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Biomedical subjects

M Quer

Publications and source records attributed to M Quer.

49 records · Page 3Linked to original sources
PubMedDate not supplied

Prevention of stomal recurrence.

BACKGROUND: The authors reviewed the incidence of stomal recurrence (SR) in a population of laryngectomized patients to study associated risk factors and determine the usefulness of certain preventive procedures. METHODS: A retrospective study was performed in 296 patients with larynx and hypopharynx carcinoma treated by total laryngectomy. RESULTS: Of the 296 patients, 6 (2%) were initially seen with SR. In all cases, a risk factor was found to be involved: subglottic extension (5 cases), tracheotomy prior to laryngectomy (1 case). Since 1989, when preventive measures were systematically introduced in patients presenting risk factors, there have been no further cases of SR. The surgical measures in tumors with subglottic extension consisted of hemithyroidectomies, paratracheal lymph node dissection, and extensive tracheal resection; in the case of a tracheotomy prior to the laryngectomy, extensive resections of the tracheal stoma were carried out. CONCLUSIONS: The systematic use of preventive surgical measures together with postoperative radiotherapy to the stoma and superior mediastinum have led to a decrease in the appearance of SR.

Aged↗
PubMedDate not supplied

Blood transfusions in laryngeal cancer: effect on prognosis.

METHODS: To evaluate the influence of homologous perioperative transfusion on oncologic control and survival in patients with larynx and hypopharynx carcinomas, we conducted a retrospective study of 269 patients with larynx and hypopharynx carcinoma treated by major surgical procedures. A total of 20 variables were analyzed for each patient. RESULTS: Perioperative transfusion was required in 86 (32%) patients, with packed red blood cells being used in all cases. Recurrence at a local, regional, or distant level was 31% for nontransfused and 35% for transfused patients. The 5-year adjusted survival was 68% for patients without transfusion and 63% for patients with transfusion. Neither the univariate nor the multivariate analysis showed that perioperative transfusion or the number of units of packed red blood cells used had any prognostic capacity. CONCLUSIONS: Homologous perioperative transfusion did not imply a significant risk regarding global control or survival in our larynx or hypopharynx cancer patients.

Adult↗
PubMedDate not supplied

[Usefulness of facial nerve monitoring during parotidectomy].

OBJECTIVE: To analyse the usefulness of facial nerve monitoring by continuous electromyography during parotidectomy. PATIENTS AND METHODS: Fifty-two consecutive patients who underwent parotidectomy (27 unmonitored and 25 monitored) between 1987 and 1998. Both groups had a similar distribution of superficial and total parotidectomy. RESULTS: Facial nerve monitoring reduced the incidence and severity of facial nerve paralysis independently of the kind of surgery performed. The incidence of temporary facial paralysis was significantly lower in the monitored group (36%) than in the unmonitored group (70%) (p = 0.013). The rates of permanent deficit were 4% for the monitored group and 30% for the unmonitored group (p = 0.025). CONCLUSIONS: The results suggest that intraoperative facial nerve monitoring reduces the incidence of postoperative facial deficit. The routine use of facial nerve monitoring is controversial. However, it is considered useful in surgery where there is a higher risk of injury to the facial nerve such as total parotidectomy, re-interventions or chronic inflammatory conditions.

Adolescent↗
PubMedDate not supplied

[Glottic immobility: retrospective study of 229 cases].

A retrospective study of the unilateral and bilateral vocal fold immobility cases diagnosed at our hospital between 1985 and 1998 was carried out. Of the 229 cases studied, vocal fold immobility was bilateral in 58 patients (25%), unilateral right in 60 (26%), and unilateral left 111 (49%). The most frequent etiologies in the bilateral cases were thyroid surgery (38%) and prolonged intubation (31%); idiopathic cases (32%) and thyroid surgery (23%) in the unilateral right cases; and idiopathic cases (28%) and extralaryngeal tumors (22%) in the unilateral left cases. Clinical compensation was achieved in more than 85% of cases of unilateral immobility when the etiology was idiopathic or due to surgical damage to the recurrent or vagus nerves, 70% when it was a prolonged intubation, 56% in neurological patients and 38% in extralaryngeal tumors. In patients with bilateral vocal fold immobility, 14% did not require any treatment, 34% had a permanent tracheostomy, and 52% recovered adequate naso-oral ventilation after surgery (tracheostomy only in 12 patients and arytenoidectomy in 18 patients).

Female↗
PubMedDate not supplied

[Treatment for the early stages (T1-T2NO) of squamous cell carcinoma of the mobile tongue].

OBJECTIVE: The aim of this study is to define the best local treatment in patients with squamous cell carcinoma of mobile tongue in the early stages (I-II) and to establish the best election for neck management. MATERIAL AND METHODS: We evaluated 90 patients classified as stage I and II between 1984 and 1999. Sixty-eight patients out of the ninety (75%) were treated with radio-therapy and twenty-two (25%) with surgery. Neck dissection was used in 39% (35/90) of patients. RESULTS: The rates of ultimate local control for T1NO lesions were similar for both treatment groups (94% vs. 95%). For T2N0 lesions the ultimate local control did improved in those patients treated with surgery (100%) compared to those that had radiotherapy (77%). Regional control was better in the group that underwent neck dissection compared to the group that had just ganglionar control (89% vs. 79%). CONCLUSIONS: We recommend local surgical treatment for T1-T2NO and in our experience prophylactic treatment of lymph nodes leads to a better regional control.

