Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Supraglottitis”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 379 records · Page 21Linked to original sources
PubMed1998

Prognostic factors in supraglottic laryngeal carcinoma.

We carried out a retrospective study of patients with supraglottic carcinomas who were treated surgically at the Marques de Valdecilla Hospital (Santander, Spain) between 1978 and 1987 and who were followed up for at least 5 years. The Kaplan-Meier survival curves were calculated for 24 clinical, histologic, and morphometric parameters. Multivariate analysis was then performed by means of the Cox regression model. In the univariate analysis, survival was related to presence of capsule rupture of the involved lymph nodes (p = 0.00001), number of metastatic lymph nodes (p = 0.0002), postoperative TNM stage (p = 0.004), grade of cell differentiation (p = 0.001), presence of intratumoral necrosis (p = 0.01), and type of invasion (p = 0.04). The nuclear area did not have an influence on survival. Only the presence or absence of capsule rupture of the metastatic lymph nodes and the grade of cell differentiation were included in the final Cox model and proved to be parameters with independent prognostic significance.

Aged↗
PubMed1998

Clinical correlations with allelotype in supraglottic squamous cancer.

Frequent allelic loss at a genetically polymorphic locus in tumors is an established marker for the presence of a tumor suppressor gene in the neighboring chromosomal region. This technique can be used to identify novel tumor suppressor genes and to monitor their status before the cloning of the gene itself. We have used the polymerase chain reaction and microsatellite loci on all 39 nonacrocentric autosomal chromosomal arms to identify sites of frequent allelic loss in squamous cell carcinomas of the supraglottic larynx. Our allelotype identified seven chromosomal arms (3p, 5q, 8p, 9p, 9q, 13q, and 17p) likely to contain tumor suppressor genes frequently inactivated during squamous tumorigenesis in the larynx. We tested for associations between allelic losses on these chromosomal arms and the clinical and histopathologic features of these tumors. There were no correlations with either T or N classifications. Allelic loss on chromosomal arm 13q is significantly associated with a number of histopathologic features characteristic of poorly differentiated or histologically aggressive tumors. Allelic loss on this arm also exhibits statistical trends toward association with early tumor recurrence and poor survival. The association with survival was substantiated by a multivariate Cox proportional hazards model.

Alleles↗
PubMed1980

Advances and controversies in the management of supraglottitis and laryngotracheobronchitis.

Recent advances in pediatric airway intubation and the introduction of pharmacotherapeutic agents, active within the larynx and tracheobronchial tree, have created significant controversies in the treatment of acute obstructive inflammatory laryngeal disease. Although the etiology, pathophysiology, and clinical patterns of supraglottitis and laryngotracheobronchitis are no longer confused, decisions concerning their medical management and method of airway control remain controversial. Both inflammatory disorders are critically examined, with a reveiw of current concepts regarding the choice between endotracheal intubation and tracheotomy. Specific problems of anesthetic technique, criteria for extubation or decannulation, and the rationale for the use of corticosteroids, antibiotics, or racemic epinephrine are evaluated. If mechanical airway control is required, careful attention to initial intubation with a relatively small, cuffless polyvinyl chloride endotracheal tube and precise surgical technique when employing tracheotomy will minimize the overall morbidity. Short term intubation in acute obstructive inflammation of the larynx appears to be well tolerated. Tracheotomy is reserved for the few patients with laryngotracheobronchitis who demonstrate persistent significant subglottic edema.

Acute Disease↗
PubMed2002

Role of brachytherapy in treatment of epidermoid carcinomas of the vallecula after conservative supraglottic laryngectomy followed by irradiation.

