搜索结果：Head and neck pathology

General Principles Cellular and Molecular Biology of the Cancer Cell Epidemiology Ethical Considerations HIB and AIDS Fine Needle Aspiration Biopsies Diseases by Anatomic Site Nasal Cavity and Paranasal Sinuses Diseases of the Nasal Cavity and Paranasal Sinuses Management of Recurrent Nasopharyngeal Canver Pathology of the Nasal Cavity, Paranasal Sinus, and Nasopharynx Salivary Glands Diseases of the Salivary Glands Pathology of the Salivary Glands Larynx, Hypopharynx, Trachea Non-neoplastic Lesions of the Larynx Neoplasms of the Larynx Pathology of the Larynx, Hypopharynx, and Trachea Oral Cavity Non-neoplastic Lesions of the Oral Cavity Neoplasms of the Oral Cavity and Oropharynx Treatment of the Odontogenic Lesions Pathology of the Oral Cavity, Oropharynx, and Odontogenic Lesions Thyroid Diseases of the Thyroid Pathology of the Thyroid Gland Parathyroid Diseases of the Parathyroid Pathology of the Parathryroid Gland Ear and Temporal Lobe Non-neoplastic Lesions of the Ear Neoplasms of the Ear Pathology of the Ear and Temporal Lobe Neck Non-neoplastic Lesions of the Neck Neoplasms of the Neck Pathology of the Neck

The purpose of this study was to examine the impact of surgical pathology, anesthesiologist experience, and airway technique on surgically relevant outcomes in patients identified by preoperative laryngoscopy to have a difficult airway due to head and neck pathology. We prospectively recorded a series of 152 difficult airway cases due to head and neck pathology out of 2,145 direct laryngoscopies undertaken between November 2005 and June 2008. One of two senior anesthesiologists specializing in head and neck procedures intubated 101 (66.4%) of the 152 patients and did so 3.3 minutes faster (p = 0.51), with better oxygenation (87.3 vs. 81.8%; p = 0.02) and fewer airway plan changes (p = 0.001) than did other, nonspecialist anesthesiologists. Predictors of failure of the first intubation plan included: cancer diagnosis (p = 0.02), previous radiotherapy (p = 0.03), and supraglottic lesions (p = 0.03). Glottic/subglottic lesions required the most intubation attempts (p = 0.02). Awake fiberoptic intubation was the most common method used (44.7%) but resulted in a change in the airway plan in 6 cases (8.8%). Gas induction maintained the best oxygenation (p = 0.01). Awake tracheostomy was infrequent (1.3%) and took the longest (p = 0.006). We concluded that difficult airways due to head and neck pathology require teamwork and a backup plan. An anesthesiologist specializing in head and neck procedures may help to avoid adverse outcomes associated with cancer, especially previously irradiated supraglottic/glottic lesions, leading to a less frequent need for awake tracheostomy.

This unique reference provides a comprehensive guide to pediatric head and neck pathology in patients up to the age of 21. Chapters take a clinicopathologic approach, offering insight into the pathobiology, diagnosis and treatment of both common and rare disorders. Imaging studies and immunohistochemical techniques are discussed alongside accepted and emerging molecular tools. The authors' holistic approach ensures coverage of the surgical management principles that pathologists must understand, particularly when called upon to diagnose odontogenic tumors and cysts, as well as benign and malignant salivary gland neoplasms. The book is richly illustrated in color throughout. Each copy of the printed book is packaged with a password, providing online access to the book's text and image library. Written by leaders in head and neck pathology and surgery, this is an essential guide to solving the diagnostic dilemmas that pathologists and clinicians encounter in the assessment of pediatric head and neck disease.

This study was conducted to present a comprehensive view of the most common head and neck pathologies among the pediatric and adolescent population of the city of Jeddah, Saudi Arabia. Data were collected from the oral and maxillofacial surgery (OMFS) records at King Abdulaziz University Hospital and King Fahad Hospital Jeddah (KFHJ) from the period 1998 to 2009. All patients who were 18 years of age and younger were included in the study. Identified lesions were classified into four categories: cystic, neoplastic, vascular and fibro-osseous. Age and sex distribution of the lesions were also calculated. A total of 155 patients were included in this study. Of all the lesions, 143 (92.26%) were benign and 12 (7.74%) were malignant; 63 (40.65%) were cysts; 48 (30.97%) were neoplasms; 23 (14.84%) were vascular and 21 (13.55%) were fibro-osseous tumors. The most common lesions were hemangioma (20 cases; 12.9%) followed by retention cyst (19 cases; 12.26%) and dentigerous cyst (15 cases; 9.68%). The most common benign odontogenic neoplasm was odontoma (7 cases; 4.52%), of which central giant cell granuloma (6 cases; 3.87%) was the most frequent benign nonodontogenic tumor and lymphoma (6 cases; 3.87%) was the most common malignant one. Although this study might benefit clinicians in guiding them through differential diagnosis of pediatric and adolescent head and neck pathology in reference to their sex and age groups, governmental efforts are badly needed to establish a Saudi childhood pathology registry.

