RESUMO
BACKGROUND: Voice restoration after laryngopharyngectomy can be achieved with an autologous ileocolic flap. We have observed that the length of the flap influences vocal outcome. This investigation aimed to evaluate the association between ileocolic flap length and vocal quality after laryngopharyngectomy. METHODS: The charts of patients who underwent voice rehabilitation with an ileocolic flap after laryngopharyngectomy between 1 January 2011 and 30 December 2012 were abstracted. The length of ileum segment in the ileocolic flap was stratified, and voice outcome was evaluated three months post-operatively, while adjusting for confounding variables. RESULTS: There was a significant association between flap length and loudness, maximum phonation time and sound pressure level (p < 0.05). All three parameters were best in the 10 cm length group. CONCLUSION: Voice rehabilitation after laryngopharyngectomy is possible with an ileocolic flap. The optimal ileocolic flap contains a 10 cm ileum segment. Complications are frequent but amenable to revision surgery.
Assuntos
Afonia/cirurgia , Laringectomia/efeitos adversos , Faringectomia/efeitos adversos , Procedimentos de Cirurgia Plástica , Retalhos Cirúrgicos , Qualidade da Voz/fisiologia , Afonia/etiologia , Afonia/patologia , Colo , Humanos , Neoplasias Hipofaríngeas/cirurgia , Íleo , Neoplasias Laríngeas/cirurgia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
OBJECTIVES: To describe an extremely rare pediatric sinonasal schwannoma, and to reviewmanagement strategies and relevant literature. METHODS: Case report of pediatric sinonasal schwannoma, that was imaged with computed tomography and magnetic resonance imaging and managed endoscopically. Immunohistochemical analysis was performed to determine pathology. RESULTS: A 12-year-old girl presented with a 2-month history of progressive left exophthalmos. Imaging studies showed a large heterogeneous tumour arising from the ethmoid sinus and extending to the base of the skull and to the orbital cavity. The lesion was removed with an endonasal radical excision. The final pathological diagnosis was schwannoma. There was no tumour recurrence or any major complication during the 2-year follow up. CONCLUSION: Schwannoma should be considered in the differential diagnosis for pediatric patients with intranasal masses. Depending on the location and extent of the tumour, endonasal endoscopic excision could be a suitable management strategy.
Assuntos
Endoscopia/métodos , Seio Etmoidal/cirurgia , Neurilemoma/cirurgia , Órbita/cirurgia , Neoplasias dos Seios Paranasais/cirurgia , Base do Crânio/cirurgia , Criança , Seio Etmoidal/diagnóstico por imagem , Seio Etmoidal/patologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Neurilemoma/diagnóstico por imagem , Neurilemoma/patologia , Órbita/diagnóstico por imagem , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/patologia , Base do Crânio/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Resultado do TratamentoAssuntos
Cartilagem/transplante , Laringoplastia/métodos , Paralisia das Pregas Vocais/cirurgia , Idoso , Feminino , Humanos , Laringoscopia/métodos , Masculino , Pessoa de Meia-Idade , Fonação , Estudos Retrospectivos , Espectrografia do Som , Resultado do Tratamento , Paralisia das Pregas Vocais/diagnóstico , Qualidade da VozRESUMO
PROBLEM: The role of elective neck dissection in early stage tongue and buccal squamous cell carcinoma with negative neck lymph nodes is still controversial. METHODS: We retrospectively reviewed patients with T1-2N0M0 buccal and tongue cancer who underwent primary tumour excision with or without elective neck dissection between January 1997 and December 2006. RESULTS: Elective neck dissection specifically improved disease-free survival of T2N0M0 buccal cancer and overall survival of T2N0M0 tongue cancer. CONCLUSION: Elective neck dissection seems to improve the disease-free survival rate of T2N0M0 buccal cancer and the overall survival rate of T2N0M0 tongue cancer but has no beneficial effect on the survival rate of T1N0M0 buccal and tongue cancer.