Regulation of function and growth in normal human thyroid tissue.
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Biomedical subjects
Publications and source records attributed to P Dor.
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This article describes the microsurgical approach of the head and neck team of the Bordet Institute. During a period of 2 1/2 years 35 free flaps, 71 Pectoralis Major and 9 local flaps were performed for oropharyngeal reconstruction. Different types of free flaps were used and analyzed: 15 latissimus dorsi myocutaneous, 8 radial forearm, 1 gastric, 3 jejunum, 2 crista iliaca osteocutaneous, 1 scapular osteomyocutaneous, 3 scapular osteo-muscular of a new type (discovered in our department), 1 serratus anterior muscular and 1 flap composed of 3 others (a latissimus myocutaneous, a serratus anterior and a scapular osteo-muscular flap). 60% of the microvascular anastomoses were performed in a previously heavily irradiated area and none failed. The indications of some of these flaps are discussed and summarized.
The deltopectoral flap was described by Bakamjian in 1965 for pharyngo-oesophageal reconstruction. Since then, the indications of this excellent flap have been extended and the versatility of the flap has allowed extensive skin and mucous membrane resections in cancerology. The authors have used 38 deltopectoral flaps in 36 patients with difficult reconstructive problems. The results have been good in 31 cases. There were 7 failures.
We reviewed the records of 33 patients who underwent surgery for removal of a thyroglossal duct cyst at the Bordet Institute between 1970 and 1983. All patients had complete resection of a midline cervical lesion. In 27 cases the provisional diagnosis at presentation was confirmed by histological examination after surgery. The surgical procedure performed at the Bordet Institute and its results are analysed. We emphasize the need of resecting the central portion of the hyoid bone as well as the proximal tract of the thyroglossal duct. Twenty-six patients have been cured using this technique.
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A survey performed in young adult males (military recruits) showed that 14.1% had wheeze in the chest, 8.9% had attacks of dyspnoea at rest with wheeze in the chest and 6.2% had asthma.
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Four cases with intra-thyroid metastases which simulate a primary tumor of the gland are reported. These metastatic lesions are probably more frequent than generally accepted. Their clinical discovery is quite frequent in patients with a renal neoplasm and is in those cases often the presenting feature of the primary tumor. Ablation of the thyroid gland is often necessary to make a correct diagnosis and to prevent local compression symptoms. This intervention is indicated whenever deemed necessary unilateral thyroid lobectomy is preferable to total ablation since it achieves its goal with a lower mortality. Postoperative radio- and chemotherapy might be added as indicated.
A rare case of nervous tumor of the neck is presented. Differential diagnosis is evoked in the discussion. A total removal of the tumor is to be realized with or without nerve reconstruction.