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Foetal rhabdomyoma
352
ABSTRACTS
mia. Documented particularly is the use of Dantrolene Sodium in the m a n a g e m e n t of this condition.--Anthony H. Alter
The Challenge of Large Facial Hamartomas and Other Benign Conditions of the Head and Neck. J. E. Woods, J. K.
Bacterial Colonization. Tracheobronchitis, and Pneumonia Following Tracheostomy and Long-Term Intubation in Pediatric Patients. I. Brook. Chest 76:420-424, (October),
Ten cases of large facial hamartomas, including large hemangiomas, arteriovenous malformations, invasive facial lymphangiomas, advanced fibrous dysplasia, vascular plexiform neuromas, and dermoid tumors of the neck are presented. Eight of the ten patients were 21 yr old or younger. Accompanying photographs indicate that improvement of varying degrees was achieved in all patients. The complexity of surgical resection and the multiple surgeries required for improvement are emphasized.--Jane F. Goldthorn
1979. Twenty-seven pediatric patients ages 2 to 16 yr requiring tracheostomy and long-term intubation (3 mo to 1 yr) underwent a prospective analysis of bacterial colonization of the trachea and the subsequent relationship to the development of clinical infection. All patients became colonized with 21 growing both aerobic and anaerobic organisms and six growing only aerobes. Twenty-four patients developed chronic tracheobronchitis with 68 recurrent episodes of pneumonia. In almost half of these patients a change in the flora occurred prior to the episode of pneumonia. The most frequently isolated aerobes were Klebsiella pneumoniae and Staphylococcus aureus and the predominant anaerobic bacteria included Peptostreptococcus sp, Fusobacterium nucleatum and Bacteroides fragilis. In all cultures 2.2 aerobes and 1.2 anaerobes grew out per specimen. This high an incidence of anaerobic isolates has not been reported previously. The role of anaerobic bacteria in colonization and active infections in pediatric patients with long-term tracheostomy must be considered in the management of these patients.--Randall IV. Powell
INTEGUMENT AND CONNECTIVE TISSUE Surgical Transplantation of Warts. J. M. Noe and R. A.
Masson, G. B. Irons. A m J Surg 138:521 527, (October), 1979.
Therapeutic Embolization of Juvenile Angiofibroma. G. H.
Roberson, A. C. Price, J. M. Davis, et al. A m J Roentgenol 133:657-663, (October), 1979. Fifteen males aged 12-18 yr underwent angiographic embolization of nasopharyngeal juvenile angiofibromas. Angiography accurately delineates the extent of tumor, amount of vascularity, and the anatomy of the feeding vessels. Prior to embolization operative blood loss averaged 2400 cc and after embolization the loss averaged 800 cc with seven patients losing less than 500 cc. No significant complications occurred but scalp pain due to transient ischemia occurred in five patients. Special care to prevent cerebral embolization is stressed. The authors feel preoperative embolization of juvenile angiofibromas is a useful preoperative adjunct.--Randall W. Powell
Chase. Plast Reconst Surg 64:101-103, (July), 1979. A case report is given concerning the inadvertant surgical transfer of the common wart (verruca vulgaris) during a hand procedure. Essentially, a wart was excised in the line of an incision used for obtaining the palmaris tendon for a tendon transplant. Postoperatively, there were warts present in multiple areas of the incision sites utilized for the tendon transplant. An excellent discussion of the common viral lesion follows. The authors make a recommendation that the wart should not be excised during the initial part of the operation.--A. B. Sokol
HEAD AND NECK Unusual Facial Hemangioma. H. Ohtsuka, S. Katayama, N. Shioya. Plast Reconstr Surg 64:13-16, (July), 1979.
A case report of a venous hemangioma is given. This patient is a 7-yr-old Oriental female who had been noted to have the presence of a temporal mass at birth. The mass was stable until ages 5 and 6 and began to increase rapidly, not only in the temporal area, but the cheek area as well. The surgery was through a temporal approach that revealed a hemangioma between the temporalis fascia and the temporal muscle that extended down into the masticator space and required a second incision made in the mouth where the tumor was removed. The histology revealed the venous hemangioma. The case is presented for purposes of instruction in rapidly growing unilateral masses and the unusual approach required to surgically remove it.--A. B. Sokol
Foetal Rhabdomyoma. S. E. Meeham and R. M. Davie. J
Royal Coil Surg Edinb 24:4, (July), 1979. Fetal rhabdomyoma is a rare subcutaneous benign tumor consisting of immature fetal type skeletal muscle cells found in the postauricular region of the neck in young children. The authors report their findings in the m a n a g e m e n t of 6-mo-old child and discuss a previous report of 9 cases. The tumor presents as a symptomless lobulated mass in the neck. Excision reveals a soft grey tissue which is well encapsulated. Histologically, there is cellular maturation at the edge of the tumor with little pleomorphism and mitotic activity. The authors stress the importance of differentiating this benign tumor from rhabdomyosarcoma and treating it by local excision alone.--W. G. Scobie CT Findings in Retinoblastoma. A. Danziger and H. L Price. A m J Roentgenol 133:783-785, (October), 1979.
Thirty-eight patients underwent C T scans to evaluate extent and possible intracranial extension of retinoblastoma that were later confirmed at surgery. Twenty-three had grade I tumors (confined to globe), 10 patients had grade II tumors (tumor extending retroorbitally or along optic nerve), and 5 had grade III tumors (extension beyond confines of orbit or intracranially). CT scans accurately reveal extent of tumor extension. T u m o r calcification, seen in 1 of 23 grade I, 2 of 10 grade 1I and 0 of 5 grade III tumors, may represent a favorable prognostic sign.--Randall W. Powell
ABSTRACTS
mia. Documented particularly is the use of Dantrolene Sodium in the m a n a g e m e n t of this condition.--Anthony H. Alter
The Challenge of Large Facial Hamartomas and Other Benign Conditions of the Head and Neck. J. E. Woods, J. K.
