tetracycline and Head-and-Neck-Neoplasms

Dental extractions in patients who had radiation therapy for cancer in the head and neck region carry with them the risks of delayed healing, prolonged alveolar bone exposure, infection, and osteoradionecrosis. Among the precautions to minimize these risks are antibiotic coverage, limited extractions at any one time, soft tissue closure, and hyperbaric oxygen treatment. Rapid epithelization and minimal bone exposure are essential after extractions in irradiated patients.. This study examined the effects of hard tissue replacement on head and neck cancer patients who were treated with radiation therapy.. In a series of eight patients who had radiation doses from 4000 cGy to 7440 cGy in the head and neck area and who had 44 teeth extracted, hard tissue replacement material mixed with tetracycline powder was placed in the extraction sites.. Of the 44 teeth extracted, 19 mandibular molars and premolars were in the direct field of radiation in seven patients. One patient also had 6 mandibular anterior teeth and 12 maxillary teeth extracted that received minimal radiation exposure. One patient had 6 mandibular anterior teeth extracted that were not in the area of direct exposure. One patient had a mandibular first molar extracted in an area that received minimal radiation exposure. Clinically, complete epithelization occurred in all patients. No infections developed. Radiographically no bone dissolution could be identified in the extraction area(s). The follow-up times ranged from 7 months to 18 months when the patients were seen last.. The hard tissue replacement particles appears to provide a matrix for fibrous connective tissue formation.

Topics: Anti-Bacterial Agents; Biocompatible Materials; Bone Substitutes; Cranial Irradiation; Drug Combinations; Head and Neck Neoplasms; Humans; Methylmethacrylates; Osteogenesis; Polyhydroxyethyl Methacrylate; Radiotherapy Dosage; Tetracycline; Tooth Extraction; Treatment Outcome

Squamous cell carcinomas and several other cancers have been found to exhibit microarray expression profiles that include genes related to nuclear factor (NF)-kappaB, a signal activated transcription factor that is evolutionarily important in regulating early response gene programs to injury and infection. Inhibition of NF-kappaB by expression of a dominant negative signal phosphorylation site mutant of inhibitor-kappaB, IkappaBalphaM, under a tetracycline inducible promoter, established the role of NF-kappaB as an essential molecular switch modulating multiple genes important in the malignant phenotype. Bioinfomatic analysis of the promoter and coding region of IkappaBalphaM-modulated genes has enabled identification of new candidates with and without known NF-kappaB related motifs for validation and functional studies of their relationship to NF-kappaB. These studies illustrate how microarray data can be used to generate a hypothesis regarding regulation of genes by a specific signal transcription factor, and how genetic mutants and bioinformatic analysis can be used to analyze the relative importance of the regulatory molecule to expression of genes involved in the malignant phenotype.

Topics: Animals; Carcinoma, Squamous Cell; Cell Line, Tumor; Computational Biology; Disease Progression; Gene Expression Profiling; Gene Expression Regulation, Neoplastic; Head and Neck Neoplasms; Humans; Mice; NF-kappa B; Oligonucleotide Array Sequence Analysis; Signal Transduction; Software; Tetracycline

The particular use of lymphoscintigraphy to document retention and drainage in cystic lymphangioma of the neck is reported. Radionuclide examination using Tc-99m colliod particles, performed before sclerosing treatment with tetracycline in a patient with a large lymphangioma located in the neck, demonstrated a satisfactory tumor retention and slow outflow, enabling the administration of tetracycline without (risk of) organ toxicity. The treatment was successfully performed.

Topics: Adult; Head and Neck Neoplasms; Humans; Injections, Intralesional; Lymphangioma; Male; Radionuclide Imaging; Sclerosing Solutions; Sclerotherapy; Technetium Tc 99m Aggregated Albumin; Tetracycline

The surgical management of osteoradionecrosis of the temporal bone has met with limited success because of the difficulty in accurate assessment of the viability of nonnecrotic bone intraoperatively. Failure to resect all nonviable bone results in recurrence of a necrotic focus. With the use of hyperbaric oxygen therapy to stabilize marginal bone and oral tetracycline to label viable bone preoperatively, removal of all nonviable bone can be accomplished. Postoperatively, a second course of hyperbaric therapy enhances wound healing, thus assuring a successful outcome. This article details a successful systematic approach that was developed to resect a necrotic focus in the temporal bone of a 10-year-old boy who had undergone a full course of radiotherapy for treatment of a rhabdomyosarcoma.

Topics: Child; Combined Modality Therapy; Head and Neck Neoplasms; Humans; Hyperbaric Oxygenation; Male; Osteoradionecrosis; Postoperative Care; Premedication; Radiation Injuries; Radiography; Temporal Bone; Tetracycline

The management of chylous fistulae remains controversial. A detailed conservative protocol and guidelines regarding surgical intervention are lacking in the literature. This paper presents our experience in the management of two cases of persistent chylous fistulae by successfully employing topical tetracycline. Our regimen of management is discussed and illustrated with the above two cases. An updated review of the pertinent anatomy, physiology, and literature is presented.

Topics: Administration, Topical; Chyle; Female; Fistula; Head and Neck Neoplasms; Humans; Larynx; Male; Middle Aged; Neck; Pharynx; Postoperative Complications; Tetracycline; Thoracic Duct

In chylous fistulas following radical neck dissections, we have found reexploration to be unrewarding, with infrequent identification of a specific leakage site intraoperatively and persistent fluid accumulation postoperatively. As an alternative, we injected tetracycline hydrochloride into the supraclavicular wound bed. This procedure resulted in a rapid, sustained decline in fistula output in two of three cases, avoiding surgical intervention. Tetracycline sclerotherapy has been described for treatment of intrathoracic and other intracavitary fluid collections. We believe that tetracycline sclerotherapy is an effective adjunct in the management of chylous fistulas following radical neck dissections and that this therapy should be attempted before surgical reexploration.

Topics: Adenocarcinoma; Aged; Carcinoma, Squamous Cell; Chyle; Drainage; Female; Fistula; Head and Neck Neoplasms; Humans; Male; Methods; Neck Dissection; Parotid Neoplasms; Postoperative Complications; Sclerosing Solutions; Tetracycline; Time Factors

The case history of a 52-year-old male with weight loss, steatorrhea and arthritis is presented. During clinical pathological conference, Whipple's disease was strongly suggested. The diagnosis could be proved morphologically. Antibiotic therapy with tetracycline 1 g daily for three months caused a prompt improvement. Small bowel biopsy showed disappearance of PAS-containing macrophages.

Topics: Body Weight; Carcinoma, Squamous Cell; Diarrhea; Head and Neck Neoplasms; Humans; Malabsorption Syndromes; Male; Middle Aged; Tetracycline; Whipple Disease