Background Parapharyngeal lymph node （PPLN） metastasis from thyroid carcinoma is rare. We describe the clinical features, diagnosis, and surgical treatment of this condition. Methods Twenty-five patients with PPLN m...Background Parapharyngeal lymph node （PPLN） metastasis from thyroid carcinoma is rare. We describe the clinical features, diagnosis, and surgical treatment of this condition. Methods Twenty-five patients with PPLN metastasis from thyroid carcinoma were treated at our institution from January 1999 to December 2010, including 22 patients with papillary carcinoma, two with medullary carcinoma, and one with follicular carcinoma. Of these, 16 had a history of surgical treatment prior to PPLN metastasis. Of the nine patients without a history of surgical treatment, five had widespread cervical lymph node metastases and four had occult papillary thyroid carcinoma. PPLN metastasis was diagnosed by enhanced computed tomography in 22 cases. Results Resection of metastases was performed via a transcervical approach in 23 patients and a transmandibular approach in two patients. After a median follow-up time of 31 months （range： 6-130 months）, nine patients developed distant metastases, and six of these died of their disease. The 5-year survival rate was 63.8%. Conclusions PPLN metastasis from thyroid carcinoma may occur in patients： with previous neck dissection, with widespread metastases to cervical lymph nodes prior to initial treatment, and with occult thyroid carcinoma. Enhanced computed tomography is helpful for diagnosis in the first two presentations. Surgical resection remains the mainstay of treatment for this disease. PPLN metastasis has a tendency to be associated with distant metastases and a poor prognosis.展开更多
Background Patients with maxillary tumor often suffer from trismus after maxillectomy, which could turn out to be a permanent sequela without proper intervention. In this study, the efficacy of mouth opening exercises...Background Patients with maxillary tumor often suffer from trismus after maxillectomy, which could turn out to be a permanent sequela without proper intervention. In this study, the efficacy of mouth opening exercises in preventing and treating trismus was observed in patients with maxillary tumor early after their operations. At the same time, radiotherapy as an influencing factor for the mouth opening exercises was evaluated. Methods In this study, 22 patients with maxillary oncology began their mouth opening exercises at an early stage （1-2 weeks） after maxillectomy. They were divided into two groups based on the principle of voluntariness： 11 patients in group 1 chose TheraBites as their instruments of mouth opening exercises, and the other 11 in group 2 chose stacked tongue depressors to help their exercises. All participants were trained to exercise 3-5 times a day, 30-40 oscillations at one time, with a 2-second pause at their maximum possible mouth open position. The maximal interincisor distances （MID） of patients were measured and recorded by a single investigator every week after the beginning of the mouth opening exercises. Medical information and the responses of patients were also recorded. Initial and final MIDs were calculated by SPSS 13.0. Results The changes of the mouth aperture every week during exercises in both groups were described in figures, and there were statistical increases in the final MIDs compared with the initial ones. However, no significant differences were achieved between groups 1 and 2 （P 〉0.05）. Radiotherapy seemed to have no negative impact on the mouth opening results during the exercises. Conclusion Physical mouth opening exercises should be executed early after maxillectomy for the prevention and treatment of trismus, especially for those who had radiotherapy as part of antitumor treatments.展开更多
Background Lymph node ratio （LNR） has recently been reported as a potential prognostic marker in many malignant diseases. We aimed to analyze the potential prognostic effect of LNR on hypopharyngeal squamous cell ca...Background Lymph node ratio （LNR） has recently been reported as a potential prognostic marker in many malignant diseases. We aimed to analyze the potential prognostic effect of LNR on hypopharyngeal squamous cell carcinoma （HPSCC） after neoadjuvant therapy in our institution.展开更多
文摘Background Parapharyngeal lymph node （PPLN） metastasis from thyroid carcinoma is rare. We describe the clinical features, diagnosis, and surgical treatment of this condition. Methods Twenty-five patients with PPLN metastasis from thyroid carcinoma were treated at our institution from January 1999 to December 2010, including 22 patients with papillary carcinoma, two with medullary carcinoma, and one with follicular carcinoma. Of these, 16 had a history of surgical treatment prior to PPLN metastasis. Of the nine patients without a history of surgical treatment, five had widespread cervical lymph node metastases and four had occult papillary thyroid carcinoma. PPLN metastasis was diagnosed by enhanced computed tomography in 22 cases. Results Resection of metastases was performed via a transcervical approach in 23 patients and a transmandibular approach in two patients. After a median follow-up time of 31 months （range： 6-130 months）, nine patients developed distant metastases, and six of these died of their disease. The 5-year survival rate was 63.8%. Conclusions PPLN metastasis from thyroid carcinoma may occur in patients： with previous neck dissection, with widespread metastases to cervical lymph nodes prior to initial treatment, and with occult thyroid carcinoma. Enhanced computed tomography is helpful for diagnosis in the first two presentations. Surgical resection remains the mainstay of treatment for this disease. PPLN metastasis has a tendency to be associated with distant metastases and a poor prognosis.
文摘Background Patients with maxillary tumor often suffer from trismus after maxillectomy, which could turn out to be a permanent sequela without proper intervention. In this study, the efficacy of mouth opening exercises in preventing and treating trismus was observed in patients with maxillary tumor early after their operations. At the same time, radiotherapy as an influencing factor for the mouth opening exercises was evaluated. Methods In this study, 22 patients with maxillary oncology began their mouth opening exercises at an early stage （1-2 weeks） after maxillectomy. They were divided into two groups based on the principle of voluntariness： 11 patients in group 1 chose TheraBites as their instruments of mouth opening exercises, and the other 11 in group 2 chose stacked tongue depressors to help their exercises. All participants were trained to exercise 3-5 times a day, 30-40 oscillations at one time, with a 2-second pause at their maximum possible mouth open position. The maximal interincisor distances （MID） of patients were measured and recorded by a single investigator every week after the beginning of the mouth opening exercises. Medical information and the responses of patients were also recorded. Initial and final MIDs were calculated by SPSS 13.0. Results The changes of the mouth aperture every week during exercises in both groups were described in figures, and there were statistical increases in the final MIDs compared with the initial ones. However, no significant differences were achieved between groups 1 and 2 （P 〉0.05）. Radiotherapy seemed to have no negative impact on the mouth opening results during the exercises. Conclusion Physical mouth opening exercises should be executed early after maxillectomy for the prevention and treatment of trismus, especially for those who had radiotherapy as part of antitumor treatments.
文摘Background Lymph node ratio （LNR） has recently been reported as a potential prognostic marker in many malignant diseases. We aimed to analyze the potential prognostic effect of LNR on hypopharyngeal squamous cell carcinoma （HPSCC） after neoadjuvant therapy in our institution.
