ABSTRACT
Background: Early glottic cancers are treated effectively with radiation or surgery but recurrence is a possibility which requireseither salvage surgery or radiotherapy (RT) depending on the initial treatment modality adopted. Conservation surgery is feasiblein approximately one-third of these recurrent cancers. Endoscopic resections using a CO2 laser or open partial laryngectomyare the current options. Similarly, if initial surgery was used to treat glottic cancers (i) repeated RT with or without chemotherapy,(ii) salvage surgery, (iii) supportive treatment, and/or (iv) palliative chemotherapy is the choices of treatment.Aim of the Study: The aim of the study was to clinically assess the result of RT as initial treatment in the control of squamous cellcarcinoma (SCC) of vocal cord (T1) lesions and undertaking salvage surgery (endoscopic or open) when there is a recurrence.Materials and Methods: Retrospectively medical records of 49 patients were analyzed with T1 SCC of the glottis in which RTwas an initial treatment with a follow-up period of 5 years.Observations and Results: The rate of recurrence after RT was 7/49 (14.28%) of the cases, mean diagnosis interval was31.8 ± 8.75 months. 2/7 (28.57%) patients underwent salvage endoscopic surgery (transmuscular Cordectomy), 3/7 (42.85%)patients underwent open surgery and excision of the tumor and the vocal cord (Horizontal partial Laryngectomy). 1/7 (14.28%)patient was treated with total laryngectomy due to a new recurrence.Conclusions: The recurrence rate was 14.28% in this study of treatment of early cancers of vocal cords (T1) by RT which ishigh when compared to the literature. RT can be a treatment option, but the patient must be aware that higher cure rates canbe achieved through surgery. Partial laryngectomy was more effective for salvage surgery
ABSTRACT
Background: Developmental disabilities are a group of related chronic disorders of early onset estimated to affect 5–10% ofchildren. Global developmental delay is a subset of developmental disabilities defined as a significant delay in two or more of thefollowing developmental domains: Gross/fine motor, speech/language, cognition, social/personal, and activities of daily living.Aim of the Study: The aim of this study was to describe the clinical profile and audiological profile in children with globaldevelopmental delay presenting to the pediatric ENT unit.Materials and Methods: The study sample size was a total of 121 children with global developmental delay. Children withcomplaints of global developmental delay underwent a detailed ENT examination including examination under microscope ofear which is the standard of care. Hearing loss was assessed by audiological tests such as behavioral observation audiometry(BOA), otoacoustic emission, brain stem evoked response audiometry (BERA), and tympanometry (Tymps). The degree ofhearing loss was classified using the American Speech-Language-Hearing Association classification.Observations and Results: Among 121 children with global developmental delay, there were 72 (59.5%) males. The meanage of the study group was 3.2 years. The youngest child in the study was 6 months old and the oldest child being 14 yearsold. 25 (20.6%) children participating in the study had syndromic association. Of 121 children, only 36 (29%) presented withspeech delay and suspected hearing loss. BOA done in 242 ears showed 56 (23%) ears with normal hearing, 68 (28%) withhearing loss, and inconsistent report in 38 (15.5%) ears. In the 80 remaining ears (33%), test could not be done.Conclusions: The mean age of referral was 3.2 years in global developmental delay children who were referred for theevaluation of speech delay. Among the 121 global developmental delay children included in the study, 36 (29%) had hearingloss with speech delay. Our study detected a higher incidence of undetected hearing loss of 144 ears (59.5%) in children withglobal developmental delay