- Email: [email protected]
Neoadjuvant intracarotid chemotherapy for treatment of advanced adenocystic carcinoma of the lacrimal gland
] Oral Maxillofac 56:1461-1465,
Surg 1998
Abstracts Silicone Gel-Filled Breast Implants and Connective Diseases. Park A, Black B, Sarhadi N, et al. Plast Reconstr Surg 101:2651,1998
rates, the authors incorporated neoadjuvant intracarotid chemotherapy combined with intravenous chemotherapy and surgery to manage patients with advanced adenocystic carcinoma of the lacrimal gland. Two patients with biopsyproven carcinomas of the lacrimal gland were treated with the new chemotherapeutic protocol. Patients received intracarotid cisplatin and intravenous doxorubicin hydrochloride before undergoing orbital exenteration. Postoperative radiation therapy, intravenous cisplatin, and doxorubicin were also administered. Patients were followed up with serial clinical and computed tomography scan examinations. In one case, the preoperative chemotherapy regimen shrunk the tumor to a more surgically amenable size. Tumor necrosis was confirmed in the exenterated specimen. Both patients have had no recurrences and have been disease-free for 9.5 and 7.5 years. Limited morbidity was associated with this treatment protocol. The authors believe that this is the first report describing the use for neoadjuvant intracarotid chemotherapy in conjunction with the conventional exenteration and radiation for the treatment of locally advanced adenocystic carcinoma of the lacrimal gland. Because of the promising results of this new treatment regimen, further investigation is warranted.-AJ. LXBUNAO
The authors conducted a cross-sectional study of the prevalence of connective tissue diseases, as well as signs and symptoms associated with these conditions, in women with silicone gel breast implants. Three hundred and seventeen patients were studied with matched controls. Results showed no increased incidence of antinuclear antibodies or rheumatoid factor. No differences in symptoms or physical signs of connective tissue diseases were found between the groups. The authors concluded that based on their study, no link between silicone gel breast implants and connective tissue disease exists.-R. HOLLOWAY Reprint requests to Dr Park: Department Hospital, Stourbridge, West Midlands,
of Plastic Surgery, United Kingdom
Wordsley
Efficacy of Nonsurgical Management of the Initial Caries Lesion. Anusavice KJ. J Dent Educ 61:895, 1997 The treatment of incipient carious lesion remains controversial for the past 2 decades. The aggressive surgical approach to this type of lesion has always been seen as the most standard treatments in those cases, even though sometimes there is no strong indications to perform surgery. Surgical indications include noncavited radiolucent lesions in the proximal areas with involvement of the outer half of the dentin structure or the staining occlusal fissures. Lately, greater attention has been paid to the remineralization of noncavited caries. The evidence of a higher resistance to subsequent demineralization in remineralizated lesions support this type of approach in addition to his conservative character. A variety of procedures are available that include the topical applications of fluoride or clorhexidine varnishes and rinses, the use of nonacidogenic chewing gums, and the placement of pit and fissure sealants. The author shows statistical data with promising results supporting this type of therapy the treatment of the earliest stages of the carious lesions. In addition, guidelines are given for clinical application. The author recommends the delay of restorations until evidence of cavitation appears or radiolucencies extend more than one third the thickness of dentin.-A.F. HERRERA Reprint College
Reprint 016880,
requests to Dr Tse: Bascom Miami, FL 33101.
Palmer
Eye Institute,
PO Box
Temporalis Myofascial Flap in Maxillofacial Reconstruction: Clinical and Histologic Studies of the Oral Healing Process. Cheung LK, Samman N, Tideman H. Br J Oral Maxillofac Surg 35:406, 1997 The temporalis myofascial flap is widely used for reconstruction of an oral defect after ablative surgery. This study reported the clinical outcome of 36 consecutive patients who underwent reconstruction of oral defects with the temporalis myofascial flap. Histologic features of the muscle fibers and repaired mucosa over the oral surface of the flap were also included. Sites of reconstruction included the maxilla, posterior mandible, cheek, palate, and retromolar trigone. Two patients had ligation of the external carotid artery on the same side as the temporalis myofascial flap had been harvested, and two patients underwent postoperative radiotherapy about 6 weeks after temporalis myofascial reconstruction. The clinical healing process in the mouth was consistent in all patients. The uncovered temporalis myofascial flap healed gradually starting with the acute inflammatory phase, going through chronic inflammatory and proliferative phases with eventual completion of epithelialization at 6 to I2 weeks. After 6 months, the features stabilized with only further fibrosis and minor shrinkage of the temporalis flap. There were no major complications. The healed mucosa showed only minor scarring in 70% of the cases and the repaired mucosa had characteristic histologic features that were distinct from the normal mucosa. This study further confirms the reliability and versatility of the temporalis myofascial flap in maxillofacial reconstruction.-M.K. ROLLERT
requests to Dr Anusavice: Department of Biomaterials, of Dentistry, University of Florida, Gainesville, FL 32610-
0446. Neoadjuvant Intracarotid Chemotherapy for Treatment of Advanced Adenocystic Carcinoma of the Lacrimal Gland. Meldrum ML, Tse DT, Benedetto P. Arch Opthalmol116:315, 1998 The most common nonlymphoid malignant tumor of the lacrimal gland is an adenocystic carcinoma, which accounts for 25% to 30% of epithelial lacrimal gland tumors. The prognosis for patients suffering from this disease is dismal, with a 5-year survival rate of less than 50% and a lo-year rate of less than 20%. In an attempt to improve these survival
