RESUMEN
BACKGROUND: The purpose of the present study was to report the oncological and functional results of our experience in open organ preservation surgery of the larynx. METHODS: Between 1978 and 2006, 140 patients were treated with organ preservation surgery of the larynx. Feeding tube and tracheotomy duration, surgical infection, fistulae, and pneumonia were recorded. RESULTS: Most patients were treated with supraglottic laryngectomies. Thirteen patients (9%) experienced a faringo-cutaneous fistula, 23 (16%) presented with a surgical site infection, and 6 (4%) developed pneumonia. Tracheotomy was maintained for a median period of 47 days in patients who did not receive postoperative radiotherapy (RT) and 140 days in patients who did. Eight (6%) total laryngectomies were performed because of oncological and functional reasons. Tube feeding continued for an average period of 34 days. Patients with squamous cell carcinoma (SCC) had 5-year disease-free survival (DFS) of 83.6%. CONCLUSION: Open organ preservation surgery proved oncologically effective with good functional outcome and acceptable complications.
Asunto(s)
Carcinoma/cirugía , Neoplasias Laríngeas/cirugía , Laringectomía/métodos , Adulto , Anciano , Carcinoma/mortalidad , Fístula Cutánea/epidemiología , Femenino , Humanos , Italia/epidemiología , Neoplasias Laríngeas/mortalidad , Tiempo de Internación , Masculino , Melanoma/mortalidad , Melanoma/cirugía , Persona de Mediana Edad , Disección del Cuello , Neumonía/epidemiología , Complicaciones Posoperatorias/epidemiología , Radioterapia Adyuvante , Sarcoma/mortalidad , Sarcoma/cirugía , TraqueotomíaRESUMEN
Schwannoma of the parotid gland is an uncommon tumor. When the facial nerve is involved by the tumor at the time of the operation, the surgical approach requires careful evaluation. The purpose of this study is to provide indications which can support the decision, taking into account the different clinical presentations of parotid schwannoma. In a retrospective study, eight cases of parotid schwannoma were collected between 1975 and 2006. In three cases the tumor affected the facial nerve itself and in the remaining ones it originated from intraparotid nonfacial peripheral nerves. When the facial nerve is involved by the tumor a conservative approach should always be considered. The indication for a surgical procedure should be discussed with the patient. If a conservative strategy is chosen, yearly follow-up by means of MRI and clinical observation should be planned.