Nasopharyngeal Radium Irradiation: The Washington County, Maryland, Study

Although there have been many studies of cancer risk associated with a variety of x-ray treatments for benign conditions of the head and neck, little is known about the possible long-term health consequences of nasopharyngeal radium irradiation. This treatment results in minimal radiation exposure to the thyroid gland, which is the focus of much of the research regarding other head and neck irradiation. With nasopharyngeal radiation, on the other hand, exposure to the pituitary gland and the nasopharynx in the area immediately adjacent to the application site may have been substantial. In 1975 a follow-up study was undertaken in Washington County, Maryland, of 2925 persons who were treated at the Health Department's Clinic for the Prevention of Deafness in Children between 1943 and 1960. Of these, 904 persons had been treated with nasopharyngeal radium. After an average of 24 years of follow-up, an excess risk from brain cancer was suggested on the basis of three cases of cancer occurring in the treated group and none occurring in those who were not treated. This finding could have resulted by chance. Other results were consistent with a potential pituitary effect of radiation, but interpretation is limited by the absence of clinical and laboratory data. The history of the study is reported along with an overview of study methods and results.

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Characteristics of 108 thyroid cancers detected by screening in a population with a history of head and neck irradiation

Cancer ◽

10.1002/1097-0142(19800901)46:5<1218::aid-cncr2820460523>3.0.co;2-h ◽

1980 ◽

Vol 46 (5) ◽

pp. 1218-1227 ◽

Cited By ~ 35

Author(s):

Arthur B. Schneider ◽

Steven Pinsky ◽

Carlos Bekerman ◽

U. Yun Ryo

Keyword(s):

Head And Neck ◽

Thyroid Cancers ◽

Neck Irradiation ◽

History Of ◽

Head And Neck Irradiation

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Five years of experience with hydroxyurea in children and young adults with sickle cell disease

Blood ◽

10.1182/blood.v97.11.3628 ◽

2001 ◽

Vol 97 (11) ◽

pp. 3628-3632 ◽

Cited By ~ 132

Author(s):

Alina Ferster ◽

Parvine Tahriri ◽

Christiane Vermylen ◽

Geneviève Sturbois ◽

Francis Corazza ◽

...

Keyword(s):

Sickle Cell Disease ◽

Sickle Cell ◽

Laboratory Data ◽

Acute Chest Syndrome ◽

Cell Disease ◽

Significant Difference ◽

History Of ◽

Ischemic Attack

The short-term beneficial effect of hydroxyurea (HU) in sickle cell disease (SCD) has been proven by randomized studies in children and adults. The Belgian registry of HU-treated SCD patients was created to evaluate its long-term efficacy and toxicity. The median follow-up of the 93 patients registered is 3.5 years; clinical and laboratory data have been obtained for 82 patients at 1 year, 61 at 2 years, 44 at 3 years, 33 at 4 years, and 22 after 5 years. On HU, the number of hospitalizations and days hospitalized dropped significantly. Analysis of the 22 patients with a minimum of 5 years of follow-up confirm a significant difference in the number of hospitalizations (P = .0002) and days in the hospital (P < .01), throughout the treatment when compared to prior to HU therapy. The probabilities of not experiencing any event or any vaso-occlusive crisis requiring hospitalization during the 5 years of treatment were, respectively, 47% and 55%. On HU, the rate per 100 patient-years of severe events was estimated to be 3.5% for acute chest syndrome, 1.2% for aplastic crisis, 0.4% for splenic sequestration; it was 0% for the 9 patients with a history of stroke or transient ischemic attack followed for an average of 4 years. No important adverse effect occurred. Long-term chronic treatment with HU for patients with SCD appears feasible, effective, and devoid of any major toxicity; in patients with a history of stroke, HU may be a valid alternative to chronic transfusion support.

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Long-term salivary effects of single-dose head and neck irradiation in the rat

Archives of Oral Biology ◽

10.1016/s0003-9969(97)00120-9 ◽

1998 ◽

Vol 43 (4) ◽

pp. 297-303 ◽

Cited By ~ 34

Author(s):

R.M Nagler ◽

B.J Baum ◽

G Miller ◽

P.C Fox

Keyword(s):

Single Dose ◽

Head And Neck ◽

Neck Irradiation ◽

Head And Neck Irradiation

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Cricopharyngeal myotomy for delayed Cricopharyngeal dysfunction after head and neck surgery – case report

BMC Surgery ◽

10.1186/s12893-019-0667-5 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

An Sung ◽

Ka-Wo Lee

Keyword(s):

