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Surgery in advanced oral cavity carcinoma after chemotherapy
P222
OtolaryngologyHead and Neck Surgery August 1999
Scientific Posters
pathology, and treatment of DFSP is presented with the use of intraoperative, postoperative, and serial reconstruction photographs. Special emphasis is made on the role of MMS and the use of tissue expanders in reconstruction of the hair-bearing scalp. 64
Frontal Sinus Obliteration with the Pericranial Flap
bilateral vestibular aplasia who showed a transient geotropic DCPN with normal cochlear development. We used routine audiometry, electronystagmography, and radiologic evaluation. Results: In electronystagmography, we noted directionchanging positional nystagmus. We also noted congenital vestibular aplasia on CT. Other tests showed normal results. Conclusion: The authors report that congenital vestibular aplasia can be one cause of DCPN and report its possible mechanism.
AFSHIN PARHISCAR MD; GADY HAR-EL MD; Brooklyn NY; Fresh Meadows NY
Objectives: To introduce the technique of obliteration of the frontal sinus with the pericranial flap and to review our experience. Methods: The records of 10 patients who underwent frontal sinus obliteration with the pericranial flap were reviewed. Demographics, indications for frontal sinus obliteration, frontal sinus size, pericranial flap size, immediate and late complications, and long-term outcome were recorded. These results were then compared with those published in the current literature. Results: Ten sinuses were obliterated by the pericranial flap. Indications included frontal sinus mucoceles, mucopyoceles, frontal sinus osteomyelitis, and frontal sinus fractures. The mean sinus size was 10.7 cm3, the mean pericranial flap size was 24.8 cm2, and the median follow up was 3 years. There was 1 short-term complication of persistent headaches for 1 month. There was asymptomatic recurrence of a "netfrontal" sinus in 1 case. Conclusions: Frontal sinus obliteration with the pericranial flap is an effective alternative to other available options. The pericranial flap is a vascularized flap that is easily harvested. The use of the pericranial flap prevents donor site morbidities associated with free fat or cancellous bone grafts. The pericranial flap works best in smaller sinuses. 65
Congenital Vestibular Aplasia with Direction-Changing Positional Nystagmus WOON KYO CHUNG MD; JUNG PYOE HONG MD; Seoul South Korea
Objectives: Direction-changing positional nystagmus (DCPN) is defined as nystagmus that changes its direction with change in head and body positions. In the past, DCPN has been believed to be the sign of a central vestibular system lesion. But recently there have been some reports that the existence of DCPN does not always indicate the site of lesion to be in the central vestibular pathway; more often it indicates a peripheral vestibular lesion site. Until now, congenital vestibular aplasia has not been reported to be a cause of DCPN. Methods: Recently, we treated a 17-year-old patient with
66
Surgery in Advanced Oral Cavity Carcinoma after Chemotherapy CHING-YI YIU MD; HUI-CHEN HSU MD; CHEN-YI HSU MD; JINCHING LIN MD; Taichung Taiwan (Republic of China)
Objectives: Combination therapy has been proved to be a standard treatment for advanced, unresectable oral cavity carcinomas. Induction chemotherapy with several combined drugs followed by radical surgery seems to achieve excellent results. Using the disease-free interval and 5-year survival rate, this study retrospectively evaluates the role of radical surgery in advanced oral cavity carcinoma after induction chemotherapy. Methods: Thirty-five advanced oral cavity carcinoma patients who received induction chemotherapy with CDDP 25 mg/m2, 5-FU 1000 mg/m2, bleomycin 10 mg/m2, methotrexate 30 mg/m2, and epirubicin 30 mg/m2 alternately biweekly. Radical surgery as previously planned was given 2 weeks later after induction chemotherapy was completed. The diseasefree interval and 5-year survival rate were calculated by the Kaplan-Meier method. Results: In the complete response group after induction chemotherapy, the median disease-free interval was 60 months, and the 5-year survival rate was 88%. However, in the partial response group, the median disease-free interval was 11 months, and the 5-year survival rate was 56%. Conclusion: Radical surgery still plays a role in advanced, unresectable oral cavity carcinoma patients after induction chemotherapy. If a complete response is achieved after chemotherapy, the disease-free interval and 5-year survival rate will be significantly better than if a partial response is achieved. 67
Acinic Cell Carcinoma of the Nasal Septum MICHAEL E JASIN MD; ROBERT HUTCHUNSON MD; Tampa FL
Objectives: Acinic cell carcinoma is a neoplasm uncommonly found in the minor salivary glands. Presented is the first report of a case of aciuic cell carcinoma arising from the nasal septum. Methods: This is a report of a 44-year-old white woman
OtolaryngologyHead and Neck Surgery August 1999
Scientific Posters
pathology, and treatment of DFSP is presented with the use of intraoperative, postoperative, and serial reconstruction photographs. Special emphasis is made on the role of MMS and the use of tissue expanders in reconstruction of the hair-bearing scalp. 64
Frontal Sinus Obliteration with the Pericranial Flap
bilateral vestibular aplasia who showed a transient geotropic DCPN with normal cochlear development. We used routine audiometry, electronystagmography, and radiologic evaluation. Results: In electronystagmography, we noted directionchanging positional nystagmus. We also noted congenital vestibular aplasia on CT. Other tests showed normal results. Conclusion: The authors report that congenital vestibular aplasia can be one cause of DCPN and report its possible mechanism.
