hospital, 444 East 68th St., New York 21.N.Y.Search for more papers by this authorJerome J. Decosse M.D., Jerome J. Decosse M.D. Head and Neck Service, Department of Surgery, and Department of Pathology, Memorial Hospital for Cancer and Allied Diseases and the James Ewing Hospital, 444 East 68th St., New York 21.N.Y.Search for more papers by this authorRobert V. P. Hutter M.D., Robert V. P. Hutter M.D. Head and Neck Service, Department of Surgery, and Department of Pathology, Memorial Hospital for Cancer and Allied Diseases and the James Ewing Hospital, 444 East 68th St., New York 21.N.Y.Search for more papers by this author H. Randall Tollefsen M.D., H. Randall Tollefsen M.D. Head and Neck Service, Department of Surgery, and Department of Pathology, Memorial Hospital for Cancer and Allied Diseases and the James Ewing Hospital, 444 East 68th St., New York 21.N.Y.Search for more papers by this authorJerome J. Decosse M.D., Jerome J. Decosse M.D. Head and Neck Service, Department of Surgery, and Department of Pathology, Memorial Hospital for Cancer and Allied Diseases and the James Ewing Hospital, 444 East 68th St., New York 21.N.Y.Search for more papers by this authorRobert V. P. Hutter M.D., Robert V. P. Hutter M.D. Head and Neck Service, Department of Surgery, and Department of Pathology, Memorial Hospital for Cancer and Allied Diseases and the James Ewing Hospital, 444 East 68th St., New York 21.N.Y.Search for more papers by this author First published: August 1964 https://doi.org/10.1002/1097-0142(196408)17:8<1035::AID-CNCR2820170810>3.0.CO;2-WCitations: 107AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL References 1 Benua, R. S.: Cicale, N. R.; Sonenberg, M., and Rawson, R. W.: Relation of radioiodine dosimetry to results and complications in treatment of metastatic thyroid cancer. Am. J. Roentgenol. 87: 171– 182. 1962. 2 Crile, G.; McNamara, J. M., and Hazard, J. R.: Results of treatment of papillary carcinoma of thyroid. Surg. Gynec. & Obst. 109: 315– 320, 1959. 3 Frantz, V. K.: Pathology of thyroid. In S. C. Werner, Ed.: The Thyroid, 2d ed. New York, N. Y. Harper and Row, Publishers, Inc. 1962; pp. 289– 372. 4 Frazell, E. L., and Foote, F. W., Jr.: Papillary cancer of thyroid; review of 25 years of experience. Cancer 11: 895– 922, 1958. 5 Hirabayashi, R. N., and Lindsay, S.: Carcinoma of thyroid gland; statistical study of 390 patients. J. Clin. Endocrinol. 21: 1596– 1610, 1961. 6 Tollefsen, H. R., and Decosse, J. J.: Papillary carcinoma of thyroid; recurrence in thyroid gland after initial surgical treatment. Am. J. Surg. 106: 728– 734, 1963. 7 Underwood, C. R.; Ackerman, L. V., and Eckert, C.: Papillary carcinoma of thyroid; evaluation of surgical therapy. Surgery 43: 610– 621, 1958. 8 Woolner, L. B.; Beahrs, O. H.; Black, B. M.; McConahey, W. M., and Keating, F. R., Jr.: Classification and prognosis of thyroid carcinoma; study of 885 cases observed in 30 year period. Am. J. Surg. 102: 354– 387, 1961. 9 Woolner, L. B.; Lemmon, M. L.; Beahrs, O. H.; Black, B. M., and Keating, F. R., Jr.: Occult papillary carcinoma of thyroid gland; study of 140 cases observed in 30-year period. J. Clin. Endocrinol. 20: 89– 105, 1960. Citing Literature Volume17, Issue8August 1964Pages 1035-1044 ReferencesRelatedInformation

LOCAL RECURRENCES AFTER RADICAL NECK DISSECTION WITH AND WITHOUT PREOPERATIVE X-RAY THERAPY.

Radical neck dissection is today considered the treatment of choice for resectable neck metastases and has become one of the most frequent cancer operations. In 1961, 402 such operations were carried out at our Center (Memorial Hospital for Cancer and Allied Diseases), a number which was surpassed only by 445 radical mastectomies. The main drawback of the radical neck dissection is the high rate of local recurrence in the dissected neck. The lowest reported rate, to our knowledge, is that of the Mayo Clinic with 26 per cent recurrences within one year (1). Preoperative irradiation has been used in the treatment of many cancers, and retrospective analysis has indicated the potential value of this combined therapy. In our Center, we have been particularly impressed by the higher five-year survival rate in a group of patients with rectal carcinomas in Duke's Stage C, who received preoperative irradiation (2, 3). In 1960, the Head and Neck Service and the Department of Radiation Therapy of the Memorial Center...

