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Biomedical subjects

W Wey

Publications and source records attributed to W Wey.

At least 19 recordsLinked to original sources

Magnetic resonance imaging for the assessment of lingual thyroid.

A 43-year-old woman was evaluated because of a round tumor at the base of the tongue. Scintigraphy with 131I showed radionuclide uptake over the posterior part of the tongue but no uptake at all at the usual pretracheal location. Magnetic resonance imaging revealed a well defined round mass of high signal intensity, which was clearly delineated from adjacent muscular tissue.

Adult↗

Magnetic resonance imaging--a useful tool for airway assessment.

The case is presented of a 58-year old man with a malignant non-Hodgkin's lymphoma of the root of the tongue. Preoperative magnetic resonance imaging (MRI) proved extremely useful in the evaluation of the upper aerodigestive tract, by providing sagittal sections of the hypopharynx and the inlet of the larynx. Thus, a potentially difficult intubation was confirmed in a patient in whom other investigations would not have produced comparable conclusions. Difficulties in airway management were avoided by performing a tracheostomy under local anesthesia. This represents a novel application of MRI, which might contribute to the safety of airway management.

Airway Obstruction↗

[Cough from the viewpoint of the otorhinolaryngologist].

Cough is a symptom frequently encountered by the rhinolaryngologist. The underlying reasons are many and varied. Every affection of the larynx causes dry cough, and many diseases of the nose and paranasal sinuses may do so as well. Cough of unknown origin requires thorough investigation of the otorhinolaryngologic status. Last but not least, the psychosomatic aspect of the problem should not be underestimated.

Cough↗

[Schwannoma and neurofibroma of the neck].

Three schwannomas and one neurofibroma of the neck were treated surgically in our department during the last years (1980-1987). These tumors are relatively rare. The different clinical and histopathological criteria of the two tumors are discussed. In spite of these differences, in most cases a correct diagnosis is made only during surgery. Therefore, the possibility of temporary or permanent damage to major nerves is always present and the patient should be informed accordingly.

Adult↗

[Significance of computerized tomography and sonography in the staging (TNM classification) of cancers of the tongue and floor of the mouth].

Computerized tomography and sonography were used for pretherapeutic staging of 40 patients with cancer of the tongue. The size of the tumors and invasion of cervical lymph nodes were assessed, and both methods were compared in relation to the stage of the tumor. Clinical findings were amended by diagnostic imaging in 25% of the cases. There was a distinct preponderance of advanced stages. Ultrasonography proved superior to CT for T1 and T2 tumors. Full assessment of T4 tumors was feasible by CT only. We were able to develop a selective protocol for the use of CT and ultrasound scan based on the TNM classification.

Adult↗

High incidence of laryngeal carcinoma in a Swiss family.

The article describes a family in which a father and both sons were treated for carcinoma of the larynx. Reports of 21 similar families were collected from the literature. Certain factors occurring in familial cases are discussed (alteration of the sex ratio, early onset of the disease, same histological type and same localization of the cancer in relatives), which could indicate a genetic susceptibility in these families.

Female↗

[Epistaxis].

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Emergencies↗

[Injury to the larynx and trachea following artificial respiration].

A general interdisciplinary survey of trends within intensive care units is necessary in order to further reduce the risk of laryngo-tracheal injury requiring treatment after prolonged intubation. Endoscopic controls of the larynx and cervical trachea should be recommended as urgent during long intubations, to ensure that a secondary tracheotomy does not ultimately occur too late. Only a perfectly performed tracheotomy minimises complications (stenoses). Repeated laryngoscopy and endoscopy of the trachea with a fibreoptic system (a few days after extubation) is recommended after every prolonged intubation.

Humans↗

[Malignant struma: changes in the clinical picture and treatment strategy].

In the Alpine countries of Switzerland and Austria iodized salt prophylaxis has greatly reduced the incidence of disease of the thyroid gland and substantially altered the pattern of malignant goitre: the previously dominant follicular carcinoma has diminished in number whereas there has been a corresponding increase in the papillary type. The number of highly malignant tumours has dwindled quite markedly within a few decades. Improved preoperative diagnosis and broader indications for surgery have been instrumental in causing most thyroid carcinomas to be treated today at an early stage. In papillary and follicular carcinomas cure rates are very gratifying if optimal advantage is taken of present strategies of treatment and aftercare. The otorhinolaryngologist should familiarize himself with modern thyroid medicine. He must realize first and foremost that thyroid malignancy today presents with much milder symptoms than the older medical literature led him to believe. Thyroid carcinoma is by no means rare in our outpatient departments.

Adenocarcinoma↗

[The diagnostic use of computed tomography in the management of mediastinal abscess (author's transl)].

Computed tomography (CT) is of outstanding importance in the current diagnosis of mediastinal pathology. We have recently treated a patient who underwent laryngectomy and then experienced a septic temperature pattern during the postoperative period which was suspect of mediastinal abscess. A mediastinal CT was obtained, and uncovered a lesion in the anterior mediastinum. Although the test was unable to differentiate between an abscess and a degenerating metastasis, the test was instrumental in first revealing the presence of the lesion, localizing it exactly, and enabling an effective surgical approach to be used for exploring the mediastinum. This entailed an anterior mediastinotomy with partial resection of a rib.

Abscess↗

Suspicion of persistent or recurrent carcinoma of the larynx after radiation therapy.

At most interdisciplinary tumour centres, radiotherapy is of prime importance in the concept of therapy for the majority of the cases of laryngeal carcinoma treated, or it is even employed--exploratively and with curative intent--as the sole therapy at first. At all events initial radiotherapy occupies a dominant position today. Against this background the question is often discussed whether, after a 'low dose' has been attained (particularly in the case of a supraglottic tumour), a partial or total laryngectomy should be performed or the radiation dose substantially increased with the aim of obtaining a cure. However, the difficulties involved immediately after irradiation or later in recognizing a persistent or recurrent carcinoma and readily identifying it histologically may be very great. Various aspects of such situations--both diagnostic and therapeutic--are discussed in general and with reference to case histories.

Carcinoma↗

[Bullous dermatoses in otorhinolaryngology (author's transl)].

The early clinical and histological diagnosis of acquired bullous dermatoses (pemphigus, bullous pemphigoid and the cicatricical pemphigoid of mucous membranes) may prove to be difficult when the disease is confined to the upper air and food passages. Histological differentiation between these diseases can also be difficult. In a number of cases it could be shown that the first signs of the disease were frequently mistaken for inflammatory conditions and that routine histological examination rarely confirmed the diagnosis. Only after immunohistological and immunoserological examination could the diagnosis be confirmed. In pemphigus, the treatment can be individually adapted to the titre of antibodies. The typical otorhinolaryngological findings in each of the three diseases are described.

Aged↗