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Osteogenic and chondrogenic sarcomas of the jaws
CURRENT LITERATURE
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dibular prognathism. The mean patient age was 42.2 years, and 86% of the patients had presurgical orthodontic treatment. A posterior mandibular skin incision was used, and the osteotomy was performed with a bur and hand piece. Skeletal fixation was used in 35 of the patients. Maxillomandibular fixation was released at six weeks. Mean operating time was 87 minutes for women and 90 minutes for men. One patient experienced some transient paresis in the distribution of the marginal mandibular branch of the facial nerve. No injuries to the inferior alveolar nerve occurred. Two patients experienced parotid swelling and salivary retention that resolved within three weeks. Forty-four of the patients have been followed for 10 years, and the authors report good stability and patient satisfaction. The authors conclude that the EVSO procedure is a safe surgical technique with few complications. The authors now use the intraoral approach as the standard operation for retruding the mandible. The EVSO is used in cases with excessive vertical ramus height of where retrusion exceeds 12 mm.-S. J. MCKENNA Reprint requests to Dr. Tornes: Department of Maxillofacial Surgery, 5016 Haukeland Sykehus, Bergen, Norway.
Head and Neck Findings in Pediatric Acquired Immunodeficiency Syndrome. Williams MA, Laryngoscope 97:713,
1987 This report reviews ten pediatric AIDS (PAIDS) cases for head and neck findings seen between July 1983 and October 1985. All patients tested positive for LAV/HTLV III antibodies. Many findings in PAIDS, which was first described in 1983, differ from adult AIDS cases. Microsomia was the most common finding, seen in 90% of the sampled PAIDS patients. The author attributed this to changes in intestinal mucosa that promote malabsorption. Concurrently, these patients also exhibit failure to thrive that include late developmental milestones and loss of obtained milestones. Some form of otitis media (serous, chronic, or acute) was seen in 80% of cases. Mucocutaneous candidiasis was found in multiple sites in eight cases. These sites, ranging from most common to least common, are oral cavity, external auditory canal, larynx, nasopharynx, and stomach. Cortical atrophy of the brain was seen by CT scan in 70% of cases. Other neurologic anomalies noted were calcification of the basal ganglia and corticospinal degeneration. Surprisingly, cervical lymphadenopathy was seen in only 40% of the sampled group, and no examples of Kaposi’s sarcoma were found. At the time of publication, seven of the ten patients had died. The cause of death was not reported. -C. T. POWELL Reprint requests to Dr. Williams: Division of Otolaryngology, University of New Mexico School of Medicine, 2211 Lomas Boulevard, NE, Albuquerque, New Mexico 8713 1.
Effect of Cleft Palate Repair and Pharyngeal Flap Surgery on Upper Ah-way Obstruction During Sleep. Orr WC, Le-
vine NS, Buchanan RT. Plast Reconstr Surg 80:226, 1987 The effects of the von Langenbeck palatoplasty and the superiorly based pharyngeal flap on sleep apnea were evaluated in 20 patients with cleft palate. Polysomnographic monitoring consisted of recordings of the electroencephalogram (EEG), electro-oculogram (EOG), electromyogram (EMG), electrocardiogram (ECG), nasal/ oral airllow (expired CO&, and thoracic breathing movements (impedance pneumogram). Patients were studied preoperatively and followed for three days and three months postoperatively. It was found that patients with palatoplasties had minimal episodes of sleep apnea, although the number of obstructive episodes per hour in the immediate postoperative period was greatly increased in those patients who received the pharyngeal flap procedures. The three month follow-up evaluation revealed that the frequency of obstructive episodes had returned toward baseline levels in all of the palatoplasty patients, and was within normal limits in all but two pharyngeal flap patients. The authors stress that close monitoring for upper airway problems in the postoperative period with the use of apnea monitors, nasopharyngeal airways, use of silk sutures in the tongue, and overnight observation in the intensive care unit would be useful in patients who undergo the superiorly based pharyngeal flap-B. W. BURGER Reprint request to Dr. Orr: Department of Clinical Physiology, Division of Plastic Surgery, Oklahoma Memorial Hospital, Northeast 13th at Lincoln Boulevard, Oklahoma City, OK 73104.
Osteogenic and Chondrogenic Sarcomas of the Jaws. Batsakis JG. Ann Otol Rhino1 Laryngol96:474, 1987 Even though osteosarcomas and chondrosarcomas constitute less than 10% of jaw bone malignancies, they are the most common primary bone tumors afflicting these structures. Despite their intramembranous embryologic origins, cartilage tumors develop in these bones, chondrosarcomas outnumbering chondromas by at least two to one. The mandible is the bone of predilection for osteogenic sarcoma, the maxilla for chondrosarcoma. Both sarcomas are preponderantly locally invasive, resisting control, with five-year cure rates of less than 50% for either sarcoma. The cure rate for chondrosarcoma is higher than that for osteogenic sarcoma (44% at five years).-G. H. SPERBER Reprint requests to Dr. Batsakis: Department of Pathology, MD Anderson Hospital, Texas Medical Center, Houston, TX 77030.
