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This article was designed to report a rare case of oropharyngeal chondroma in a 31 year-old male patient. Computed tomography revealed an encapsulated cystic-solid tissue mass having the clear-cut contours with multiple diffuse foci of calcification in the tissue thickness. The neoplasm was morphologically characterized as a chondroma. The tumour was removed with the use of the modified Lauers-Balon procedure with the dissection of the lower jaw.

The objective of the present study was to estimate the effectiveness of chemoradiotherapy and surgical treatment of the patients presenting with oropharyngeal cancer depending on the character of the tumorigenic process, the intensity of radiotherapy, and time of the surgical intervention. The study included 47 patients who underwent routine clinical examination, endoscopic study, contrast-enhanced computed tomography, magnetic resonance imaging, and evaluation of oropharyngeal conditions under general anesthesia. It was shown that the mode of surgical approach (largely median mandibulotomy) is of primary importance for the surgical intervention in the oropharyngeal region and its plastic reconstruction. The surgical intervention on the regional lymph collector following chemotherapy for oropharyngeal cancer with the excellent clinical effect was performed 2 months after the persisting tumorigenic process in cervical lymph nodes had been confirmed. In the patients with operable metastases of squamous- cell carcinoma in the cervical lymph nodes and the absence of the identified primary site of the neoplastic growth, the surgical intervention was followed by dynamic observations. In the case of discovery of the primary oropharyngeal tumour, the course of radical chemotherapy was prescribed. It is concluded that precise evaluation of the extent of the tumour is indispensable for the targeted choice of the patients with recurrent oropharyngeal cancer for the surgical treatment.

This work was designed to analyse outcomes of the treatment of 65 patients with advanced oropharyngeal cancer who had received combined treatment including radical resection of the tumour. Thirty three patients underwent surgery without ligation of exterior carotid artery while the remaining 32 (control group) were operated after preceding ligation of this vessel. The influence of ligation of exterior carotid artery on cerebral circulation was evaluated by the following methods: estimation of the intraoperative blood loss from A.T. Staroverov's formula, ultrasound dopplerography of extracranial carotid segments, electroencephalography, measurement of the fields of vision using statistical quantitative perimetry, evaluation of the patients' neurologic status. It was shown that ligation of exterior carotid artery has no apparent effect on the intraoperative blood loss during radical surgery for the management of oropharyngeal cancer nor does it influence healing of the postoperative wound and oncological outcome of this treatment.

A new technique of intraoperative bolus-assisted administration of chemical drugs for oropharyngeal carcinoma has been developed. In tongue tumor, the lingual artery was ligated at the site of origin from the external carotid artery and catheter was installed after venous flow was blocked. Bolus was used to administer 5-fluorouracyl intraoperatively before and after removal of primary tumor. The external carotid artery was ligated at a site above the origin of the upper thyroid artery after venous flow was blocked and paracervical fat excised when tumor site was at the back of the oral cavity, oropharynx or in cases of locally advanced cancer. Subsequently, depending on tumor site, catheter was installed into the external carotid artery trunk at a site below the origin of the lingual artery, the external carotid artery was ligated once more at a site above the origin of the facial artery, and bolus was used to administer 5-fluorouracyl intraoperatively before and after removal of primary tumor. According to the end results, relapse occurred after 28 months instead of 12 and survival improved within the first 2 years after surgery.

Surgical method of treatment was used in 194 patients with tumors of the mouth cavity and oral part of the pharynx. Combined treatment (radiation therapy and operation in various combinations) was used in 110 of these patients and in 84 patients the treatment was complex (polychemotherapy + operation + postoperative course of radiation therapy). Comparative characterization of operations fulfilled on the initial focus has shown that the number of function-saving operations in the group of patients treated by complex methods was 86.9%, and in the group of patients treated by combined methods it was 70.9%. It can be explained by a higher degree of tumor regression under the influence of neo-adjuvant polychemotherapy than under the action of preoperative course of radiation therapy as well as due to the development of a number of function-saving operations which could be used in patients after a course of neo-adjuvant chemotherapy.