Radiation Therapy in the Management of Cancers of the Oral Cavity and OropharynxRadiation Therapy in the Management of Cancers of the Oral Cavity and Oropharynx. By FletcherGilbert H., M.D., Radiotherapist, and MacCombWilliam S., M.D., Surgeon, Chief of Head and Neck Service. With the collaboration of BallantyneAlando J., M.D., Associate Surgeon, Head and Neck Service.Physics Section: The Calculation of Dose in

Radiation Therapy in the Management of Cancers of the Oral Cavity and Oropharynx<scp>Radiation Therapy in the Management of Cancers of the Oral Cavity and Oropharynx</scp>. By FletcherGilbert H., M.D., Radiotherapist, and MacCombWilliam S., M.D., Surgeon, Chief of Head and Neck Service. With the collaboration of BallantyneAlando J., M.D., Associate Surgeon, Head and Neck Service.<scp>Physics Section: The Calculation of Dose in

The Foundation scholarship trip: an opportunity for eclecticism.

†Formerly Resident in Plastic Surgery, The New York Hospital-Cornell Medical Center: Clinical Assistant Attending, Head and Neck Service, Memorial Hospital For Cancer and Allied Diseases, New York City

Nasopharyngeal Angiofibroma: Removal with Hypothermia

Nasopharyngeal fibroma is a relatively rare lesion, admissions for this to the Head and Neck Service of the Memorial Hospital in New York for example, representing only 1 in 1500 cases.^1,4Nevertheless, the serious and complicated nature of the lesion and the surgical problems encountered which can present enormous technical difficulties, are sufficient to warrant our most serious consideration. The tumor occurs almost exclusively in males, the incidence of reported occurrence in females being minute. Serious question has been raised as to whether or not, even in those few cases reported in females, the diagnosis has been correct.^2,6 There is considerable disagreement upon the relationship of the tumor to the processes of sexual growth. This is of considerable practical importance, since the concept of this relationship to the sex hormones is reflected in suggested plans of treatment. Some authors^7,9believe that with the development of sexual maturity,

A method of tracheotomy care.

In recent years, the indication for tracheotomy has been recognized more frequently. Severe accident cases, chest injuries, postoperative neurosurgical cases, and head and neck cases often require tracheotomy, not only to prevent immediate asphyxiation but also to promote a smoother post-traumatic or postoperative convalescence. The successful outcome of many of these cases is partially dependent on a systematic and efficient system of tracheotomy care. Experience has proved that this is often lacking on some surgical floors. Many of the patients admitted to the Head and Neck Service of the Roswell Park Memorial Institute require tracheotomy. It is the purpose of this paper to describe a simple and adequate method of tracheotomy care now in use on this Service. The method of care must take into consideration the alterations in physiology of the patient. First, the freshly tracheotomized patient is unable to cough efficiently and rid the tracheobronchial tree of secretions.

CANCER CLINICS: Tumor Conference from the Head and Neck Service, American Oncologic Hospital, Philadelphia, Pennsylvania

CA: A Cancer Journal for CliniciansVolume 6, Issue 1 p. 28-32 Cancer ClinicFree Access Tumor Conference from the Head and Neck Service, American Oncologic Hospital, Philadelphia, Pennsylvania S. Gordon Castigliano M.D., S. Gordon Castigliano M.D.Search for more papers by this author S. Gordon Castigliano M.D., S. Gordon Castigliano M.D.Search for more papers by this author First published: January 1956 https://doi.org/10.3322/canjclin.6.1.28AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume6, Issue1January 1956Pages 28-32 RelatedInformation

The case for prophylactic neck dissection.

CancerVolume 4, Issue 1 p. 92-97 ArticleFree Access The case for prophylactic neck dissection Hayes Martin M.D., Hayes Martin M.D. Head and Neck Service, Memorial Center for Cancer and Allied Diseases, New York, New YorkSearch for more papers by this author Hayes Martin M.D., Hayes Martin M.D. Head and Neck Service, Memorial Center for Cancer and Allied Diseases, New York, New YorkSearch for more papers by this author First published: January 1951 https://doi.org/10.1002/1097-0142(195101)4:1<92::AID-CNCR2820040109>3.0.CO;2-JCitations: 29AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume4, Issue1January 1951Pages 92-97 RelatedInformation