ABSTRACT
The object of this investigation was to evaluate in the long-term the risk of malignancy occurring in the larynx of patients with dysplasia in the laryngeal epithelium. Over an 8-year period, 1974-82, 170 patients underwent microlaryngoscopic examination of the larynx including biopsy, showing hyperplasia and/or keratosis with or without dysplasia in the laryngeal epithelium. Of these, 147 patients were examined, on an average, 5 years and 4 months later. All histological specimens were reviewed by the same pathologist. Of the patients initially showing mild dysplasia, 7.8% developed aggravation while 55.6% of the patients displaying moderate dysplasia had developed severe dysplasia or carcinoma. 93.2% were smokers. It is concluded that all patients with atypia in the laryngeal epithelium should be observed at regular intervals, but special attention should be given to patients showing moderate dysplasia or worse.
Subject(s)
Laryngeal Neoplasms/pathology , Precancerous Conditions/pathology , Adult , Aged , Biopsy , Female , Humans , Laryngeal Neoplasms/epidemiology , Male , Middle Aged , Risk FactorsSubject(s)
Apgar Score , Delivery, Obstetric , Twins , Humans , Infant, Newborn , Retrospective Studies , Time FactorsSubject(s)
Diverticulum/diagnosis , Urethral Diseases/diagnosis , Vaginal Fistula/diagnosis , Adult , Diagnosis, Differential , Diverticulum/complications , Diverticulum/surgery , Female , Humans , Rupture, Spontaneous , Urethral Diseases/complications , Urethral Diseases/surgery , Vaginal Fistula/complications , Vaginal Fistula/surgeryABSTRACT
The purpose of this investigation was to evaluate the extent to which voice quality recovers and is retained in the long term, and the incidence of recurrence of Reinke's oedema, in patients treated by stripping of the vocal cords. Of 120 patients treated consecutively over an eight-year period, 111 comprised the follow-up investigation group. Only 19 per cent had a normal voice. The remaining 81 per cent had voice problems, and of these, 68 per cent displayed obvious hoarseness, with recurrence of Reinke's oedema in 58 per cent. It is concluded that the long term curative effect of this traditional treatment is over-estimated, and that the elimination of various etiological factors, particularly habitual tobacco smoking and voice abuse, is of prime importance.
Subject(s)
Laryngeal Edema/surgery , Vocal Cords/surgery , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Postoperative Complications , Recurrence , Smoking , Voice Disorders/etiology , Voice QualityABSTRACT
Eighteen consecutive cases of intrathoracic goitres operated in an ENT department during a four-year period from 1977-1981 are presented. Massive intrathoracic extension, with at least half of the gland located below the top of the sternum, was seen in all cases. Seventy-eight per cent of the patients had respiratory symptoms, which, in most cases, was so extreme that periodic or manifest stridor was present. The gland could be extirpated through a wide Kocher's incision in all cases. There was no mortality, only a single case of hypoparathyroidism and no recurrent nerve paresis or other complications. Traditionally operation of intrathoracic goitre is performed in thoracic surgical departments. Sternal splitting or lateral thoracotomy, however, is only necessary in a very few cases. It is concluded that surgical treatment of patients with large intrathoracic extension can be performed with advantage in ENT departments by surgeons experienced in head and neck cancer surgery using the operating microscope to lessen risk of damage to the recurrent laryngeal nerves.
Subject(s)
Goiter, Substernal/surgery , Adult , Aged , Female , Goiter, Substernal/complications , Goiter, Substernal/diagnosis , Humans , Male , Middle Aged , Postoperative Complications , Respiratory Insufficiency/etiologyABSTRACT
The purpose of the present follow-up investigation was to evaluate the indications for tonsillectomy à chaud in the presence of a peritonsillar abscess. Of 76 consecutive patients treated for peritonsillar abscess, 45 were treated by incision and drainage, and no tonsillectomy à froid was planned. None of these patients had had previous peritonsillar abscess or recurrent tonsillitis; therefore tonsillectomy was not indicated. A follow-up investigation including 44 of these 45 patients showed that among patients under 30 years of age, 63 per cent had another peritonsillar abscess or recurrent tonsillitis during he follow-up period. Within an average period of 3 years, 41 per cent in this group underwent tonsillectomy. Among patients older than 30 years only 12 per cent had recurrent tonsillar symptoms, and in no case was tonsillectomy performed. The indication for tonsillectomy à chaud is discussed, and the method is recommended as a routine in peritonsillar abscess in patients under 30 years old, whereas conservative treatment with incision and drainage is recommended in patients older than 30 years if the patient has had no previous peritonsillar abscess or recurrent tonsillitis.
Subject(s)
Peritonsillar Abscess/surgery , Adolescent , Adult , Age Factors , Aged , Child , Child, Preschool , Drainage , Female , Follow-Up Studies , Humans , Infant , Male , Middle Aged , RecurrenceABSTRACT
The treatment of a peritonsillar abscess by tonsillectomy à chaud obviously offers advantages over the more conservative treatment with incision, daily dilatations and possibly a later tonsillectomy. The patient avoids the painful drainage of the abscess with daily dilatations. Technically, the operation is easier to perform than later on when fibrosis has developed. The operative complications are not greater than in elective tonsillectomy, and there is no risk of spread of the infection when the patient is treated with antibiotics.