BACKGROUND AND PURPOSE: The purpose of this work was to study differences in apparent diffusion coefficient (ADC) values between benign and malignant head and neck lesions at 3T field strength imaging. MATERIALS AND METHODS: Our study population in this retrospective study was derived from the patient population who had undergone routine neck 3T MR imaging (for clinical indications) from December 2005 to December 2006. There were 33 patients identified: 17 with benign and 16 with malignant pathologies. In all of the subjects, conventional MR imaging sequences were performed apart from diffusion-weighted sequences. The mean ADC values in the benign and malignant groups were compared using an unpaired t test with unequal variance with a P < 0.05 considered statistically significant. RESULTS: There was a statistically significant difference (P = .004) between the mean ADC values (in 10(-3) mm(2)/s) in the benign and malignant lesions (1.505 +/- 0.487; 95% confidence interval, 1.305-1.706, and 1.071 +/- 0.293; 95% confidence interval, 0.864-1.277, respectively). There were 2 malignant lesions with ADC values higher than 1.3 x 10(-3) mm(2)/s and 5 benign lesions with ADC values less than 1.3 x 10(-3) mm(2)/s. The lack of overlap of ADC values within 95% confidence limits suggests that a 3T ADC value of 1.3 x 10(-3) mm(2)/s may be the threshold value for differentiation between benign and malignant head and neck lesions. CONCLUSION: ADC values of benign and malignant neck pathologies are significantly different at 3T imaging, though larger studies are required to establish threshold ADC values that can applied in daily clinical practice.

Each year approximately 40,000 people in the United States and 500,000 people worldwide are diagnosed with head-and-neck squamous cell carcinoma (HNSC). Although there have been significant improvements in the treatment of this disease, leading to decreased morbidity, over the past few decades the 5-year survival rate has remained largely unchanged at 50%. Genetic and epigenetic alterations as well as viral agents have been implicated in the development of head-and-neck cancer. Advances in our understanding of the molecular biology underlying these processes have spawned numerous, diverse strategies to exploit this understanding in applied pathology. Preliminary investigations have analyzed body fluids and margins for the presence of cancer cells. Specific molecular alterations have been associated with improved treatment response and prognosis. Molecular therapy has been shown to have some clinical efficacy in HNSC. Expression profiles may be generated for specific primary tumors and compared to known markers of disease. Improved molecular characterization of primary tumors, surgical margins and body fluids may allow clinicians to detect and treat earlier lesions, predict a tumor's response to treatment, tailor treatment to specific molecular alterations and ultimately improve clinical outcomes related to HNSC.

Studies have demonstrated that poor assessment and planning contribute to airway complications and that current airway assessment strategies have a poor diagnostic accuracy in predicting difficult intubation in the general population. Patients with head and neck pathology are at higher risk for difficulties during airway management and are more likely to need emergency surgical access. Therefore, thorough assessment of this group of patients is mandatory. The addition of virtual endoscopy (VE) to clinical history and computerised tomography imaging has been shown to improve diagnostic accuracy for supraglottic, glottic and infraglottic lesions and has a positive influence in formulating a more cautious and thorough airway management strategy in this high-risk group of patients. This article reviews whether VE can enhance airway assessment in patients with head and neck pathology and help reduce airway complications.

The prototypic head and neck squamous cell carcinoma (HNSCC) arises from the mucosal lining of the upper aerodigestive tract, demonstrates squamous differentiation microscopically, involves older men with a long history of cigarette smoking and alcohol consumption, and is treated by multimodality therapy. HNSCC has long been regarded as a uniform disease process requiring a methodical and unwavering therapeutic approach. Divergence in epidemiologic trends among HNSCCs arising from different anatomic sites has introduced a view that, morphologic repetition aside, head and neck cancers form a heterogeneous group. This view has been supported at the molecular genetic level. A more complete understanding of the molecular genetics of head and neck cancer is providing new insights into long-held but poorly comprehended concepts such as field cancerization and is introducing various biomarkers with potential application for diagnosing, staging, monitoring, and prognosticating HNSCC.

The longstanding notion that head and neck squamous cell carcinoma (HNSCC) is a uniform disease process is changing. Divergence in epidemiologic trends among HNSCCs arising in different anatomic subsites has introduced a view that HNSCC is a heterogeneous group. Analysis of molecular genetic changes discloses not just individual tumor differences, but also consistent large-scale differences that permit the recognition of important tumor subtypes. One recently recognized subtype is the human papillomavirus (HPV)-positive oropharyngeal carcinoma. HPV-positive oropharyngeal cancer now dominates the head and neck oncology landscape, and its escalating incidence is impacting on diagnostic, preventive and therapeutic practices.

Pigmented lesions, including melanomas, of the mucous membranes of the head and neck are far outnumbered by their counterparts in the skin. This relative dearth is partially responsible for the fact that scientific inquiry into mucosal melanomas has not kept pace with the advances in knowledge of the pathogenesis of cutaneous melanomas and their diagnosis and treatment. Integral to these latter advances have been the refinements in clinical and histologic classification and clinicopathologic correlations with quantitative evaluation of melanomas of skin-enhancements that up to now have been singularly lacking for mucosal melanomas. This report acknowledges this slowness in progress, present recommendations for purifying the nomenclature of pigmented lesions of the mucosae, and at the same time, also notes the poorer prognosis for melanomas of the upper aerodigestive tracts, as a group, when compared with cutaneous melanomas. Only prospective studies will answer the question of whether the poor prognosis is intrinsic to these mucosal melanomas or whether delay in detection and removal are responsible.

1. Nasal cavity and paranasal sinuses 2. Nasopharynx 3. Hypopharynx, larynx and trachea 4. Oral cavity and oropharynx 5. Salivary glands 6. Odontogenetic tumours 7. Ear 8. Paraganglionic systems

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