Treatment outcomes in patients with supraglottic laryngeal cancer: a single centre study.

BACKGROUND: Treatment of squamous cell carcinoma of the supraglottic larynx (SCCSL) in Denmark has changed in several ways from the year 2000 to 2014, including the introduction of IMRT radiation technique and the addition of concurrent chemotherapy (CRT), as well as systematic reduction in waiting times until treatment initiation. AIM/OBJECTIVES: Our aim is to investigate the effect of the abovementioned factors on overall survival (OS) and locoregional control (LC) for SCCSL patients. MATERIALS AND METHODS: Retrospective cohort study with data from the DAHANCA database. We used the Kaplan-Meier and Cumulative Incidence plots as well as Cox regression analysis. RESULTS: We found a statistically significant improvement of the 5-year OS of 19.3 percentage points (pp). Cox regression found LC was not improved in patients receiving CRT compared to radiotherapy (RT) alone. CONCLUSIONS AND SIGNIFICANCE: Introduction of CRT treatment for head and neck cancers in general is known to improve LC. We could not demonstrate this effect for SCCSL specifically, as our results were not statistically significant on this point. OS was significantly improved.

[The internal carotid artery as a pulsating protrusion into the pharyngeal wall].

This case report describes an aberrant course of the internal carotid artery (ICA) in a patient presenting with symptoms of globus sensation, mild chronic cough and occasional aspiration. Clinically, a pulsating oro-hypopharyngeal tumour could only be visualized by fiberlaryngoscopy. A CT-scan showed a tortuous ICA protruding into the lateral and posterior pharyngeal wall. This condition may need treatment in itself, and it can lead to co-morbidity and serious surgical complications in undiagnosed patients. Referral to an oto-rhino-laryngologist is highly recommended for diagnostics.

The introduction of sialendoscopy has significantly contributed to a decreased number of excised salivary glands in Denmark.

Excision has been the treatment of choice in benign non-tumorous obstructive disorders of the major salivary glands, when symptoms persisted in spite of conservative measures. Unfortunately surgical resection has been associated with a relatively high rate of adverse effects. To meet the need for a less invasive treatment modality for benign obstructive non-tumorous disorders (i.e., salivary stones or stenosis), sialendoscopy has been developed and implemented in several countries here among Denmark. This study is a 13-year retrospective registry-based study using The Danish National Patient Register. ICD-10 codes used for non-tumorous obstructive disease of the salivary glands were identified and used to extract patients potentially eligible for sialendoscopy in order to compare sialendoscopic surgery and extirpations of salivary glands. In 2012 sialendoscopy accounted for almost 20 % of all surgical interventions on the major salivary glands due to benign non-tumorous disease. Nationally and regionally the total number of resected major salivary glands due to benign obstructive disease also decreased significantly during the study period. A positive outcome, like the ones described here, will inspire further development and dissemination of gland preserving techniques, to great benefit for the patients.

[Successful conservative treatment after accidental stab wound to the chest]. / Vellykket konservativ behandling efter knivtraume mod hjertet.

A five year-old girl was admitted to hospital following an accidental stab wound to the chest, inflicted by a knife placed in a dishwasher's cutlery tray. Investigations revealed a traumatic ventricular septum defect of the heart, with a pericardial effusion. Since the patient remained haemodynamically stable, surgical intervention was considered unnecessary. At the first follow-up, an echocardiogram showed no visible pericardial effusion. At ten month follow-up, she showed initial symptoms of cardiac failure, and a renewed echocardiogram revealed a new pericardial effusion. It is important to perform long-term follow-up on patients with traumatic chest wounds.