1,721,009 research outputs found
Salvage surgery for recurrent or persistent advanced laryngeal or hypopharyngeal squamous cell cancer: systematic review
No full textINTRODUCTION: The common use of non-surgical protocols implies the possible indication for salvage surgery in irradiated tissue in case of recurrent or new primary carcinomas after radiotherapy or chemo-radiotherapy. Surgery in form of salvage total laryngectomy/pharyngo-laryngectomy is the main curative treatment in patients with advanced recurrent or persistent laryngeal or hypopharyngeal squamous cell carcinoma. EVIDENCE ACQUISITION: All studies reporting oncologic outcomes and complication rate of patients who underwent total laryngectomy with or without subtotal or circular pharyngectomy for advanced-stage (stage III and IV) squamous cell carcinoma of the larynx or hypopharynx, as a salvage procedure after failure of radiotherapy with or without chemotherapy were included. EVIDENCE SYNTHESIS: Ten studies (547 patients) were included in the review. The full text of the included studies was reviewed with extraction of patient number, tumor site, TNM stage, primary treatment, salvage treatment, incidence of salivary fistula, and 5-year oncological outcomes. Comparison of survival and incidence of salivary fistula for laryngeal and hypopharyngeal cancer was performed. CONCLUSIONS: Local control should be the most important value when choosing the treatment modality for advanced-stage primary squamous cell carcinoma of the larynx and hypopharinx since failures after non-surgical organ preservation therapy are burdened by a bad prognosis despite rescue treatment. Recurrences without pharyngeal extension have better outcomes compared to the hypopharyngeal recurrence (5-year OS, DSS and DFS of 47.3%, 47% and 46.4% vs. 39.3%, 23.6%, and 36.3% respectively). Salivary fistula is the most frequent postoperative complication, mainly observed in patients with hypopharyngeal relapse (36% vs. 26.7% observed in patients exclusive laryngeal relapse) and after primary chemo-radiotherapy (36.2% vs. 23.6% in patients who relapsed after radiotherapy alone). Free and pedicled flaps have a major role in salvage surgery for recurrent advanced laryngeal or hypopharyngeal squamous cell carcinoma
Management of tracheostomy during COVID-19 outbreak: Heat and moisture exchanger filter and closed suctioning system
Full text linkPrecautions for safer management of tracheostomy should be taken for all patients.
HMEFs and closed endotracheal suctioning systems protect patients and healthcare professionals.
Precaution for reduce the COVID-19 diffusion should be taken until the epidemic is controlled
Résultats oncologiques et incidence des complications à long terme chez les patients opérées de laryngectomie partielle avec CHP ou CHEP: expérience fondée sur 50 cas
No full textFourth branchial cleft anomaly: management strategy in acute presentation
No full textObjectives: Branchial malformations are common congenital head and neck lesions usually diagnosed in childhood during the first decade of life. Acute presentation is usually managed with conservative protocols before a definitive surgical procedure although the risk of life-treating septic complications may influence the physician's decision. Surgery is the treatment of choice with the removal of the lesion alone, nevertheless more aggressive approaches must be considered in complicated cases. Selective neck dissection including the removal of part of the thyroid lobe with the congenital lesion should be considered as the "ultima ratio" treatment to avoid recurrence.
Methods: We reviewed literature and report our experience concerning two patients with fourth branchial cleft sinus.
Results: A three-year-old child with a clinical history of recurrent neck abscess was referred to our department after several drainages performed in another centre. A three-year-old child referred to our department for a left side lower primary neck abscess. In both cases the diagnosis of a complicated fourth cleft remnant was confirmed by rigid endoscopic visualization of the mucosal orifice of the sinus in the pyriform fossa. Surgical management during acute presentation was challenging; in one patient the early fasciitis required an emergency procedure to remove the infected sinus that were strictly adherent to the deep vascular-nervous axis.
Conclusion: Surgery was the definitive treatment in both cases and at 12 and 25 months follow-up respectively no recurrences were observe
Traitement chirurgical du cancer du larynx par voie endoscopique avec laser CO2: expérience sur 207 cas.
No full textEndoscopic management of adult-type rhabdomyoma of the glottis: case report and review of the literature
No full textRole of endoscopic approach in the management of inverted papilloma
No full textThe aim of this work, based on a recent review of the literature concerning sinonasal inverted papilloma, is to describe the diagnostic strategy for inverted papilloma and to propose an algorithm for the choice of surgical techniques, based on recent results of clinical series
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