PURPOSE: To evaluate survival and functional results of the treatment of carcinomas of the vallecula using surgery, irradiation, and interstitial brachytherapy. METHODS AND MATERIALS: Between 1990 and 1998, 36 patients with squamous cell carcinoma of the vallecula were treated with horizontal supraglottic functional laryngectomy, external beam radiotherapy (median dose 54 Gy), and additional interstitial brachytherapy (median dose 16 Gy). Results were compared with a previous series of 22 patients treated without brachytherapy. RESULTS: The median follow-up was 44 months. The 5-year actuarial overall survival rate was 61.3%. The 5-year specific survival rate was 86%, with 2 local failures (local control rate 94.4%) and 4 isolated distant metastases. Ten patients developed a second primary. The overall survival was 34% for 22 patients previously treated without brachytherapy. Severe toxicities occurred in 9 patients: death (related to larynx edema or inhalation, n = 1), soft tissue necrosis (n = 1), aspiration pneumonia (n = 1), mandibular necrosis (n = 2), pharyngocutaneous fistula (n = 2), and laryngeal edema (n = 2). All the patients fed orally with no definitive gastrostomy or tracheotomy. CONCLUSION: Additional brachytherapy for vallecula carcinoma seems to improve locoregional control and overall survival dramatically. Functional results were also excellent. To our knowledge, this original therapeutic schedule has never been previously described.

Adult↗
PubMed1997

Prognostic value of hemoglobin concentration in radiotherapy for cancer of supraglottic larynx.

PURPOSE: The aim of this work is the estimation of correlations between hemoglobin concentration either before or after radiotherapy and local tumor control probability for laryngeal cancer. METHODS AND MATERIALS: Retrospective analysis of 847 cases of laryngeal supraglottic squamous cell carcinoma treated with radiation alone was performed using maximum likelihood estimations, and step-wise logistic regression. All patients were in good initial performance status (Karnofsky index >70). The minimum follow-up time was 3 years. RESULTS: Logistic regression showed that the hemoglobin concentration after radiotherapy is an important prognostic factor. There was a very strong correlation between hemoglobin concentration and tumor local control probability. Hemoglobin concentration at the beginning of radiotherapy does not correlate with treatment outcome, but any decrease of hemoglobin during therapy is a strong prognostic factor for treatment failure. CONCLUSIONS: Although regression models with many variables may be instable, the present results suggest that hemoglobin concentration after treatment is at least as important as overall treatment time. It was not possible to find out whether the low concentration of hemoglobin is an independent cause of low TCP or whether it reflects other mechanisms that may influence both hemoglobin level and the TCP.

Carcinoma, Squamous Cell↗
PubMed2001

Concurrent chemotherapy and radiotherapy as initial treatment for stage II supraglottic squamous cell carcinoma.

OBJECTIVE: To evaluate the efficacy and safety of concurrent carboplatin (CBDCA) and radiotherapy for laryngeal carcinoma. we investigated survival rates and laryngeal preservation rates in patients with this treatment modality and those with radiation therapy only. METHODS: We underwent chemotherapy with CBDCA and conventional radiotherapy concurrently to 17 patients with untreated stage II (T2NOM0) supraglottic squamous cell carcinoma since November 1990. CBDCA (100 mg/m2) was administered intravenously once a week concurrently with radiotherapy (2.5 Gy/fr, 4 times a week). At the dose of 40 Gy, the results were evaluated, and some of the patients underwent planned surgery and others continued the radiotherapy up to 65 Gy. RESULTS: Overall 5-year survival rate by Kaplan-Meier method was 81.1%. Actual laryngeal preservation rate was 76.0%. Toxicity over grade III was noticed in two patients. Compared with 14 cases of historical controls, which were treated by radiation therapy alone between 1988 and 1990, the cases with concurrent radiotherapy and chemotherapy had statistically significant advantage in overall successful laryngeal preservation rate (P < 0.05), whereas the two groups were not significantly different in the overall 5-year survival rate.

Aged↗
PubMed1981

Combined pre-operative telecobalt therapy and supraglottic laryngectomy.

At Groote Schuur Hospital, Cape Town, over a 5-year period (1974 to 1978) 15 patients with squamous cell carcinoma of the larynx or hypopharynx have had planned 2,000 Rad Telecobalt therapy followed by supraglottic horizontal laryngectomy. Five patients following surgery had a further 3,600--4,000 Rad Telecobalt therapy. The peri-operative complications, in addition to those of whole organ resection, included debilitating laryngeal incompetence in three patients, two of whom underwent total laryngectomy. All 15 patients have remained free of recurrent disease for 2 years and 10 have been free for 3 or more years. One patient died 4 years after surgery from a primary bronchial carcinoma.

