ABSTRACT
The objective of this article is to describe our experiences in treating patients for head and neck pilomatrixoma at our institution during a 5-year period and to compare our findings with previously published results. To that end, we conducted a 5-year retrospective chart review to identify those patients who had a confirmed histopathologic diagnosis of pilomatrixoma involving the head and neck area. We reviewed medical records for presenting signs and symptoms, lesion characteristics, treatment rendered, and outcomes. We identified 26 patients, aged 6 to 77 (mean: 33), who met the criteria for inclusion in our study. All had been treated for solitary tumors with simple surgical excision and closure. We found no reported adverse outcomes and no tumor recurrences at the surgical sites. These findings support the use of simple surgical excision as the treatment of choice for these tumors.
Subject(s)
Hair Diseases/surgery , Head and Neck Neoplasms/surgery , Pilomatrixoma/surgery , Skin Neoplasms/surgery , Adolescent , Adult , Aged , Child , Female , Follow-Up Studies , Hair Diseases/diagnosis , Head and Neck Neoplasms/diagnosis , Humans , Male , Middle Aged , Pilomatrixoma/diagnosis , Retrospective Studies , Skin Neoplasms/diagnosis , Treatment OutcomeABSTRACT
Endoscopically placed airway stents offer a viable option in primary or adjunctive treatment of severe pediatric tracheobronchial stenoses. Optimistic clinical reports substantiate the need for experimental studies to more effectively evaluate their clinical role. Development of an animal model comparable with the pediatric airway, amenable to endoscopic instrumentation, and capable of assessing effect on growth was the purpose of this pilot project. Nine 4-week-old piglets underwent endoscopic midtracheal placement of the balloon-expandable Palmaz metallic stent. Initial expansion and stent position were verified fluoroscopically and by direct videobronchoscopy. Serial endoscopic examination and stent reexpansion were performed 2 and 4 weeks after stent insertion. Animal weight, clinical tolerance, tracheal growth, and stent integrity were observed. Tracheal inflammation was evaluated grossly and by objective histopathologic criteria. Successful endotracheal stent placement and expansion were accomplished in all piglets. One pig died of anesthesia complications less than 24 hours after stent insertion. The remaining pigs exhibited excellent clinical tolerance through experiment completion. No detrimental effect on growth was noted, and effective dilatation of the stented tracheal region was observed. Stent incorporation was evident with significant mucosal ingrowth. Inflammation in the form of nonobstructing granulation tissue was present, and no evidence of necrosis or cartilage invasion was evident. The piglet trachea appears to be an excellent model for evaluation of expandable metallic airway stents in management of congenital and acquired tracheobronchial stenoses.
Subject(s)
Disease Models, Animal , Stents , Trachea/growth & development , Animals , Animals, Newborn , Bronchoscopy , Swine , Trachea/pathologyABSTRACT
Aspirated foreign bodies (FB) in the peripheral tracheobronchial tree may present challenging management problems for the bronchoscopist. Critical to successful removal is maintaining airway control while minimizing endoscopy time. An innovative approach utilizing rigid and flexible bronchoscopy in removal of a distal impacted airway is presented. Difficulties encountered as well as advantages of this combined approach are discussed.