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dibular prognathism. The mean patient age was 42.2 years, and 86% of the patients had presurgical orthodontic treatment. A posterior mandibular skin incision was used, and the osteotomy was performed with a bur and hand piece. Skeletal fixation was used in 35 of the patients. Maxillomandibular fixation was released at six weeks. Mean operating time was 87 minutes for women and 90 minutes for men. One patient experienced some transient paresis in the distribution of the marginal mandibular branch of the facial nerve. No injuries to the inferior alveolar nerve occurred. Two patients experienced parotid swelling and salivary retention that resolved within three weeks. Forty-four of the patients have been followed for 10 years, and the authors report good stability and patient satisfaction. The authors conclude that the EVSO procedure is a safe surgical technique with few complications. The authors now use the intraoral approach as the standard operation for retruding the mandible. The EVSO is used in cases with excessive vertical ramus height of where retrusion exceeds 12 mm.-S. J. MCKENNA Reprint requests to Dr. Tornes: Department of Maxillofacial Surgery, 5016 Haukeland Sykehus, Bergen, Norway.
Head and Neck Findings in Pediatric Acquired Immunodeficiency Syndrome. Williams MA, Laryngoscope 97:713,
1987 This report reviews ten pediatric AIDS (PAIDS) cases for head and neck findings seen between July 1983 and October 1985. All patients tested positive for LAV/HTLV III antibodies. Many findings in PAIDS, which was first described in 1983, differ from adult AIDS cases. Microsomia was the most common finding, seen in 90% of the sampled PAIDS patients. The author attributed this to changes in intestinal mucosa that promote malabsorption. Concurrently, these patients also exhibit failure to thrive that include late developmental milestones and loss of obtained milestones. Some form of otitis media (serous, chronic, or acute) was seen in 80% of cases. Mucocutaneous candidiasis was found in multiple sites in eight cases. These sites, ranging from most common to least common, are oral cavity, external auditory canal, larynx, nasopharynx, and stomach. Cortical atrophy of the brain was seen by CT scan in 70% of cases. Other neurologic anomalies noted were calcification of the basal ganglia and corticospinal degeneration. Surprisingly, cervical lymphadenopathy was seen in only 40% of the sampled group, and no examples of Kaposi’s sarcoma were found. At the time of publication, seven of the ten patients had died. The cause of death was not reported. -C. T. POWELL Reprint requests to Dr. Williams: Division of Otolaryngology, University of New Mexico School of Medicine, 2211 Lomas Boulevard, NE, Albuquerque, New Mexico 8713 1.
Effect of Cleft Palate Repair and Pharyngeal Flap Surgery on Upper Ah-way Obstruction During Sleep. Orr WC, Le-
vine NS, Buchanan RT. Plast Reconstr Surg 80:226, 1987 The effects of the von Langenbeck palatoplasty and the superiorly based pharyngeal flap on sleep apnea were evaluated in 20 patients with cleft palate. Polysomnographic monitoring consisted of recordings of the electroencephalogram (EEG), electro-oculogram (EOG), electromyogram (EMG), electrocardiogram (ECG), nasal/ oral airllow (expired CO&, and thoracic breathing movements (impedance pneumogram). Patients were studied preoperatively and followed for three days and three months postoperatively. It was found that patients with palatoplasties had minimal episodes of sleep apnea, although the number of obstructive episodes per hour in the immediate postoperative period was greatly increased in those patients who received the pharyngeal flap procedures. The three month follow-up evaluation revealed that the frequency of obstructive episodes had returned toward baseline levels in all of the palatoplasty patients, and was within normal limits in all but two pharyngeal flap patients. The authors stress that close monitoring for upper airway problems in the postoperative period with the use of apnea monitors, nasopharyngeal airways, use of silk sutures in the tongue, and overnight observation in the intensive care unit would be useful in patients who undergo the superiorly based pharyngeal flap-B. W. BURGER Reprint request to Dr. Orr: Department of Clinical Physiology, Division of Plastic Surgery, Oklahoma Memorial Hospital, Northeast 13th at Lincoln Boulevard, Oklahoma City, OK 73104.
Osteogenic and Chondrogenic Sarcomas of the Jaws. Batsakis JG. Ann Otol Rhino1 Laryngol96:474, 1987 Even though osteosarcomas and chondrosarcomas constitute less than 10% of jaw bone malignancies, they are the most common primary bone tumors afflicting these structures. Despite their intramembranous embryologic origins, cartilage tumors develop in these bones, chondrosarcomas outnumbering chondromas by at least two to one. The mandible is the bone of predilection for osteogenic sarcoma, the maxilla for chondrosarcoma. Both sarcomas are preponderantly locally invasive, resisting control, with five-year cure rates of less than 50% for either sarcoma. The cure rate for chondrosarcoma is higher than that for osteogenic sarcoma (44% at five years).-G. H. SPERBER Reprint requests to Dr. Batsakis: Department of Pathology, MD Anderson Hospital, Texas Medical Center, Houston, TX 77030.