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Biomedical subjects

S M Zeitels

Publications and source records attributed to S M Zeitels.

41 records · Page 3Linked to original sources
PubMed1990

Laser epiglottectomy: endoscopic technique and indications.

Endoscopic epiglottectomy (epiglottidectomy) may be performed with relative ease and minimal morbidity by using standard microlaryngoscopy techniques and the CO2 laser. Depending on the indications, the removal may be partial or complete. Indications for 51 epiglottectomies included treatment of supraglottic airway obstruction--30 cases; discovery of benign or malignant neoplasm (diagnosis and staging)--20 cases; treatment of malignant neoplasm--7 cases; glottic visualization--4 cases; and treatment of chronic inflammatory conditions--1 case. It is not unusual for a patient to have more than one indication for this procedure. Some epiglottic cancers invade the pre-epiglottic space. This crucial information may not be detectable by MRI or CT scanning techniques. Laser epiglottectomy provides a method to explore and perform a biopsy of the pre-epiglottic space and thereby stage these lesions accurately. There are no significant problems with postoperative alimentation, airway, or voice. Any form of primary or adjuvant therapy can be started without delay.

Airway Obstruction↗
PubMed1990

The adjustable supraglottiscope.

Transoral surgery in the supraglottic larynx is facilitated by the use of a new instrument, an adjustable supraglottiscope. Conventional adjustable laryngoscopes are not designed for supraglottic surgery and are therefore difficult to use in this area. The adjustable supraglottiscope: (1) provides wide exposure of the supraglottis and much of the lower pharynx, (2) allows instruments to be introduced from the side (between the blades), (3) allows for true suspension, and (4) retracts the endotracheal tube out of the way. These factors provide greater visualization and control of the surgical field and thus improve hemostasis and precision. The adjustable supraglottiscope has been used successfully in a variety of clinical situations. Transoral supraglottic surgery now takes considerably less time and is done with much greater ease. The adjustable supraglottiscope is a valuable instrument in our armamentarium and extends our versatility for endoscopic management of lesions of the supraglottic larynx and lower pharynx.

Glottis↗
PubMedDate not supplied

Tongue-base-cancer resection with partial supraglottic laryngectomy.

INTRODUCTION: Cancer in the tongue base, which is adjacent to or invading the lingual epiglottis, requires resection of part or all of the larynx to assure adequate surgical margin. Based on whole mount laryngeal sections, a tongue base-partial supraglottic laryngectomy procedure was designed for tumors adjacent to or minimally invading the lingual epiglottis. METHODS: A group of five patients with carcinoma of the tongue base adjacent to or minimally invading the lingual epiglottis was identified. This technique requires excision of the epiglottis, hyoepiglottic ligament, and pre-epiglottic space with the lesion. The structural physiological integrity of the false vocal cords with or without the hyoid bone is preserved. RESULTS: Clear tumor margins were obtained in all five patients. In three patients who required up to 50% resection of the tongue base, decannulation and resumption of a full oral diet was achieved. Two patients with more extensive lesions required 70% resection of the tongue base. Both patients underwent completion laryngectomy months later because of persistent aspiration. CONCLUSION: This preliminary report suggests that partial supraglottic laryngectomy may be used with acceptable functional results in patients with limited tongue base lesions.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Endoscopic laser management of supraglottic cancer.

Current concepts of endoscopic management of supraglottic cancer are an extension of precepts fostered by Jackson. The current approach has been facilitated by a half century of technological developments: the surgical microscope, the CO2 laser, improved laryngoscopes, and general endotracheal anesthesia. Selected small-volume cancers can be curatively resected, whereas excisional biopsy can be performed on larger neoplasms. With this cost effective minimally-invasive surgical approach, there is less disturbance of normal tissue, thereby minimizing morbidity rate and hospitalization. If the transoral excision is inadequate, radiotherapy can not be depended on to eradicate known residual disease. Endoscopic resection of supraglottic cancer should not alter the surgeon's standard management of the neck.

Endoscopy↗