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Hemangiomas of the parotid region in children
INTERNATIONAL ABSTRACTS OF PEDIATRIC SURGERY
sacrifice important structures. Although surgical treatment is the method of choice, modern technics of irradiation should be used in attempting to control lesions that cannot be controlled surgically.--N. K. ConnoUy. HEMANGIOIX{AS OF THE PAROTID REClON IN CHIL-
9REN. P. Aubrespy, M. Pierre, S. Derlon and J, P. Jouglard. Ann. Chir. Infant. 7:173-188, 1966. In cavernous henaangiomas of the parotid region in infants and children radiotherapy and curie-therapy are not advisable because of secondary lesions such as necrosis of the mandible, x-ray dermatitis, atrophy of the face, etc. Surgical excision is more satisfactory, but only if the facial nerve is spared. The authors operated upon 9 cases between 1963 and 1965. Hemostasis necessitated temporary or pernlanent ligature of the A. carotis externa in all patients. The facial nerve was always exposed from its emergence toward the periphery and could be spared in all cases; however, only 3 children had no facial paralysis following surgery. 6 patients had a more or less severe postoperative facial paralysis which disappeared in all but 1 after 2 to 3 months. The overall results are good and no recurrences were observed.--M. Bettex. CONGENITAL TUMORS OF THE PAROTID GLAND.
G. F. Vawter and M. Tefft. Arch. Path. (Chicago) 82:240-245, September 1966. Two cases of newborn infants with a parotid tumor are reported. In each case the lesion was present at birth and was treated with wide local excision followed by irradiation and chemotherapy. Each ease had facial palsy postoperatively. One case was alive and well without evidence of tumor at 3 years of age, and the other case was alive and well without evidence of tumor at 12 years of age, although this latter case had 2 local recurrences in the first year after surgery which required additional excision. A detailed description of the histopathology, including photomicrographs, is presented. The authors suggest the term embryoma to designate the tumors. They are considered to have a local malignant potential, but amenable to surgical treatment.--D. T. Cloud. TaYuOID CARCINOMA AND X-IRRADIATION. F. N. Silverman. Pediatrics 38:943-945, December 1966.
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This authoritative review of the etiological association of x-irradiation and thyroid carcinoma emphasizes that up to the present there are approximately 300 documented cases of thyroid carcinoma preceded by therapeutic irradiation, thus firmly establishing this relationship. In these patients x-ray dosage has usually exceeded 250 rad. and the safe threshold level appears to be 10O rad. It is emphasized that diagnostic x-ray studies are below 1/1000 of this. Even extensive studies rarely approach to 1 per cent of this figure. Indicated diagnostic procedures should therefore never be withheld. Ionizing radiation from therapeutic use of [ lal in children has been associated with tile subsequent development of thyroid cancer in 3 instances. While there have been no instances of carcinoma in patients following diagnostic doses of 1131 in children the safety of the diagnostic use is still being debated.--W. K. Sieber. CERVICOMEDIASTINAL CYSTIC HYGROMA: ONESTAGE EXCISION IN AN EIGHT-WEEK-OLD INFANT. P. A, Kirschner. Surgery 60:1104-1107,
November 1966. The author reports a case of an 8-week old infant who developed symptoms of acute respiratory obstruction from a large cervicomediastinal cystic hygroma. The lesion was removed in a single staged procedure utilizing a median sternotomy which offered excellent surgical access to the area.--D. T, Cloud.
THORAX THE 19ULlkIONARY SYNDROME OF WILSON AND MIKITY, AND RESPIRATORY FUNCTION IN VERY
SMALL PREMATURE INFANTS. E. D. Burnard. Pediat. Clin. N. Amer. 13:999, November 1966. The eponym is preferred at present as causation is obscure. Prolonged dyspnea develops in a premature infant usually 3 or 4 days after birth or later, accompanied by a distinctive radiographic picture appearing as a rule in the first month. Grossman et al. described this picture as "bilateral diffuse reticulonodular or reticular pattern with small round lucent loci producing a bubbly appearance." These changes progress to better defined densities and coarse streaks radiating from the hilus by the fourth month. In favorable cases, resolution occurs by the age of 1 year.