Adult↗
PubMedDate not supplied

[Assessment of the prognostic capacity improvement of the 5th edition of the TNM in patients with nasopharyngeal carcinoma].

OBJECTIVE: Evaluate the changes included in the 5th edition of the TNM classification in patients with nasopharyngeal carcinoma. PATIENTS AND METHODS: Retrospective study of 103 patients with nasopharyngeal carcinoma treated with radical intention in our centre from 1985 to 1997. A reclassification according to the criteria defined in the 5th edition of the TNM was carried out. The loco-regional control and survival obtained when patients were classified with the 4th and 5th editions of the TNM were compared. RESULTS: The use of the 5th edition of the TNM led to a decrease in local category (T) and stage grouping, improving the prognostic capacity in local control and survival. The changes included in the 5th edition of the TNM did not modify the regional classification in a essential way. CONCLUSIONS: The changes included in the 5th edition of the TNM improved the classification of patients with nasopharyngeal carcinoma.

Adult↗
PubMedDate not supplied

[A retropharyngeal synovial sarcoma].

The synovial sarcomas constitute the 7-10% of the soft tissue malign tumors, with a preferred location in the limbs. In the head and neck a 5% of the totality are placed. We present one case of retropharyngeal synovial sarcoma and the accomplished treatment, together with a revision of the bibliography.

Adolescent↗
PubMedDate not supplied

[Chondrosarcoma of the larynx: review of the Western literature and presentation of a new case].

We present the case of a 70 year old man with cricoid chondrosarcoma treated with total laryngectomy. This report reviews the occidental literature, with nine cases reported by national authors in the las 25 years. We have recollected 104 laryngeal chondrosarcoma, in all. Clinical and diagnostical data, location, and treatment were analysed and compared with our case.

Aged↗
PubMedDate not supplied

[Laryngeal amyloidosis: treatment vs. abstention].

Four cases of laryngeal amyloidosis diagnosed between 1986 and 1992 are reported. Two cases had supraglottic localization and the remaining two involved both glottis and subglottis. CT was performed in all cases. Diagnosis was made in the four cases by biopsy. All of them were classified as localized laryngeal amyloidosis after doing immunoelectrophoretic study in blood and urine, and rectal biopsy in two cases. Surgical excision by carbon dioxide laser was performed in one patient, while in the remaining three patients, a preservative attitude was taken. Results of both attitudes are presented, as well as a literature review on the topic.

Adult↗
PubMedDate not supplied

[Carcinoma of superior aerodigestive pathways in the Otolaryngological Services of the Santa Creu and Sant Pau Hospital in Barcelona].

We have studied 1,353 patients with squamous cell carcinoma of the head and neck diagnosed between June 1984 and December 1991, at the Service of Otolaryngology of the Hospital de la Santa Creu i Sant Pau of Barcelona. We have analysed tumor location, age, sex, tobacco and alcohol consumption, tumor staging, and the incidence of nodal involvement as they relate to the extension of the primary tumor. We have found the features accepted for the south of Europe such as a high male predominance, and a very high incidence of advanced stages at the moment of diagnosis for all the regions except for the glottis. The glottis has been the only region--in the present study--where we have achieved an early diagnosis in a high proportion of cases.

Adolescent↗
PubMedDate not supplied

[Complications of the pectoralis major myocutaneous flap in the cervical reconstruction].

The complications of the pectoralis major myocutaneous flap (PMMF) placed at cervical level, carried out in oncologic patients during the period 1984-1992 are reviewed. A total of 33 PMMF for reconstruction at the cervical level were carried out in 30 patients. Data referred to the age, sex, indication, technics, complications and evolution of the patients were analysed. The global rate of patients affected by complications was 67%, with a 17% of failures. Considering the 33 PPMF carried out, in 15 occasions there appeared fistulas (45%) and in other 8 cases dehiscence or partial necrosis (24%). In only one case a total necrosis of the flap appeared (3%). The appearance of complications significatively increased the hospital stay.

Female↗
PubMedDate not supplied

[Complications of total laryngectomy in relation to the previous radiotherapy].

Different factors, particularly prior radiotherapy, are associated with the occurrence of postoperative complications after total laryngectomy. We compared the postoperative complications of 50 patients who underwent total laryngectomy without prior radiotherapy and those of 50 patients who underwent total laryngectomy for tumor recurrence or persistence after radiotherapy. Twenty-four percent of the patients without previous irradiation suffered cervical complications compared with 26% of the patients with previous irradiation. The most frequent cervical complication was pharyngo-cutaneous fistula, which occurred in 12% of the non-irradiated patients and in 18% of the irradiated patients. There were no significant differences in the frequency of complications or in the occurrence of fistulas in relation to prior radiotherapy. In the group of irradiated patients, the proportion of major fistulas was greater. The occurrence of cervical complications, particularly pharyngo-cutaneous fistulas, significantly prolonged the hospital stay.

Carcinoma, Squamous Cell↗