Results after supracricoid horizontal partial laryngectomy.

OBJECTIVES: This study analyzed oncological and functional results of supracricoid horizontal partial laryngectomy. METHODS: A retrospective study was conducted involving 20 patients with squamous cell carcinoma (SCC) of the larynx who underwent SCPL between 1996 and 2005 in Faculty of Medical Sciences of Santa Casa Hospital of Sao Paulo, Brazil. There were 18 male and 2 female patients with ages ranging from 39 to 74 years (median=58 years), of whom 19 were smokers and 14 alcoholics. The tumors were present in the glottis in 16 cases and supraglottis in 4; 5 were stage I or II and 15 were stage III or IV. We analyzed treatment given when rehabilitation was unsuccessful, oncological results of SCPL, including local and regional recurrences, time to recurrence and treatment given, distal metastases, global survival, survival free of disease, and appearance of second primary tumors. We also calculated the index of functional preservation of the larynx. RESULTS: Rehabilitation of swallowing capabilities and speech was achieved in 18 patients. Removal of the tracheostomy varied between 1 and 9 months. Rehabilitation was unsuccessful in two patients. Three patients required a total laryngectomy, two for unsuccessful rehabilitation and one for recurrence. The preservation of a functional larynx was 85%, with 10% of patients requiring a total laryngectomy after failed rehabilitation. CONCLUSIONS: Supracricoid horizontal partial laryngectomy is an efficient surgical oncology technique that yields good functional results for the treatment of laryngeal cancer.

Prehistoric hawaiian fishponds.

One of the important technological concepts that was developed in the Hawaiian Islands is that of the fishpond. From the 14th to the 19th centuries, these sites served as aquariums for the raising of selected fish. From its inception until the 1900's, the fishpond progressed little in design and function. Its rudimentary nature was a function of both technology and religion. Because of the open ditches, sluice grates, and permeable walls, neither the types nor the quantity of juvenile fish entering or leaving could be controlled. In addition, religious beliefs prevented experimenting with fertilization to increase yield. Although seemingly inefficient, the native aquacultural system was not intended to produce a great amount of fish but rather to yield selected fish on call. Fishponds became symbols of the chiefly right to conspicuous consumption and to ownership of the land and its resources. They were manifestations of the chief's political power and his ability to control and tap his resources. As soon as the native aristocracy changed to a Western-style kingdom, the fishpond's function changed, until, by the 1930' s, the majority were simply archeological remains-mounds and walls of rock along a river or shore.