Subject(s)
Humans , Voice , Voice Disorders/prevention & control , Health Education/methods , Health Promotion/methods , BrazilSubject(s)
Health Education/methods , Health Promotion/methods , Voice Disorders/prevention & control , Voice , Brazil , HumansABSTRACT
Paracoccidioidomycosis (PCM) is a systemic granulomatous disease caused by Paracoccidioides brasiliensis or P. lutzii. It is a neglected tropical infectious disease that poses a major public health burden in endemic areas of Latin America. Mucosae of the upper digestive and respiratory tracts are commonly involved and many patients have disease at multiple mucosal sites, with or without lung involvement. Mucosal PCM presenting as solitary true vocal fold disease is relatively rare. We present the case of a 67-year-old Brazilian forest guard who presented with a 6-month history of hoarseness and globus pharyngeus due to a solitary left true vocal fold infiltration and vegetation diagnosed as PCM. Silent pulmonary disease was also present. A laryngoscopy video is offered as supplemental material to this report. He completely remitted after surgical removal and amphotericin B deoxycholate treatment.
ABSTRACT
OBJECTIVES: To assess the integration of an autologous composite fascia and fat graft implanted into the lamina propria of a porcine vocal fold using two different approaches. STUDY DESIGN: An experimental prospective study on the porcine larynx was conducted at a tertiary research institution. METHODS: An external cervical approach was used to expose the thyroid cartilage of 24 healthy minipigs under general anesthesia. The composite fascia/fat graft was implanted through two distinct approaches, transmuscular and submuscular. Animals were sacrificed at 7, 30, 90, and 180 days for macroscopic and histological study of the larynx. Graft integration and local inflammatory response were studied. RESULTS: The survival rate of the experimental model was 100% and all animals had local inflammatory response to the surgical procedure. Only 41.7% of the grafts placed inside the thyroarytenoid (TA) muscle fibers were identified postmortem, whereas 83.3% of the submuscular grafts remained intact. CONCLUSIONS: Graft incorporation was better and there was less inflammation when the architecture of the TA muscle fibers was preserved. Graft extrusion was observed in the most of the cases where it was placed inside the muscle.
Subject(s)
Adipose Tissue/transplantation , Fascia/transplantation , Laryngoplasty/methods , Thyroid Cartilage/surgery , Vocal Cords/surgery , Animals , Graft Survival , Laryngeal Muscles/surgery , Male , Models, Animal , Mucous Membrane/surgery , Postoperative Complications/prevention & control , Swine , Swine, Miniature , Tissue and Organ Harvesting/methodsABSTRACT
Os autores apresentam uma atualizaçäo sobre o assunto
Subject(s)
Intraoperative Complications , Laryngectomy/adverse effects , Larynx/surgery , Postoperative ComplicationsABSTRACT
Os autores analisam 45 casos de pacientes portadores de tumor de Warthin, diagnosticados e tratados no Servico de Cirurgia de Cabeca e Pescoco do Instituto Nacional do Cancer-RJ, no periodo de 1972 a 1989. O proposito deste trabalho foi analisar os dados referentes a cor, idade, sexo e intervalo diagnostico, correlacionando-os com o tratamento efetuado, assim como com as complicacoes advindas deste tratamento e os indices de recorrencia local. Todos os pacientes foram tratados com cirurgia exclusiva, com apenas duas variantes tecnicas: parotidectomia total e parotidectomia superficial.A parotidectomia superficial se mostrou a apcao terapeutica mais adequada para a maioria dos casos e as complicacoes advindas da cirurgia obtiveram evolucao benigna,apenas com tratamento conservador. Os indices de recorrencia local foram muito baixos, confirmando os relatos da literatura internacional.