Surgery was used in the treatment of 194 patients with tumors of the oral cavity and throat. In 110 of them the treatment was combined (radiotherapy and surgery) and in 84 - complex (polychemotherapy + surgery + postoperative radiotherapy). Characteristics of surgeries are compared. It is demonstrated that number of function-preserving operations in patients given complex treatment was 86.9%, combined treatment - 70.9%.

Chordomas are relatively rare dysontogenetic tumors developing from the remnants of the spinal chord. Intracranial chordomas consist of 85% of all chordomas. Slowly progressive growth with destructive osteolysis in adjacent bones and low metastatic potential are specific for chordomas. Ninety six surgeries were performed in 71 patients with chordomas at the Burdenko Institute of Neurosurgery from 1987 to 1996. This article presents a clinical case of large clival chordoma with extra-intracranial growth in a 58 year-old female patient. The clinical picture is characterized by lesions in the caudal cranial nerves, predominantly on the right side, as well as cerebellar and brainstem signs and symptoms. Two-stage partial removal of malignant clival chordoma was performed via transoral and retrosigmoid approaches. The interval between the stages was 6 months. In the authors' opinion, multistage surgery is preferred in the treatment of giant clival chordomas. Partial removal should be started from the portions of a tumor producing the most prominent neurological signs. This method allows the patient's status to be temporarily improved.

Available are the results of surgical treatment of 11 patients with cancer of the esophagus revealed metachronously through 6 months--3 years after treatment of oro-pharyngeolaryngeal cancer (5 patients) and diagnosed synchronously with cancer of the stomach (3 patients), the lung (2 patients) and leiomyoma of the esophagus (1 patient). Radical operations on the esophagus were performed in all the patients, in synchronous tumors they were one-stage surgical intervention. Postoperative complications such as pneumonia were observed in the majority of patients, who previously underwent radiation or combined treatment for laryngeal cancer, as well as in all patients, who were operated on the esophagus and the lung in one stage. The necessity of active bronchial sanation in pre- and postoperative period of patients after treatment of laryngeal cancer and advisability of two-stage surgical treatment of synchronous tumors of the esophagus and the lung, the operation for lung cancer being performed at the second stage of treatment, are stressed in conclusion. In synchronous involvement of the esophagus and the stomach one-stage intervention on these organs is the most advisable.

The oral part of the pharynx affected by cancer is subject to radiation, surgical and combined treatment. In stage IIIb the author practices resection of the oral pharynx by means of posterolateral pharyngotomy. This provides an adequate approach to the lesion area (the root of the tongue, vallecules, posterior and lateral walls of the pharynx) to perform ablastic resection of the oral pharynx with radical dissection of cervical fat.

Some advances have been recently made to improve survival rates among patients with common advanced larynx and oropharyngeal cancer. In this connection, it is essential to improve the quality of such patients' life. A total 382 patients with Degrees III-IV laryngeal and oral cancers were followed up. New approaches to treating these patients by combining various radiation, chemoradiation and surgical treatments, as well wide application of various primary plastic surgeries have yielded good functional and cosmetic results in most patients.

Analysis of 113 typical (within the same anatomical area) surgeries has helped define the indications for such interventions in stage-III squamous cell carcinoma, of the moving part of the tongue and cheek first of all. Clinical indications are dissemination of the tumor within one anatomical area, exophytic or ulcerous form of its growth, a higher than 50 percent realization of the effect of previous conservative therapy, no regional metastases; morphologic indications include the presence of a clear-cut borderline, manifest lymphoplasmacytic reaction of the adjacent tissues.

An analysis of primary reconstructive surgical treatment of 254 patients with carcinoma of the mouth mucosa and oral pharynx was made. The character of operative procedures for different localizations of the tumour is described. The primary reconstructive surgical treatment was shown to reduce the amount of postoperative complications to 11.4%, to keep intact the natural ways of respiration and nutrition at the early postoperative period. If without recidivation, about 70% of the patients continued working.

Defects resulting from surgical treatment for maxillo-facial tumors of various origin were studied. Procedures for reconstruction versus site are discussed and immediate results are presented. Reconstruction should be performed in early postoperative period to assure normal food passage.