Primary tracheal tumors (PTT) are relatively rare and their diagnosis often late because the symptomatology is noncharacteristic and the signs only appear when over 60% of the lumen is obstructed. The most frequent histologic type is epithelioma (50 to 60%), but the glandular type which has a low malignant potential constitutes 25% to 40% of PTT, especially cystic adenoid carcinoma (cylindroma), which has a slow development but widely infiltrates the submucosa, distant from the macroscopic limits of the tumor. True benign tumors are rare. It is very important to know the tumor dimensions, and radiology is the best means of diagnosis in suspect cases. The usual treatment is surgery alone or associated with radiotherapy. The surgical techniques are now well-known and the operative mortality is very low when the indications are good. Excellent long-term results have been obtained with benign tumors, poor results, but sometimes with long palliation, in cases of epithelioma, and good results in cases of recurrent cylindroma. Statistics are, however, unavailable due to the fact that there is no large and homogeneous series.

Humans↗

PubMedDate not supplied

[Use of the laser in otorhinolaryngology].

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Adult↗

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[Metastases to the thyroid from adenocarcinomas. Review of the world literature around five personal cases (author's transl)].

The authors propound five personal clinical cases of intra-thyroid metastases from epithelial carcinomas. Looking through the world literature, they found 134 other such cases. Analyzing these cases, there is a marked preponderance of renal cancers. The other most frequency primary cancers are of the breast, tract, lungs and skin epitheliomas. Undeclared metastases discovered at autopsy seem to be much more frequency (approximately 7.7% of those who die of their cancer have such metastases). This discrepancy between the rarity of clinical metastases and the frequency of microscopic metastases is explained by their very great latency and their very slow progress. This justifies the attempt at a curative treatment every time this is possible: surgery plus cobalt therapy. This can produce a fairly long survival rate: one year and four months on average when the metastasis is discovered before the primary cancer; two years and then months when the metastasis is discovered after.

Aged↗

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[Use of acrylic prosthesis for the repair of large defects of the chest wall (author's transl)].

The experience of the authors is based on 17 patients 28 to 76 years old. The defect was always too large to be filled by the surrounding tissues. Six resections were on the sternum or the sternum with ribs. In 4 cases there was also a large resection of skin and muscles and in 3 cases pulmonary resection was associated. Prior to 1971 the authors used a crinoplate 3 times, a thin Marlex plate once and a thick one 5 times. Since 1971, 11 prostheses of methyl methacrylate were fixed with a double metal mesh (3 cases) or a Marlex mesh (8 cases). The authors insist on the interest of the latter prosthesis, made concurrently, easily and solidly fixed, and immediately and indefinitely well tolerated. In cases of large resections of muscle and skin the greater omentum can be used as described by Kiricuta to protect skin flaps from the plate prosthesis.

Adult↗

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[Laryngeal and tracheal stenoses after intubation and/or tracheotomy. A review of 32 cases including 39 lesions and 33 operations (author's transl)].

After reviewing their cases of scarr-stenosis of the upper airway between 1966 and 1976 the authors compare laryngeal to tracheal lesions: Laryngeal and laryngo-tracheal stenoses are long and difficult to repair and all too often yield poor results. These stenoses are usually due to technical faults (tracheotomy after prolonged intubation, forced intubation, tracheotomy through the first ring). They are most often avoidable. Pure tracheal stenoses nearly always result from ischemic destruction from the pressure in the balloons of the tubes and cannulae. They are difficult to prevent when resuscitation requires high pressure ventilation. Their treatment however is simple: resection and anastomosis yields excellent results though it should only be performed in pure scarr-tissue stenosis. Endoscopic dilatations may be a necessary preparation.

Adolescent↗