1461
Surg 1998
Abstracts Silicone Gel-Filled Breast Implants and Connective Diseases. Park A, Black B, Sarhadi N, et al. Plast Reconstr Surg 101:2651,1998
rates, the authors incorporated neoadjuvant intracarotid chemotherapy combined with intravenous chemotherapy and surgery to manage patients with advanced adenocystic carcinoma of the lacrimal gland. Two patients with biopsyproven carcinomas of the lacrimal gland were treated with the new chemotherapeutic protocol. Patients received intracarotid cisplatin and intravenous doxorubicin hydrochloride before undergoing orbital exenteration. Postoperative radiation therapy, intravenous cisplatin, and doxorubicin were also administered. Patients were followed up with serial clinical and computed tomography scan examinations. In one case, the preoperative chemotherapy regimen shrunk the tumor to a more surgically amenable size. Tumor necrosis was confirmed in the exenterated specimen. Both patients have had no recurrences and have been disease-free for 9.5 and 7.5 years. Limited morbidity was associated with this treatment protocol. The authors believe that this is the first report describing the use for neoadjuvant intracarotid chemotherapy in conjunction with the conventional exenteration and radiation for the treatment of locally advanced adenocystic carcinoma of the lacrimal gland. Because of the promising results of this new treatment regimen, further investigation is warranted.-AJ. LXBUNAO
The authors conducted a cross-sectional study of the prevalence of connective tissue diseases, as well as signs and symptoms associated with these conditions, in women with silicone gel breast implants. Three hundred and seventeen patients were studied with matched controls. Results showed no increased incidence of antinuclear antibodies or rheumatoid factor. No differences in symptoms or physical signs of connective tissue diseases were found between the groups. The authors concluded that based on their study, no link between silicone gel breast implants and connective tissue disease exists.-R. HOLLOWAY Reprint requests to Dr Park: Department Hospital, Stourbridge, West Midlands,
of Plastic Surgery, United Kingdom
Wordsley
Efficacy of Nonsurgical Management of the Initial Caries Lesion. Anusavice KJ. J Dent Educ 61:895, 1997 The treatment of incipient carious lesion remains controversial for the past 2 decades. The aggressive surgical approach to this type of lesion has always been seen as the most standard treatments in those cases, even though sometimes there is no strong indications to perform surgery. Surgical indications include noncavited radiolucent lesions in the proximal areas with involvement of the outer half of the dentin structure or the staining occlusal fissures. Lately, greater attention has been paid to the remineralization of noncavited caries. The evidence of a higher resistance to subsequent demineralization in remineralizated lesions support this type of approach in addition to his conservative character. A variety of procedures are available that include the topical applications of fluoride or clorhexidine varnishes and rinses, the use of nonacidogenic chewing gums, and the placement of pit and fissure sealants. The author shows statistical data with promising results supporting this type of therapy the treatment of the earliest stages of the carious lesions. In addition, guidelines are given for clinical application. The author recommends the delay of restorations until evidence of cavitation appears or radiolucencies extend more than one third the thickness of dentin.-A.F. HERRERA Reprint College
Reprint 016880,
requests to Dr Tse: Bascom Miami, FL 33101.
Palmer
Eye Institute,
PO Box
Temporalis Myofascial Flap in Maxillofacial Reconstruction: Clinical and Histologic Studies of the Oral Healing Process. Cheung LK, Samman N, Tideman H. Br J Oral Maxillofac Surg 35:406, 1997 The temporalis myofascial flap is widely used for reconstruction of an oral defect after ablative surgery. This study reported the clinical outcome of 36 consecutive patients who underwent reconstruction of oral defects with the temporalis myofascial flap. Histologic features of the muscle fibers and repaired mucosa over the oral surface of the flap were also included. Sites of reconstruction included the maxilla, posterior mandible, cheek, palate, and retromolar trigone. Two patients had ligation of the external carotid artery on the same side as the temporalis myofascial flap had been harvested, and two patients underwent postoperative radiotherapy about 6 weeks after temporalis myofascial reconstruction. The clinical healing process in the mouth was consistent in all patients. The uncovered temporalis myofascial flap healed gradually starting with the acute inflammatory phase, going through chronic inflammatory and proliferative phases with eventual completion of epithelialization at 6 to I2 weeks. After 6 months, the features stabilized with only further fibrosis and minor shrinkage of the temporalis flap. There were no major complications. The healed mucosa showed only minor scarring in 70% of the cases and the repaired mucosa had characteristic histologic features that were distinct from the normal mucosa. This study further confirms the reliability and versatility of the temporalis myofascial flap in maxillofacial reconstruction.-M.K. ROLLERT
requests to Dr Anusavice: Department of Biomaterials, of Dentistry, University of Florida, Gainesville, FL 32610-
0446. Neoadjuvant Intracarotid Chemotherapy for Treatment of Advanced Adenocystic Carcinoma of the Lacrimal Gland. Meldrum ML, Tse DT, Benedetto P. Arch Opthalmol116:315, 1998 The most common nonlymphoid malignant tumor of the lacrimal gland is an adenocystic carcinoma, which accounts for 25% to 30% of epithelial lacrimal gland tumors. The prognosis for patients suffering from this disease is dismal, with a 5-year survival rate of less than 50% and a lo-year rate of less than 20%. In an attempt to improve these survival
1461