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Irradiation mucositis: Prevention and treatment
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in increasing the overall muscle strength of the study subjects. They conclude that further studies of the relationship between vitamin DJ and muscle strength need to be done, because of possible weaknesses in their study (eg, it may have used an inadequate dose of vitamin D+W.J. STARCK
Airway Management for Trauma Patients With Potential Cervical Spine Injuries. Hastings RH, Marks JD Anesth Analg 73:471, 1991 In this article, the mechanisms of traumatic cervical spine injury, physical and radiologic examination, and methods for initially stabilizing the injured spine are reviewed. The advantages and disadvantages of alternative methods of establishing an airway in patients with actual or potential cervical spine trauma are reviewed. A case-specific strategy for airway management for patients with potential cervical spine (C-spine) injuries based on limited studies, the estimated risks of iatrogenic spinal cord injury, and the anticipated benefits and pitfalls of the various airway control techniques in specific clinical situations are discussed. The C-spine is the most mobile portion of the vertebral column. It is the most susceptible to excessive movement and injury during impact accidents. Hyperextension injuries can occur with blows to the face or head. There is an overall 1% to 3% risk of C-spine injury in major trauma patients. Victims of headfirst falls or high-speed motor vehicle accidents have a 10% or greater chance of an injury. C-spine roentgenograms showing normal results do not eliminate the possibility of an injury. Most victims are men between 15 and 35 years old. Young children are less vulnerable to C-spine injury, presumably because they weigh less and have more cartilage than adults. Alert patients without neck pain or tenderness probably do not have cervical injury and should not require further C-spine evaluation, neck immobilization, or special precautions during airway management. The presence of facial injuries does not increase the likelihood of a C-spine injury above the 1% to 3% incidence for trauma patients. Three standard radiographic views of the C-spine should be obtained early in the evaluation. All seven vertebrae must be examined because 20% of all Cspine injuries are at C-7. The “gold standard” is computed tomography (CT) scan.-P.H. ARTENBERG Reprint requests to Dr Hastings: San Francisco General Hospital, Department of Anesthesia, 3S-50,lOOl Potrero Ave, San Francisco, CA 94110.
Salivary Gland Tumors in Children. Luna MA, Batsakis JG, El-Naggar AK. Ann Otol Rhino1 Laryngol 100:869, 199 1 Fewer than 5% of all primary salivary gland neoplasms occur in children, but if benign supporting tissue tumors are excluded, a higher proportion than in adults are malignant. In the first decade of life, particularly the first 2 years, the preponderance of neoplasms are benign. In the second decade, the incidence of carcinomas increases. Most are mucoepidermoid and acinic cell carcinomata. Pleomorphic adenoma is the most common epithelial salivary tumor throughout childhood. The embryoma may be a uniquely childhood epithelial salivary gland tumor.-G.H. SPERBER Reprint requeststo Dr BatsakiszDepartment of Pathology, University of Texas, 15 15 Holcomhe Blvd, Houston, TX 77030.
CURRENT LITERATURE
Rosai-Dorfman Disease Involving the Premaxilla. Shemen L, D’Anton M, Klijian A, et al. Ann Otol Rhino1 Laryngol 100:845, 1991 Sinus histiocytosis with massive lymphadenopathy (SHML) described by Rosai and Dorfman (1969) is a benign, self-limited pseudolymphomatous entity with characteristic histopathology. Massive cervical lymphadenopathy often aids in the diagnosis of SHML, although the disease may appear in the absence of detectable nodal involvement. A review of 365 cases showed a preponderance of eyelid and/or orbital involvement; only 26 cases were found with subcutaneous or soft-tissue involvement other than the eyelid or orbit. This report of a right recurrent nasofacial mass involving the premaxilla and not the orbit or eyelid represents an atypical presentation of SHML. Resections were performed and radiotherapy administered, without recurrence. A premaxillary prosthesis was placed.-G.H. SPERBER Reprint requests to Dr Shemen: 233 E. 69th St, New York, NY 10021.
New Book Annotations Imaging of the Temporomandibular Joint. Westesson P-L, Katzberg, RW (eds), with 12 contributors. Cranio Clinics International, vol 1, no 1, Baltimore, MD, Williams & Wilkins, 1991, $65.00 This text provides an overview of the various imaging procedures used for the diagnosis of temporomandibular joint disorders. Particular emphasis is placed on internal derangements. Covered are plain film imaging and tomography, computed tomography, arthrography, magnetic resonance imaging, and nuclear medicine imaging. In addition, there are chapters on imaging for such specific conditions as rheumatoid arthritis and internal derangement, as well as one on differential diagnosis of craniofacial pain. Irradiation Mucositis: Prevention and Treatment. SpijkeNet FKL. Copenhagen, Denmark, Munksgaard, 199 1, 136 pages, illustrated, paperback This monograph on irradiation mucositis combines both clinical information and research data. Based on discussions of assessment of oral defenses, selective elimination of oral flora, and use of chlorhexidine mouth rinses, the author proposes methods for the prevention of this debilitating condition. Facial Pain (ed 3). Mahan PE, Alling CC, III. Philadelphia, PA, Lea & Febiger, 199 1,376 pages, 229 illustrations, $59.00 This new edition represents the works of two authors rather than of the 20 contributors who participated in the previous edition. The text has therefore been completely reorganized and updated. It covers diagnostic procedures, the psychopathology of pain, and pain originating from the musculoskeletal system, the temporomandibular joint, the vascular and nervous systems, the oral and nasal cavities, and the salivary glands. Each of these major areas is extensively covered, with emphasis on the application of the basic biomedical sciences to the clinical conditions.