AFSHIN PARHISCAR MD; GADY HAR-EL MD; Brooklyn NY; Fresh Meadows NY
Objectives: To introduce the technique of obliteration of the frontal sinus with the pericranial flap and to review our experience. Methods: The records of 10 patients who underwent frontal sinus obliteration with the pericranial flap were reviewed. Demographics, indications for frontal sinus obliteration, frontal sinus size, pericranial flap size, immediate and late complications, and long-term outcome were recorded. These results were then compared with those published in the current literature. Results: Ten sinuses were obliterated by the pericranial flap. Indications included frontal sinus mucoceles, mucopyoceles, frontal sinus osteomyelitis, and frontal sinus fractures. The mean sinus size was 10.7 cm3, the mean pericranial flap size was 24.8 cm2, and the median follow up was 3 years. There was 1 short-term complication of persistent headaches for 1 month. There was asymptomatic recurrence of a "netfrontal" sinus in 1 case. Conclusions: Frontal sinus obliteration with the pericranial flap is an effective alternative to other available options. The pericranial flap is a vascularized flap that is easily harvested. The use of the pericranial flap prevents donor site morbidities associated with free fat or cancellous bone grafts. The pericranial flap works best in smaller sinuses. 65
Congenital Vestibular Aplasia with Direction-Changing Positional Nystagmus WOON KYO CHUNG MD; JUNG PYOE HONG MD; Seoul South Korea
Objectives: Direction-changing positional nystagmus (DCPN) is defined as nystagmus that changes its direction with change in head and body positions. In the past, DCPN has been believed to be the sign of a central vestibular system lesion. But recently there have been some reports that the existence of DCPN does not always indicate the site of lesion to be in the central vestibular pathway; more often it indicates a peripheral vestibular lesion site. Until now, congenital vestibular aplasia has not been reported to be a cause of DCPN. Methods: Recently, we treated a 17-year-old patient with
66
Surgery in Advanced Oral Cavity Carcinoma after Chemotherapy CHING-YI YIU MD; HUI-CHEN HSU MD; CHEN-YI HSU MD; JINCHING LIN MD; Taichung Taiwan (Republic of China)
Objectives: Combination therapy has been proved to be a standard treatment for advanced, unresectable oral cavity carcinomas. Induction chemotherapy with several combined drugs followed by radical surgery seems to achieve excellent results. Using the disease-free interval and 5-year survival rate, this study retrospectively evaluates the role of radical surgery in advanced oral cavity carcinoma after induction chemotherapy. Methods: Thirty-five advanced oral cavity carcinoma patients who received induction chemotherapy with CDDP 25 mg/m2, 5-FU 1000 mg/m2, bleomycin 10 mg/m2, methotrexate 30 mg/m2, and epirubicin 30 mg/m2 alternately biweekly. Radical surgery as previously planned was given 2 weeks later after induction chemotherapy was completed. The diseasefree interval and 5-year survival rate were calculated by the Kaplan-Meier method. Results: In the complete response group after induction chemotherapy, the median disease-free interval was 60 months, and the 5-year survival rate was 88%. However, in the partial response group, the median disease-free interval was 11 months, and the 5-year survival rate was 56%. Conclusion: Radical surgery still plays a role in advanced, unresectable oral cavity carcinoma patients after induction chemotherapy. If a complete response is achieved after chemotherapy, the disease-free interval and 5-year survival rate will be significantly better than if a partial response is achieved. 67
Acinic Cell Carcinoma of the Nasal Septum MICHAEL E JASIN MD; ROBERT HUTCHUNSON MD; Tampa FL
Objectives: Acinic cell carcinoma is a neoplasm uncommonly found in the minor salivary glands. Presented is the first report of a case of aciuic cell carcinoma arising from the nasal septum. Methods: This is a report of a 44-year-old white woman