[Speech disorders due to anatomic abnormalities of the phonation organs].
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Biomedical subjects
Publications and source records attributed to M Legros.
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A new method of irradiation known as hyperfractionated radiotherapy was studied in 56 patients with cancers in the region of the ear, nose, and throat. The dose was 72 grays given during 80 sessions over a period of 28 days, with a rest period of two weeks at the half-way point. Each session lasted 2 hours. The results (complications and survival rate) were compared with those obtained in a control group treated with 70 grays in 35 sessions over a period of 7 weeks. The complication rate was 21% in the series treated with hyperfractionated radiotherapy, against 19% in those given classical treatment (results not significant). The survival rate was better, however, (63% against 33% after 18 months), for the patients treated with this new method of irradiation.
So-called "hyperfractionated" radiotherapy is aimed at obtaining synchronisation of tumour cells and to kill the cells synchronised in this way. The technique has been used now for approximately a year and a half in the treatment of 45 advanced or inoperable squamous carcinomas of the upper respiratory and digestive tract. The initial results are encouraging. Oncological sterilisation of the lesions is obtained at the price of actinic reactions which rapidly disappear, but also tumour necrosis, which indicates the need for review of the protocol.
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The authors consider the problems raised by severe closed laryngotracheal trauma and report 4 cases. -the immediate tisk to life is due to direct involvement of the respiratory tract requiring emergency measures including cardiorespiratory resuscitation in cases of acute asphyxia. -the origin of the initial respiratory distress, if not obvious from the start, may be suspected in view of the difficulties or impossibility of tracheal intubation, which is also liable to aggravate lesions due to trauma. It is one of these rare cases of resuscitation where emergency tracheotomy is essential. It permits also early, precise surgical exploration. -in cases of fracture of the larynx, a wound of the trachea or rupture and separation of the trachea, the reconstruction must be constructiononstruction must be considered within the first 48 hours. Provision of food and resting of the larynx may be conciliated by installing an esophageal catheter or performing a gastrostomy. Benign trauma, such as contusion or laryngeal commotion, requires close supervision association with medical treatment designed to prevent the onset of lesional oedema.
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