Head And Neck ◽

Neck Surgery ◽

Cricopharyngeal Myotomy ◽

Medialization Thyroplasty ◽

History Of ◽

Lymph Nodes Dissection ◽

Cricopharyngeal Dysfunction ◽

Contrast Swallow

Abstract Background Head and neck surgeries can perturb normal structures of neck muscles and nerve innervations, which are supposed to function in harmony to allow complicated process like swallowing. It is still likely that cricopharyngal dysfunction emerges years after the head and neck surgeries. Case presentation We report a case with history of left unilateral vocal cord immobility and development of dysphagia and aspiration 2 years after radical thyroidectomy with neck lymph nodes dissection and medialization thyroplasty. Cricopharyngeal dysfunction was impressed and was confirmed with visualization of cricopharyngeal narrowing segment in radiographic contrast swallow examination. The patient was treated successfully by cricopharyngeal myotomy, achieving long-term relief in our 4 years of follow up. Conclusions Our case of delayed cricopharyngal dysfunction after radical thyroidectomy and medialization thyroplasty shows that it is important to follow up swallowing functions after patients with UVCI undergo medialization thyroplasty. In the event of delayed manifestation of cricopharyngeal function, it can still be treated successfully by cricoharyngeal myotomy, achieving long term relief of dysphagia.

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Primary hyperparathyroidism with a history of head and neck irradiation: The consequences of associated thyroid tumors

Surgery ◽

10.1016/j.surg.2011.07.046 ◽

2011 ◽

Vol 150 (4) ◽

pp. 869-877 ◽

Cited By ~ 12

Author(s):

Stuart D. Wilson ◽

Kara M. Doffek ◽

Tracy S. Wang ◽

Elizabeth A. Krzywda ◽

Douglas B. Evans ◽

...

Keyword(s):

Primary Hyperparathyroidism ◽

Head And Neck ◽

Thyroid Tumors ◽

Neck Irradiation ◽

History Of ◽

Head And Neck Irradiation

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Salivary gland tumors in patients with a history of childhood head and neck irradiation: Report of fory-one cases

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/0360-3016(81)90325-4 ◽

1981 ◽

Vol 7 ◽

pp. 86

Author(s):

Alfred D. Katz ◽

Stephen E. Lee ◽

Susan Preston-Martin

Keyword(s):

Salivary Gland ◽

Head And Neck ◽

Salivary Gland Tumors ◽

History Of Childhood ◽

Neck Irradiation ◽

History Of ◽

Head And Neck Irradiation

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Long-Term Complications of Osteocutaneous Free Flaps in Head and Neck Reconstruction

Otolaryngology ◽

10.1177/0194599820912727 ◽

2020 ◽

Vol 162 (5) ◽

pp. 641-648 ◽

Cited By ~ 1

Author(s):

Brian Swendseid ◽

Ayan Kumar ◽

Larissa Sweeny ◽

Mark K. Wax ◽

Tingting Zhan ◽

...

Keyword(s):

Head And Neck ◽

Perioperative Complications ◽

Tertiary Care ◽

Free Flaps ◽

Head And Neck Reconstruction ◽

Free Flap Reconstruction ◽

Wound Breakdown ◽

History Of

Objective To determine the frequency at which patients with osteocutaneous free flap reconstruction of the head and neck develop long-term complications and identify predisposing perioperative factors. Study Design A prospectively maintained database of free flaps performed at a single institution over a 10-year period was queried. Setting Single tertiary care referral center. Subjects and Methods In total, 250 osseous or osteocutaneous free flaps (OCFFs) for mandibular or maxillary reconstruction were analyzed. Data were collected on demographics, preoperative therapy, resection location, adjuvant treatment, complications, and subsequent surgeries, and multivariate analysis was performed. Subgroup analysis based on perioperative factors was performed. Results The median follow-up time was 23 months. In 185 patients with at least 6 months of follow-up, 17.3% had at least 1 long-term complication, most commonly wound breakdown, fistula or plate extrusion (13.5%), osteoradionecrosis or nonunion (6.5%), and infected hardware (5.9%). Prior chemoradiotherapy and cancer diagnosis predisposed patients to long-term complications. At the 5-year follow-up, 21.7% of patients had experienced a long-term complication. Conclusions Long-term complications after OCFF occurred in 17% of patients. In this series, a preoperative history of chemoradiation and those undergoing maxillary reconstruction were at high risk for the development of long-term complications and thus warrant diligent follow-up. However, OCFFs can often enjoy long-term viability and survival, even in the case of perioperative complications and salvage surgery.

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