Adult↗
PubMed1986

Acute supraglottic laryngitis in adults.

Four cases of supraglottic laryngitis in adults have been presented. All were treated conservatively with I.V. hydrocortisone and I.V. antibiotics under close observation. No intubation or tracheostomy was carried out. The author recommends the use of I.V. Cefuroxime as an initial form of antibiotic treatment. Mirror laryngoscopy is mandatory in any adult patient who presents with sore throat if epiglottitis is not to be missed as the first consultation.

Acute Disease↗
PubMed1988

Surgical salvage for squamous cancer involving the supraglottic larynx.

Anatomically the supraglottic larynx has been shown to be self contained as regards its boundaries and lymphatic compartments which tend to limit the spread of cancer arising within the region until it reaches the margins of the supraglottis (Pressman and Simon, 1961). These may be called Type A tumours. Advanced glottic tumours secondarily involving the supraglottis may be considered a sub-group within the larynx (transglottic).

Carcinoma, Squamous Cell↗
PubMed1989

Metastatic bone marrow involvement from supraglottic squamous cell carcinoma.

A case of an aggressive supraglottic squamous cell carcinoma, which was managed with neo-adjuvant chemotherapy and radical surgery, is described. The post-operative course was of rapid deterioration and death due to progressive metastatic disease involving bone marrow and liver. This is the first reported case of bone marrow infiltration by squamous cell carcinoma of the head and neck diagnosed ante-mortem. The incidence and pattern of metastatic disease from head and neck tumours is reviewed, and the importance of initial staging in determining the risk of distant metastatic disease is emphasised.

Bone Marrow↗
PubMed1995

Supraglottic transection: results of repair and functional outcome.

We present two cases of supraglottic transection, with concomitant neurotemesis of the superior laryngeal nerve. Both cases were repaired primarily and a temporary tracheostomy was used to protect the airway. In both cases subsequent decannulation was achieved within four weeks, following the initial injury. No long-term swallowing or voice disturbance was noted in either case. We recommend that in such cases it is unnecessary to repair the nerves directly, but that careful repair of the wound itself will achieve a functional result.

Adult↗
PubMed1997

Occult metastases from supraglottic laryngeal carcinoma.

One hundred and sixty-one patients with a supraglottic laryngeal carcinoma and clinically negative neck were studied. All patients had primary surgery and occult cervical node metastases were found in 18% (29/161). Local dissemination of tumour in the epilarynx did not influence the incidence of occult metastases, while the incidence of occult metastases increased with the degree of local spread in the supraglottis excluding the epilarynx. Ipsilateral occult metastases were more common (76%, 22/29), but both bilateral and contralateral spread was also seen (14%, 4/29 and 10%, 3/29, respectively).

Female↗
PubMed2003

Leptomeningeal carcinomatosis from squamous cell carcinoma of the supraglottic larynx.

Leptomeningeal carcinomatosis is an uncommon but devastating form of metastatic spread. To our knowledge, only 16 cases originating from a head and neck cancer have been reported. We describe the first case of a patient with leptomeningeal carcinomatosis arising from a laryngeal squamous cell carcinoma. Shortly after completing treatment for an advanced supraglottic laryngeal cancer, this 63-year-old man presented with lower limb neurological symptoms and signs. Radiological and cytological evidence of leptomeningeal carcinomatosis of the distal spinal canal was identified. He was treated with intrathecal methotrexate and palliative radiotherapy. Although his pain improved, his lower limb weakness worsened. He died 3 weeks after completing radiotherapy. Presumed mode of spread was via the haematogenous route. The natural history and management of leptomeningeal carcinomatosis are discussed. Clinicians should be aware of the uncommon possibility of leptomeningeal carcinomatosis in a patient presenting with an appropriate constellation of symptoms and signs, and a past history of cancer.

Carcinoma, Squamous Cell↗
PubMed1991

[Treatment results after supraglottic partial resection of the larynx in carcinoma of the laryngeal entrance, the base of the tongue and hypopharynx. 2. Radiotherapy and late results after combined surgical-radiological treatment].