Bacterial Colonization. Tracheobronchitis, and Pneumonia Following Tracheostomy and Long-Term Intubation in Pediatric Patients. I. Brook. Chest 76:420-424, (October),
Ten cases of large facial hamartomas, including large hemangiomas, arteriovenous malformations, invasive facial lymphangiomas, advanced fibrous dysplasia, vascular plexiform neuromas, and dermoid tumors of the neck are presented. Eight of the ten patients were 21 yr old or younger. Accompanying photographs indicate that improvement of varying degrees was achieved in all patients. The complexity of surgical resection and the multiple surgeries required for improvement are emphasized.--Jane F. Goldthorn
1979. Twenty-seven pediatric patients ages 2 to 16 yr requiring tracheostomy and long-term intubation (3 mo to 1 yr) underwent a prospective analysis of bacterial colonization of the trachea and the subsequent relationship to the development of clinical infection. All patients became colonized with 21 growing both aerobic and anaerobic organisms and six growing only aerobes. Twenty-four patients developed chronic tracheobronchitis with 68 recurrent episodes of pneumonia. In almost half of these patients a change in the flora occurred prior to the episode of pneumonia. The most frequently isolated aerobes were Klebsiella pneumoniae and Staphylococcus aureus and the predominant anaerobic bacteria included Peptostreptococcus sp, Fusobacterium nucleatum and Bacteroides fragilis. In all cultures 2.2 aerobes and 1.2 anaerobes grew out per specimen. This high an incidence of anaerobic isolates has not been reported previously. The role of anaerobic bacteria in colonization and active infections in pediatric patients with long-term tracheostomy must be considered in the management of these patients.--Randall IV. Powell
INTEGUMENT AND CONNECTIVE TISSUE Surgical Transplantation of Warts. J. M. Noe and R. A.
Masson, G. B. Irons. A m J Surg 138:521 527, (October), 1979.
Therapeutic Embolization of Juvenile Angiofibroma. G. H.
Roberson, A. C. Price, J. M. Davis, et al. A m J Roentgenol 133:657-663, (October), 1979. Fifteen males aged 12-18 yr underwent angiographic embolization of nasopharyngeal juvenile angiofibromas. Angiography accurately delineates the extent of tumor, amount of vascularity, and the anatomy of the feeding vessels. Prior to embolization operative blood loss averaged 2400 cc and after embolization the loss averaged 800 cc with seven patients losing less than 500 cc. No significant complications occurred but scalp pain due to transient ischemia occurred in five patients. Special care to prevent cerebral embolization is stressed. The authors feel preoperative embolization of juvenile angiofibromas is a useful preoperative adjunct.--Randall W. Powell
Chase. Plast Reconst Surg 64:101-103, (July), 1979. A case report is given concerning the inadvertant surgical transfer of the common wart (verruca vulgaris) during a hand procedure. Essentially, a wart was excised in the line of an incision used for obtaining the palmaris tendon for a tendon transplant. Postoperatively, there were warts present in multiple areas of the incision sites utilized for the tendon transplant. An excellent discussion of the common viral lesion follows. The authors make a recommendation that the wart should not be excised during the initial part of the operation.--A. B. Sokol
HEAD AND NECK Unusual Facial Hemangioma. H. Ohtsuka, S. Katayama, N. Shioya. Plast Reconstr Surg 64:13-16, (July), 1979.
A case report of a venous hemangioma is given. This patient is a 7-yr-old Oriental female who had been noted to have the presence of a temporal mass at birth. The mass was stable until ages 5 and 6 and began to increase rapidly, not only in the temporal area, but the cheek area as well. The surgery was through a temporal approach that revealed a hemangioma between the temporalis fascia and the temporal muscle that extended down into the masticator space and required a second incision made in the mouth where the tumor was removed. The histology revealed the venous hemangioma. The case is presented for purposes of instruction in rapidly growing unilateral masses and the unusual approach required to surgically remove it.--A. B. Sokol
Foetal Rhabdomyoma. S. E. Meeham and R. M. Davie. J
Royal Coil Surg Edinb 24:4, (July), 1979. Fetal rhabdomyoma is a rare subcutaneous benign tumor consisting of immature fetal type skeletal muscle cells found in the postauricular region of the neck in young children. The authors report their findings in the m a n a g e m e n t of 6-mo-old child and discuss a previous report of 9 cases. The tumor presents as a symptomless lobulated mass in the neck. Excision reveals a soft grey tissue which is well encapsulated. Histologically, there is cellular maturation at the edge of the tumor with little pleomorphism and mitotic activity. The authors stress the importance of differentiating this benign tumor from rhabdomyosarcoma and treating it by local excision alone.--W. G. Scobie CT Findings in Retinoblastoma. A. Danziger and H. L Price. A m J Roentgenol 133:783-785, (October), 1979.
Thirty-eight patients underwent C T scans to evaluate extent and possible intracranial extension of retinoblastoma that were later confirmed at surgery. Twenty-three had grade I tumors (confined to globe), 10 patients had grade II tumors (tumor extending retroorbitally or along optic nerve), and 5 had grade III tumors (extension beyond confines of orbit or intracranially). CT scans accurately reveal extent of tumor extension. T u m o r calcification, seen in 1 of 23 grade I, 2 of 10 grade 1I and 0 of 5 grade III tumors, may represent a favorable prognostic sign.--Randall W. Powell