PubMed · 13588856
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M A SURPINA. 1958. [Multiple liver abscesses].. https://pubmed.ncbi.nlm.nih.gov/13588856/
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INTRODUCTION: Surgical voice rehabilitation after total laryngectomy is still only a partially solved problem. Because of easy handling and rare complications, the Provox voice prosthesis has become common in voice rehabilitation. CASE REPORT: The 69 year old patient underwent laryngectomy, selective bilateral neck dissection and the implantation of a Provox voice prosthesis because of a glottic squamous cell carcinoma (pT(4), pN(0), M(0)). Postoperative healing ensued without any complications. During adjuvant radiochemotherapy, the patient developed distinctive cervical edema which led to a tilting of the Provox prosthesis. Due to a perforation of the posterior esophageal wall, the patient developed a pronounced mediastinal abscess which was relieved through a transcervical mediastinotomy. Antibiotic therapy led to a partial remission of the symptoms. CONCLUSION: Severe complications may not only occur during the early phase of surgical voice rehabilitation, but also at a much later stage, after completion of the healing process. A voice prosthesis which is too long or generates pressure from a radiogenic edema, cannula and finger pressure used to close the tracheostoma is transmitted through the prosthesis and may lead to a perforation of the posterior esophageal wall. In particular, when the tissue is injured during the course of radiotherapy, this type of complication should be taken into consideration.
AIM: The aim of this study was to obtain information regarding the incidence of cellulitis or cutaneous abscess in children of Polynesian ethnicity (including New Zealand Maori), and to calculate the relative risk increase versus other ethnicities. METHODS: We reviewed all patients aged between 1 to 14 years who were admitted at our tertiary care institution during the year 2000. Ninety-one children (of 10 different ethnicities) with skin infections were identified. RESULTS: The most common diagnosis was cutaneous abscess (46 of 91 cases, 50.5%), followed by cellulitis (45 of 91 cases, 49.5%). The most common location of infection was the lower limb (79.1%). The major pathogenic organisms were Staphylococcus aureus and Streptococcus pyogenes. All but one of the children had an uneventful recovery. The incidence of infection in the Polynesian children was 137.7 per 100,000, and the incidence in European children (and children of other ethnic groups) was 35.4 per 100,000. In addition, we calculated a relative risk increase of 3.89 (95% confidence interval of 2.33 to 6.52, p <0.05), which underlines the increased risk that Polynesian children suffer from skin infection. CONCLUSION: This is the first study showing (in detail) how Polynesian children are affected by a high incidence and increased relative risk of skin infections in their limbs (arms and legs). However, further research (to identify whether genetic disposition or social and environmental circumstances are involved) is required.
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