RESUMO
Transantral ligation of the arteria maxillares internae (AMI) (with or without ligation of the arteria ethmoidalis) and percutaneous embolisation of AMI in cases of intractable epistaxis (i.e. epistaxis not responding to classical posterior packing) are compared. Except when ethmoidal bleeding is suspected, we recommend embolisation for epistaxis not responding to classical measures as it leads to fewer complications and recurrences, to shorter hospital stay and to improved postoperative comfort.
Assuntos
Embolização Terapêutica , Epistaxe/terapia , Artéria Maxilar/cirurgia , Seio Maxilar/cirurgia , Adolescente , Adulto , Idoso , Criança , Terapia Combinada , Epistaxe/reabilitação , Hospitalização , Humanos , Tempo de Internação , Ligadura , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
A series of 62 patients treated by (repeated) CO2 laser excision and/or vaporization for premalignant lesions of the vocal cords was analysed retrospectively. Of the 54 patients available for follow-up (ranging from 1 to 15 years), five patients (9%) developed an invasive glottic carcinoma and needed radiotherapy. Only two patients (4%) needed extensive surgery (total laryngectomy). One patient (2%) died of a recurrent carcinoma despite radiotherapy and laryngectomy, and six patients (11%) died of a metachronic lung carcinoma. The therapeutic results of (repeated) laser therapy were comparable to those in other reports regarding radiotherapy or stripping. The subjective functional results were satisfactory and tended to improve along with refinement of laser surgery techniques. Follow-up of patients who once had a premalignant laryngeal lesion is mandatory ad vitam, regardless of the grade of the lesion. For the screening of lung cancer, there is still no consensus on a standard-of-care. The classical chest X-ray remains the most accessible and comfortable screening procedure.
Assuntos
Carcinoma in Situ/cirurgia , Neoplasias Laríngeas/cirurgia , Terapia a Laser , Lesões Pré-Cancerosas/cirurgia , Prega Vocal/patologia , Carcinoma in Situ/epidemiologia , Carcinoma in Situ/patologia , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Neoplasias Laríngeas/epidemiologia , Neoplasias Laríngeas/patologia , Masculino , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/epidemiologia , Lesões Pré-Cancerosas/patologia , Estudos Retrospectivos , Fumar/epidemiologia , Fatores de Tempo , Resultado do TratamentoRESUMO
Conservative surgical technique (Partial inferior turbinoplasty) for enlarged inferior turbinates, not responding to adequate local and systemic therapy is described. Short and long term results are evaluated. Relief of nasal obstruction is reported in 94.7% of the patients. There is a good correlation between this success-rate and the objective measurements of the nasal resistance by active anterior rhinomanometry. Rhinorrhea or postnasal drip was still present in 34.2%. Atrophic changes in the nasal mucosa were not observed. Early post-operative epistaxis was found in 5.3% of the patients. Late post-operative epistaxis did not occur.
