Biomedical subjects
Publications and source records attributed to V Strunski.
Reaming of piriform orifices is a simple, short procedure easily integrated into functional surgery of nasal fossae. Results in 27 cases were rated as very good in 20 patients. Results are compared with those of three series reported in the literature, and the rare side effects noted are discussed.
Two groups could be distinguished in a series of 18 patients with glottic lesions: one with pure glottic tumors (12 cases) and the other with tumors extending beyond the glottic region (6 cases). All patients but one were operated upon by first intention for epidermoid carcinoma, but also for associated pronounced dysplasia. The so-called Tucker technique was used with slight modifications (less extensive resection of thyroid cartilage, conservation of the two arytenoid cartilages). The postoperative course was satisfactory with decanulation and ablation on the 13th day, and a mean hospital stay of 22 days. Two postoperative deaths due to vascular complications occurred and one patient developed a swinging epiglottis after 2 years. The remaining 16 patients are all alive, including 8 after less than 3 years. Analogous results were noted in an analysis of a total of 93 case-reports from 5 different series of patients. This method provides an elegant and satisfactory repair of pure cordal surgery, but adds nothing from the oncologic point of view since other better adapted and currently well defined operations have to be envisaged for lesions extending beyond this region.
Certain types of glomerulonephritis develop typically as the result of focal infection, and may recover following effective treatment of the infective focus at cause. Apart from the classical immunity mechanism consisting of the formation of immune complexes with the bacterial antigen, a major role for environmental allergens must also be evoked, as well as the probable existence of different immunity mechanisms at the origin of certain types of GN (mainly mesangial GN with IgA deposits and lipoid nephrosis). Invasion of the pulmonary allergen through a rhinosinusal route is responsible for a rhinosinusitis demonstrating a typical clinical features and course. Progression of the rhinosinusitis runs parallel with that of the GN. The course of the GN may be improved after treatment of the sinusitis and the allergic disposition. Ten particularly significant case-reports of GN associated with rhinosinusitis are studied from various aspects.
Pectoralis major musculocutaneous flaps were used for reconstruction after transmaxillary buccopharyngectomy to treat 22 patients with large oropharyngeal tumors. Short and medium term results are discussed. Large excisions such as these raise many functional problems, even though the use of a musculocutaneous flap for reconstruction is a valid procedure from the anatomical point of view. The cancer prognosis must still be reserved as follow up is still limited for these cases.
Musculocutaneous flaps from pectoralis major were used during cervico-facial surgery for repair after cancer operations in 46 patients. Use of this technique in surgical practice is discussed as a function of the site of cancer, and results described in relation to the viability of the flap and the outcome. Removal of the flap is simple and possible by a one-stage operation, and the method provides functional improvement for these patients.
A case of post-traumatic opto-chiasmatic syndrome is described, and the principal characteristics of the affection outlines. This rare syndrome complicates severe cranial injuries, and is simple to diagnose when confronted with a patient with bitemporal hemianopsia frequently associated with diabetes insipidus or paralysis of certain cranial nerves. Suggested mechanisms for the lesion include sagittal stretching of the chiasma or an ischemic focus.
Seventy two head and neck cancers have been treated with a combination of Cis-DDP (20 mg/m2/day) and bleomycin (6 mg/m2/day, 24 hours infusion) given for 5 days 3 courses every 3 weeks in preoperative cases and for 6 days (4 courses every 3 weeks) in non preoperative cases. Fifteen patients treated for local recurrence after irradiation experienced no significant response and their actual survival at 12 months is 22%. For the other patients the objective response rate was 78% with 10 complete responses and the projected survival at 12 months varies from 62% to 92% according to the subsequent treatment (irradiation or surgery followed by irradiation). These results are in agreement with a few reports using similar combinations; but it needs to answer new questions about possibility of surgical strategy variations in the cases of good or complete responses with such a chemotherapy.
Thirty three patients have been operated with total laryngectomy (LT) or pharyngolaryngectomy (PLT) with or without Zadical neck dissection, without nasogastric feeding to be and in five cases without tracheal cannula (but connection of a large tracheostomy). The authors demonstrated that there is no increasement of pharyngeal fistua. The beginning of oral alimentation has been made between the 4th and the 6th postoperative day. Such a procedure is more comfortable for the patients and decrease the hospitalisation duration.