RESUMO
To our knowledge this is the first systematic review of tracheal chondrosarcoma treatment outcomes. Management insights are thoroughly discussed. Men constitute 93.8% of cases, and most of these occur in the distal trachea. The most common symptom, dyspnea, occurs in virtually all patients. Extratracheal extension had occurred in 78.6% of patients. Definitive treatment with tracheal resection showed no recurrences in 10 patients with mean follow-up of 3.1 years. Adjuvant radiotherapy may be utilized for improving local control when open complete resection cannot be performed, but only after endoscopic excision of gross tumor.
RESUMO
OBJECTIVES/HYPOTHESIS: To assess the effect of genioglossus, geniohyoid, and anterior digastric muscle advancement on base of tongue and hyoid position. STUDY DESIGN: Cadaver experiments. METHODS: In fresh cadavers, the mandibular attachments of the genioglossus, geniohyoid, and anterior digastric muscles were advanced anteriorly by 6, 10, or 14 mm, and the anterior displacement of the base of tongue and hyoid was measured. The degrees of displacement of the tongue base and hyoid by the individual muscles and combinations of muscles were compared to one another. RESULTS: In 11 cadavers, 462 measurements were taken. Genioglossus advancement alone produced significantly greater tongue base advancement than any other muscle (P < .001). No combination of muscles produced significantly more tongue base advancement than the genioglossus alone. Geniohyoid (P < .001) and anterior digastric muscle (P < .001) advancement both produced significantly greater hyoid advancement than the genioglossus, but there was no difference between the two (p = .615). No combination of muscles produced significantly more hyoid advancement than the geniohyoid or anterior digastric alone. CONCLUSIONS: Genioglossus muscle advancement produces the greatest base of tongue advancement. Geniohyoid or anterior digastric muscle advancement produces the greatest hyoid advancement. Advancement of neither base of tongue nor hyoid was superior when combinations of muscles were moved. LEVEL OF EVIDENCE: NA Laryngoscope, 127:1938-1942, 2017.