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Results for “Supraglottitis”

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At least 559 records · Page 31Linked to original sources
PubMed2000

Supracricoid partial laryngectomy with cricohyoidoepiglottopexy and cricohyoidopexy for glottic and supraglottic carcinomas.

OBJECTIVES: To review the patients operated in our department with supracricoid partial laryngectomy with either cricohyoidoepiglottopexy (CHEP) (59 cases) or cricohyoidopexy (CHP) (10 cases) technique, for primary or recurrent glottosupraglottic squamous cell carcinoma and compare the technique with other surgical or conservative approaches for treatment of laryngeal carcinoma. METHODS: From hospital charts, we retrospectively reviewed 69 patients who had undergone supracricoid partial laryngectomy with the CHEP or CHP technique between 1983 and 1996 for primary or recurrent glottosupraglottic squamous cell carcinoma in our department. Statistical evaluation of oncological and functional results were conducted. Results were compared with other surgical and conservative treatment for glottosupraglottic carcinoma of the larynx that were published previously in the literature. RESULTS: Sixty-nine patients had CHEP or CHP for glottosupraglottic carcinoma of the larynx. Thirteen percent of the patients received adjuvant radiotherapy. Minimum follow-up was 2 years or until death. Five-year actuarial survival (Kaplan-Meier method) was 68%. Global local control was achieved in 84% of cases. Among previously untreated patients (n = 54), local control rate was 94.5%. After 1 year, 92.7% of patients achieved normal swallowing and respiration. Salvage total laryngectomy had to be performed in four patients (5.7%) for persistent aspiration and in five patients (7.2%), who were previously treated with radiotherapy, for local recurrence. No permanent tracheostomy or gastrostomy was required. CONCLUSIONS: Our experience with supracricoid partial laryngectomy with either CHP or CHEP suggests that this technique is a valuable alternative to radiotherapy for T2-T4 glottosupraglottic carcinomas, particularly those with extension and invasion of the anterior commissure. It allows for preservation of a good laryngeal function without altering the long-term survival, keeping total laryngectomy as a salvage procedure.

Adult↗
PubMedDate not supplied

Effect of supraglottic mechanoreceptors on spatial mapping of respiratory related evoked responses using wavelet and Laplacian methods.

Respiratory related evoked potentials (RREPs) were recorded from eight normal subjects in response to brief pressure pulses of -10 cm H2O with a duration of 200 ms to identify the contribution of supralaryngeal mechanoreceptors to the evoked responses by constraining application of the stimulus to the larynx and sublaryngeal regions through insertion of a laryngeal mask airway (LMA). Wavelet decomposition of RREP responses from 30 electrodes on the right side of the scalp was performed for eight frequency scales in time. The RREPs at each wavelet scale were enhanced by eliminating the wavelet coefficients due to artifacts and noise. After denoising, the third (125-150 Hz), fourth (62.5-125 Hz), fifth (31.25-62.5 Hz) and sixth (13.62-31.25 Hz) wavelet scales were used for estimation of the Laplacian. In addition, the global field power was calculated to quantify the wavelet-filtered RREP activity and to extract features for statistical analysis. Our results show that estimates of the global field power at the fourth and fifth wavelet scales are more significantly decreased after the insertion of the LMA than was true for scales 3 and 6. Further, after the LMA was inserted, the Laplacian showed reduced activity in the posterior-lateral region in four subjects and reductions in other places in the rest.

Biomedical Engineering↗
PubMed1977

Acute inflammation of epiglottitis and supraglottic structures in adults.

Acute epiglottitis, an unusual cause of acute upper airway obstruction in adults, is probably more common than previously recognized. While the history and physical findings are characteristic, the clinical diagnosis is often unsuspected. Radiographic findings include swelling of the epiglottis, aryepiglottic folds, arytenoids, uvulae, and prevertebral soft tissues, with ballooning of the hypopharynx and mesopharynx and obliteration of the valeculae. The epilgottic airway may show a characteristic pencil-thin configuration due to edema.

Adult↗
PubMedDate not supplied

Histological grading, growth fraction and DNA-ploidy as criteria for the treatment of pharyngeal and supraglottic squamous cell carcinomas: a preliminary, prospective study.

BACKGROUND: Individualized treatment for patients with squamous cell carcinomas is most desirable. Biologic parameters of tumors may provide relevant criteria to achieve this goal. The aim of this study was: (1) to avoid elective neck dissection in patients with squamous cell carcinomas of the pharynx and supraglottis staged N0 by ultrasonography; (2) to administer postoperative radiotherapy only in patients staged 'highly aggressive' by biologic tumor parameters, in order to reduce patient morbidity and to improve quality of life. STUDY DESIGN AND METHODS: This prospective trial was performed in 35 patients (any T stage, N0 or N1 by ultrasonographic examination). Tumor biopsies were taken for histological examination and for evaluation of some biological tumor markers. These parameters comprised DNA cytometric examinations, histological grading of the tumor front and immunohistochemical staining for proliferation markers (MIB1, PCNA). Based on these parameters, tumors were classified into 'low aggressive' (group 1) and highly aggressive (group 2) behavior. In all patients, second primaries were excluded by endoscopy, and the presenting tumor was resected with clear margins. In cases of ultrasonographically enlarged lymph nodes, functional neck dissection was performed. When biologic tumor profile showed low aggressive behavior (group 1), no postoperative radiotherapy was advised. In cases of highly aggressive tumors, radiotherapy was recommended postoperatively independent of all other parameters (group 2a and 2b). RESULTS: The average follow-up was 36 months (range 16-65 months). Fifteen patients were included in group 1, 20 patients in group 2. Three patients with highly aggressive tumors who refused RTx were regarded independently (group 2b). In this pilot study of 35 patients, there was no difference in disease-free survival between group 1 and group 2a. Twenty-five of 35 patients were alive with no evidence of disease 29-65 months after treatment (3 died of disease; 5 died of second primary carcinomas; 2 died independent of disease). Eleven of 15 patients survived disease free in group 1, 13/17 in group 2a. In group 2b, 2 out of 3 patients, who were advised but refused postoperative radiotherapy, had recurrences. CONCLUSIONS: The results of this preliminary study point towards usefulness of some tumor biologic parameters in decision making for individualized treatment in patients with squamous cell carcinomas.

Adult↗