110 Patients were followed-up after supraglottic laryngectomy: The 3-year survival rate was 74%. The overall 5-year survival rate was 49%. For the cases of T3-tumours from these of the entrance of the larynx the 5-year survival rate was about 73%. For the T4-tumours the 5-year survival rate was only about 22%. Better results are not possible at the present even if other kinds of therapy are used.

Cobalt Radioisotopes↗
PubMed2004

Open supraglottic laryngectomy.

Open supraglottic laryngectomy is an oncologically sound surgical procedure for selected cases of laryngeal cancer which maintains physiologic speech and swallowing without the need for a permanent tracheostoma. The oncologic principles, techniques for resection and reconstruction, postoperative management and complications are discussed.

Epiglottis↗
PubMed2005

The role of epidermal growth factor receptor and E-cadherin for the outcome of reduction in the overall treatment time of radiotherapy of supraglottic larynx squamous cell carcinoma.

Reduction of the overall treatment time (OTT) of radiotherapy results in increased T-site control in squamous cell carcinomas of the head and neck (HNSCC). However, the response is heterogeneous and accelerated repopulation of clonogenic tumour cells during therapy may be one of the factors determining this response. The aim of the present study was to identify the influence of the epidermal growth factor receptor (EGFr) and E-cadherin for T-site control when the OTT was reduced and whether the markers add information to the histopathological grading in selecting patients for accelerated radiotherapy. A total of 209 patients from randomized DAHANCA-trials with supraglottic larynx squamous cell carcinomas treated with primary radiotherapy with different OTT of 9(1/2), 6(1/2), and 5(1/2) weeks. Available formalin-fixed paraffin embedded tumour tissues were re-evaluated for histopathological characteristics and stained for EGFr and E-cadherin. Data were correlated with patient and tumour characteristics and 5-year T-site control. EGFr and E-cadherin were not associated with patient or tumour characteristics except that EGFr correlated to carcinomas with a well to moderate histopathological feature. Tumours with high EGFr or low E-cadherin did benefit from reduced OTT, and the combination of the two (high EGFr and low E-cadherin) had the most significant acceleration of treatment effect, compared with tumours with other combinations of EGFr and E-cadherin expression. Tumours with high expression of EGFr and low expression of E-cadherin showed the most significant increase in T-site control when the overall treatment time of radiotherapy was reduced, and the markers may be useful for selecting patients who will benefit from accelerated radiotherapy.

Adult↗
PubMed1998

Recurrence after different primary treatment for cancer of the supraglottic larynx.

Retrospective analysis of patient records at two hospitals was performed with the principal goal of clarifying the role of primary radiotherapy ill patients with squamous cell carcinoma of the supraglottic larynx. Primary surgery was frequently performed during the first period from 1958 to 1978. Primary radiotherapy with surgery in reserve was the prevailing therapy during the second period from 1978 to 1993. Fewer recurrences were observed during the second period. The improved results were apparent mainly in patients with the more advanced stages (III, T4N0 and T4N1). Analysis of many factors suggest that the more frequent choice of primary radiotherapy with surgery in reserve, or applied as preoperative treatment, with optimal dosage and technique, might have contributed to the improved results.

Carcinoma, Squamous Cell↗
PubMed1999

Survival of patients with squamous cell carcinoma of the supraglottic larynx--thirty-five-year experience with radiotherapy.

A retrospective comparison of treatment policies in two institutions revealed a change in the reliance on radiotherapy. Since 1978, high-energy, high-dosage radiotherapy has played a prominent role in the primary therapy of squamous cell carcinoma of the supraglottic larynx. Statistically, the overall determinate survival rate has improved compared with results during the preceding period, but the death rate from intercurrent disease and second primary cancers has remained unchanged. Improved cancer control and patient survival were restricted to clinical tumor stages III, T4N0, and T4N1. The choice of primary therapy and the radiation dose and fractionation pattern were important variables influencing the survival. A description of the data is followed by a critical analysis of the significance of the findings, in view of the fact that the treatments were performed in two different institutions at different time periods.

Adult↗