[A case of pulmonary metastases from laryngeal cancer showing a complete response to chemotherapy with docetaxel].

Docetaxel (TXT) is a new cytotoxic agent against head and neck, (H and N) cancer since the emergence of cisplatin. We herein describe the efficacy of TXT in treating distant metastases from H and N cancer. The patient was a 61-year-old man who had undergone laryngectomy and irradiation for laryngeal cancer (glottic type: T3N0M0). More than 2 years later after the first course of therapy, pulmonary metastases involved in the left lower area were revealed by lung CT. The divided TXT therapy (20 mg, 3 times, and 40 mg, 3 times) was carried out without any sequelae. This consecutive therapy resulted in complete disappearance of the metastases on follow-up CT. It is suggested that divided TXT therapy has potential as a new treatment modality for distant metastases of H and N cancer.

[Surgical treatment of patients with severe obstructive sleep apnea syndrome].

No standard indications currently exist for surgical treatment of severe obstructive sleep apnea syndrome (OSAS). We treated 15 patients with severe OSAS surgically, evaluated surgical indications, and evaluated surgical success. We retrospectively reviewed 15 cases of surgery for OSAS in which polysomnography met 2 or more criteria for the following surgical indications: (1) apnea hypopnea index (AHI) > or = 50, (2) minimum SpO2 below 80%, and (3) enlarged tonsils (grade III, Mackenzie's classification). Among the 15, mean AHI was 85.1. Surgery was done under general anesthesia, with uvulopalatopharyngoplasty (UPPP) in 13 and tonsillectomy alone in 2. Postoperative AHI was measured in 9 patients. According to Nishimura's criteria for assessing surgical success, improvement was "excellent" in 5, "good" in 1, "fair" in 1, and "poor" in 2. When we compared preoperative and postoperative use of continuous positive airway pressure (CPAP) in 7, we found that surgery decreased CPAP requirements. Surgical success was assessed in patients requiring CPAP and improvement was "excellent" in 5, "good" in 1, and "fair" in 1. In conclusion, surgical indications for severe OSAS, including the criterion of enlarged tonsils, were useful. Surgery decreased CPAP requirements and the degree of improvement in this requirement and AHI was valuable in assessing surgical success.