Pain and dysphagia in patients with squamous carcinomas of the head and neck: the role of perineural spread.

摘要: Clinical and pathological features of perineural spread have been investigated in patients with squamous carcinomas at several sites the head neck. In 100 surgical cases, clinical findings were congruent 76%. Combined histological evidence invasion was recorded 33% overall incidence nerve involvement detected morphologically 44%. Perineural infiltration demonstrated histologically 51% major excisions from buccal cavity 34% resections oropharynx, hypopharynx cervical oesophagus. The neurological dominated by hypoaesthesia, dysaesthesia referred pain – mainly territories cranial nerves V IX. Multiple and/or sequential occasionally seen. No correlation established between metastasis to regional lymph nodes. Long-distance trunks, multiple involvement, are grave prognostic features. In 17 terminal submitted autopsy, 65% had combined 88%. Sensory changes again predominated. observed 35%. An apparently new `dysphagia syndrome' is described 4 oropharyngeal whom gross mechanical obstruction simulated a combination tumour into ipsilateral vagal trunk, sometimes accompanied segmental infarction, variable sympathetic chain, `splinting' pharynx local fibrosis soft tissues Short-term palliation achieved these high-dose steroids.