Search PubMed⌕ Search

Biomedical subjects

D G Sessions

Publications and source records attributed to D G Sessions.

At least 73 records · Page 4Linked to original sources
PubMed1976

Surgical management of bilateral vocal cord paralysis.

Fifty-five patients with bilateral abductor paralysis of the vocal cords were managed surgically from 1957 to 1973. Initially, unilateral arytenoidectomy or arytenoidopexy was employed. If this was not satisfactory, a contralateral arytenoidectomy was performed 6 to 12 months later. If the patient's airway was still inadequate, then open unilateral submucous resection of the vocal cord was accomplished. Initial management was successful in 62 patient (34/55) of patients, and 50 to 55 patients (91 percent) were eventually decannulated. Failure of the arytenoidectomy appeared to be related to traumatic etiology of the bilateral paralysis presence of previous treatment, and technical problems of the procedure itself.

Adolescent↗
PubMed1976

Surgical pathology of cancer of the larynx and hypopharynx.

A study was designed to determine the influence of certain surgical pathologic findings on tumor spread and survival in patients with cancer of the larynx and hypopharynx. All patients with primary epidermoid carcinoma of the larynx and hypopharynx, treated by either surgery or preoperative irradiation and surgery, between 1955 and 1971 were included in the study. The patient population consisted of 791 patients all of whom were eligible for three-year follow-up. Information from a retrospective study of the surgical pathology reports regarding resection margins, size and differentiation of the primary tumor, histopathologic characteristics of the primary tumor and neck dissection, number, position and size of positive lymph nodes and post treatment staging, was correlated with tumor spread and survival.

Carcinoma, Squamous Cell↗
PubMed1976

Medullary carcinoma of the thyroid.

Medullary carcinoma is an unusual malignant neoplasm. The cell of origin is considered to be the C-cell which is derived from the ultimobranchial body and neural crest. The tumor is solid and has characteristic amyloid in the stroma. The lesion usually presents as a neck mass, and multicentricity is not unusual. In some patients diarrhea may be an important presenting symptom. Serum calcitonin is typically elevated and is important in the diagnostic confirmation. About 10 percent of the cases are part of a familial endocrine syndrome which includes pheochromocytomas, mucosal neuromas, and other endocrine gland adenomas. Frequent multicentricity and early cervical lymphatic and systemic metastases necessitate total thyroidectomy and radical neck dissection. Prognosis varies from a rapid demise to long term survival.

Adult↗
PubMed1975

Tongue flap reconstruction in cancer of the oral cavity.

The mobility, size, and composition of the tongue make it ideal for oral cavity reconstruction following resection for carcinoma. The tongue flap provides a ready means of primary closure without increased morbidity, especially in patients who have had extensive therapeutic or preoperative irradiation treatment. The position of the tongue adjacent to the surgical defect and its excellent blood supply allow its nondelayed utilization. In most cases, use of the tongue flap precludes the necessity for multiple-staged reconstruction with regional pedicle flaps, with an improvement in functional results in terms of immediate healing, swallowing, and articulation over previous methods of reconstruction.

Carcinoma, Squamous Cell↗
PubMed1975

Complications of dermal graft protection of carotid artery.

The efficacy of autogenous dermal grafts for carotid artery protection in head and neck surgery has been investigated experimentally and propounded clinically. A review of 194 dermal grafts from 1966 to 1972 at the otolaryngology service of Washington University Medical Center revealed two broad categories of complications that were unique to dermal graft protection of the carotid artery. Two cases of inclusion cysts that developed two years after implantation of the dermal graft were classified as a complication secondary to technical problems of taking the graft. The second category of complications arose as a result of epithelialization of the exposed dermal graft. While the overall incidence of complications that were attributable to the dermal graft was approximately 6%, autogenous dermis continues to provide an excellent method for carotid artery protection.

Carotid Arteries↗
PubMed1975

Carcinoma of the subglottic area.

The subglottic area is defined as an anatomic region which is cylindrical in shape whose inferior margin is the inferior border of the cricoid cartilage and which is limited superiorly by an imaginary circle 5 mm below the free margin of the true vocal cords. Of 591 patients with glottic and subglottic cancers, only five (percent) had primary subglottic tumors and 132 (22 percent) had glottic tumors with subglottic extension. Sixty-five percent of the patients with glottic primary with subglottic extension were Stage 2 and 35 percent were Stage 3. Most patients were treated surgically. Hemilaryngectomy is a very satisfactory primary modality in the treatment of Stage 2 and some Stage 3 glottic lesions with subglottic extension. Stage 2 and 3 glottic cancers which involve greater than 10 mm of the subglottis carry a significantly decreased prognosis. Patients with T3 lesions with cord fixation with subglottic extension show a decreased survival.

Carcinoma, Squamous Cell↗
PubMed1975

Analysis of surgical therapy for epidermoid carcinoma of the laryngeal glottis.

Four hundred sixty-three patients with glottic carcinoma were treated by surgical techniques with or without preoperative irradiation. Two hundred eighty-one had hemilaryngectomy and 182 total laryngectomy procedures. The overall cure rate for the hemilaryngectomy group was 91 percent and 80 percent for the total laryngectomy group, with an overall cure rate of 87 percent. Our observations support the fact that Stage I glottic carcinoma has slightly better prognosis when treated by hemilaryngectomy. Stage II and III lesions have a significant improvement in cure rate and survival when treated with combined preoperative irradiation and partiall vertical laryngectomy or total laryngectomy than by irradiation alone.

Carcinoma, Squamous Cell↗
PubMed1975

The anterior commissure in glottic carcinoma.

The laryngeal anterior commissure is a specific anatomic area of the glottis which is often involved by cancer. Of 586 patients with glottic cancer, five (1 percent) had pure anterior commissure lesions and 175 (25 percent) had vocal cord tumors secondarily involving the anterior commissure. One of three of these anterior commissure tumors also had subglottic extension. Despite the presence of blood vessels and lymphatics in the anterior commissure, metastasis to regional lymph nodes in rare (8 percent). Patients with Stage 1 and 2 lesions were treated by hemilaryngectomy with satisfactory results (45/61 -- 74 percent). Only three patients had local recurrence after hemilaryngectomy. Patients with bilateral cord-anterior commissure lesions had the poorest survival and highest recurrence rate, even after total laryngectomy. Subglottic extension of these anterior commissure tumors did not correlate with survival. Survival and recurrence rates were conversely proportional to the stage of the tumor at presentation. Although the anterior commissure is a theoretical site for cancer breakthrough and lymphatic spread, its apparent significance lies in the fact that its involvement by glottic primaries represents only increasing tumor size and thus an advanced stage of disease.

Glottis↗
PubMed1975

Glottic cancer with extension to the arytenoid.

Hemilaryngectomy with removal of a greater part or all of the arytenoid was done in 79 patients with good functional results with an overall cure rate of 94 percent. The survival rate for the primary modality of therapy was 90 percent.

Adult↗
PubMed1975

Adenocarcinoma of the larynx.

Nine patients with primary adenocarcinoma of the larynx representing 0.1 per cent of 888 patients with primary laryngeal malignancy treated between 1955 and 1971 are reported. Following surgical therapy, four patients are alive without disease and five patients are dead due to their disease. Survival time was not related to histopathologic type, stage of disease, or mode of therapy. We cautiously advocate the use of the most conservative surgery feasible as the primary treatment of this poorly understood and highly fatal disease.

Animals↗