in increasing the overall muscle strength of the study subjects. They conclude that further studies of the relationship between vitamin DJ and muscle strength need to be done, because of possible weaknesses in their study (eg, it may have used an inadequate dose of vitamin D+W.J. STARCK
Airway Management for Trauma Patients With Potential Cervical Spine Injuries. Hastings RH, Marks JD Anesth Analg 73:471, 1991 In this article, the mechanisms of traumatic cervical spine injury, physical and radiologic examination, and methods for initially stabilizing the injured spine are reviewed. The advantages and disadvantages of alternative methods of establishing an airway in patients with actual or potential cervical spine trauma are reviewed. A case-specific strategy for airway management for patients with potential cervical spine (C-spine) injuries based on limited studies, the estimated risks of iatrogenic spinal cord injury, and the anticipated benefits and pitfalls of the various airway control techniques in specific clinical situations are discussed. The C-spine is the most mobile portion of the vertebral column. It is the most susceptible to excessive movement and injury during impact accidents. Hyperextension injuries can occur with blows to the face or head. There is an overall 1% to 3% risk of C-spine injury in major trauma patients. Victims of headfirst falls or high-speed motor vehicle accidents have a 10% or greater chance of an injury. C-spine roentgenograms showing normal results do not eliminate the possibility of an injury. Most victims are men between 15 and 35 years old. Young children are less vulnerable to C-spine injury, presumably because they weigh less and have more cartilage than adults. Alert patients without neck pain or tenderness probably do not have cervical injury and should not require further C-spine evaluation, neck immobilization, or special precautions during airway management. The presence of facial injuries does not increase the likelihood of a C-spine injury above the 1% to 3% incidence for trauma patients. Three standard radiographic views of the C-spine should be obtained early in the evaluation. All seven vertebrae must be examined because 20% of all Cspine injuries are at C-7. The “gold standard” is computed tomography (CT) scan.-P.H. ARTENBERG Reprint requests to Dr Hastings: San Francisco General Hospital, Department of Anesthesia, 3S-50,lOOl Potrero Ave, San Francisco, CA 94110.
Salivary Gland Tumors in Children. Luna MA, Batsakis JG, El-Naggar AK. Ann Otol Rhino1 Laryngol 100:869, 199 1 Fewer than 5% of all primary salivary gland neoplasms occur in children, but if benign supporting tissue tumors are excluded, a higher proportion than in adults are malignant. In the first decade of life, particularly the first 2 years, the preponderance of neoplasms are benign. In the second decade, the incidence of carcinomas increases. Most are mucoepidermoid and acinic cell carcinomata. Pleomorphic adenoma is the most common epithelial salivary tumor throughout childhood. The embryoma may be a uniquely childhood epithelial salivary gland tumor.-G.H. SPERBER Reprint requeststo Dr BatsakiszDepartment of Pathology, University of Texas, 15 15 Holcomhe Blvd, Houston, TX 77030.
CURRENT LITERATURE
Rosai-Dorfman Disease Involving the Premaxilla. Shemen L, D’Anton M, Klijian A, et al. Ann Otol Rhino1 Laryngol 100:845, 1991 Sinus histiocytosis with massive lymphadenopathy (SHML) described by Rosai and Dorfman (1969) is a benign, self-limited pseudolymphomatous entity with characteristic histopathology. Massive cervical lymphadenopathy often aids in the diagnosis of SHML, although the disease may appear in the absence of detectable nodal involvement. A review of 365 cases showed a preponderance of eyelid and/or orbital involvement; only 26 cases were found with subcutaneous or soft-tissue involvement other than the eyelid or orbit. This report of a right recurrent nasofacial mass involving the premaxilla and not the orbit or eyelid represents an atypical presentation of SHML. Resections were performed and radiotherapy administered, without recurrence. A premaxillary prosthesis was placed.-G.H. SPERBER Reprint requests to Dr Shemen: 233 E. 69th St, New York, NY 10021.
New Book Annotations Imaging of the Temporomandibular Joint. Westesson P-L, Katzberg, RW (eds), with 12 contributors. Cranio Clinics International, vol 1, no 1, Baltimore, MD, Williams & Wilkins, 1991, $65.00 This text provides an overview of the various imaging procedures used for the diagnosis of temporomandibular joint disorders. Particular emphasis is placed on internal derangements. Covered are plain film imaging and tomography, computed tomography, arthrography, magnetic resonance imaging, and nuclear medicine imaging. In addition, there are chapters on imaging for such specific conditions as rheumatoid arthritis and internal derangement, as well as one on differential diagnosis of craniofacial pain. Irradiation Mucositis: Prevention and Treatment. SpijkeNet FKL. Copenhagen, Denmark, Munksgaard, 199 1, 136 pages, illustrated, paperback This monograph on irradiation mucositis combines both clinical information and research data. Based on discussions of assessment of oral defenses, selective elimination of oral flora, and use of chlorhexidine mouth rinses, the author proposes methods for the prevention of this debilitating condition. Facial Pain (ed 3). Mahan PE, Alling CC, III. Philadelphia, PA, Lea & Febiger, 199 1,376 pages, 229 illustrations, $59.00 This new edition represents the works of two authors rather than of the 20 contributors who participated in the previous edition. The text has therefore been completely reorganized and updated. It covers diagnostic procedures, the psychopathology of pain, and pain originating from the musculoskeletal system, the temporomandibular joint, the vascular and nervous systems, the oral and nasal cavities, and the salivary glands. Each of these major areas is extensively covered, with emphasis on the application of the basic biomedical sciences to the clinical conditions.