sacrifice important structures. Although surgical treatment is the method of choice, modern technics of irradiation should be used in attempting to control lesions that cannot be controlled surgically.--N. K. ConnoUy. HEMANGIOIX{AS OF THE PAROTID REClON IN CHIL-
9REN. P. Aubrespy, M. Pierre, S. Derlon and J, P. Jouglard. Ann. Chir. Infant. 7:173-188, 1966. In cavernous henaangiomas of the parotid region in infants and children radiotherapy and curie-therapy are not advisable because of secondary lesions such as necrosis of the mandible, x-ray dermatitis, atrophy of the face, etc. Surgical excision is more satisfactory, but only if the facial nerve is spared. The authors operated upon 9 cases between 1963 and 1965. Hemostasis necessitated temporary or pernlanent ligature of the A. carotis externa in all patients. The facial nerve was always exposed from its emergence toward the periphery and could be spared in all cases; however, only 3 children had no facial paralysis following surgery. 6 patients had a more or less severe postoperative facial paralysis which disappeared in all but 1 after 2 to 3 months. The overall results are good and no recurrences were observed.--M. Bettex. CONGENITAL TUMORS OF THE PAROTID GLAND.
G. F. Vawter and M. Tefft. Arch. Path. (Chicago) 82:240-245, September 1966. Two cases of newborn infants with a parotid tumor are reported. In each case the lesion was present at birth and was treated with wide local excision followed by irradiation and chemotherapy. Each ease had facial palsy postoperatively. One case was alive and well without evidence of tumor at 3 years of age, and the other case was alive and well without evidence of tumor at 12 years of age, although this latter case had 2 local recurrences in the first year after surgery which required additional excision. A detailed description of the histopathology, including photomicrographs, is presented. The authors suggest the term embryoma to designate the tumors. They are considered to have a local malignant potential, but amenable to surgical treatment.--D. T. Cloud. TaYuOID CARCINOMA AND X-IRRADIATION. F. N. Silverman. Pediatrics 38:943-945, December 1966.
183
This authoritative review of the etiological association of x-irradiation and thyroid carcinoma emphasizes that up to the present there are approximately 300 documented cases of thyroid carcinoma preceded by therapeutic irradiation, thus firmly establishing this relationship. In these patients x-ray dosage has usually exceeded 250 rad. and the safe threshold level appears to be 10O rad. It is emphasized that diagnostic x-ray studies are below 1/1000 of this. Even extensive studies rarely approach to 1 per cent of this figure. Indicated diagnostic procedures should therefore never be withheld. Ionizing radiation from therapeutic use of [ lal in children has been associated with tile subsequent development of thyroid cancer in 3 instances. While there have been no instances of carcinoma in patients following diagnostic doses of 1131 in children the safety of the diagnostic use is still being debated.--W. K. Sieber. CERVICOMEDIASTINAL CYSTIC HYGROMA: ONESTAGE EXCISION IN AN EIGHT-WEEK-OLD INFANT. P. A, Kirschner. Surgery 60:1104-1107,
November 1966. The author reports a case of an 8-week old infant who developed symptoms of acute respiratory obstruction from a large cervicomediastinal cystic hygroma. The lesion was removed in a single staged procedure utilizing a median sternotomy which offered excellent surgical access to the area.--D. T, Cloud.
THORAX THE 19ULlkIONARY SYNDROME OF WILSON AND MIKITY, AND RESPIRATORY FUNCTION IN VERY
SMALL PREMATURE INFANTS. E. D. Burnard. Pediat. Clin. N. Amer. 13:999, November 1966. The eponym is preferred at present as causation is obscure. Prolonged dyspnea develops in a premature infant usually 3 or 4 days after birth or later, accompanied by a distinctive radiographic picture appearing as a rule in the first month. Grossman et al. described this picture as "bilateral diffuse reticulonodular or reticular pattern with small round lucent loci producing a bubbly appearance." These changes progress to better defined densities and coarse streaks radiating from the hilus by the fourth month. In favorable cases, resolution occurs by the age of 1 year.