Evaluation of selective neck dissection in the management of no cancer larynx

Neck node metastasis is the most important prognostic factor in the management of head and neck cancer. Therefore, the early ability to identify the risk of metastasis and its appropriate treatment is crucial to obtaining a cure in these patients. To evaluate selective neck dissection as a treatment option in the management of NO neck in cases of cancer larynx using histopathology and immunohistochemistry. Twenty four patients had laryngeal tumours were staged as clinically NO according to clinical and radiological [CT scan] examination were included in this work. Selective neck dissection was the performed procedure for management of their necks [lateral neck dissection levels II -lv]. Thirty three lateral neck dissections were performed in 24 cases as bilateral neck dissection was done in 9 cases. Lymph nodes were assessed intraoperatively to whether negative for metastasis, positive or suspected. Histopathologically, the specimens examined first with serial sectioning in 5-to 6- micron interval with hematoxylin and eosin [H and E] staining, then inmunostaining for cytokeratins using the monoclonal antibody cocktail AE1/AE3 was done for the negative specimens. Suspected lymph nodes were recorded intraoperatively in seven out of 33 dissections [21.2%]. Using the ordinary hematoxylin and eosin staining, lymph nodes were positive in 11 specimens [33.3%] and negative in 22 specimens [66.7%] with false positive rate [14.3%] and false negative rate [19.2%], Cytokeratin immunohistochemical analysis increases the affected specimens to 13 sepcimens [39.4%] with the same false positive rate [14.3%] and increased false negative rate to [26.9%]. Selective neck dissection [SND] is a valuable treatment option in all cases of NO neck in laryngeal carcinoma when open surgery is selected for the treatment of the primary tumour. SND allows removal of subclinical and subpathological metastases and thus allows accurate staging and treatment of occult disease and assists in patient counseling and prognosis

Mucociliary function of the inferior turbinate after radiofrequency tissue volume reduction versus submucosal diathermy "electron microscopic study"

Nasal obstruction is one of the most common chronic presenting symptom encountered by otolaryngologists. In most patients, the cause of nasal obstruction is either septal deviation or turbinate hypertrophy. Most cases of hypertrophic turbinate are usually mild and respond to antihistamine therapy, local decongestants or corticosteroid [1]. However, surgery is required in some cases and there is a trend toward less invasive than invasive techniques [2]. In order to compare and evaluate radiofrequency tissue volume reduction [RFTVR] and submucosal diathermy [SMD] for treatment of nasal obstruction due to bilateral hypertrophy of the inferior turbinates, 40 patients with bilateral nasal obstruction were divided into 2 groups; 20 patients underwent RFTVR and 20 patients underwent SMD. All 40 patients were followed for 2 months after surgery. Postoperative improvement in nasal breathing after RFTVR was reported for 85% of patients 8 weeks after surgery, while after SMD, improvement was reported for 80% of patients. Rhinomanometric results demonstrated a significant decrease in nasal resistance on both sides after both techniques 6 weeks postoperatively [P < 0.01]. As regard saccharine transit time [STT], in the RFTVR group the mean post operative STT was 10.65 mm, while that in the SMD group was 12.05 min which suggests good preservation of surface mucosa and mucocilinary function in group A than group B patients. Electron microscopic study in both groups showed that in group A patients, RFTVR did not induce any epithelial damage with preservation of ciliated cells and mucociliary function which was markedly better than the SMD technique. In conclusion, both techniques are relatively safe and effective in improving the nasal airway but RFTVR is more superior in preservation of the nasal mucociliary mechanism

method for correction of the deviated cartilagenous nose

Surgical attempts to straighten a deviated nose do not always produce a satisfactory result. In a trial to correct simple and moderately deviated noses we selected 16 patients with cartilaginous nasal deviations, their ages ranged from 16 to 45 years, the septum was corrected and separated from the upper lateral cartilage in the side of the deviation so, freed from its pulling effect and brought to the midline and maintained in position by plastic splints. The follow up period was 12 to 18 months. Early results are promising both aesthetically and functionally