RESUMEN
Glomangiomas of the external ear are exceptionally rare. These tumors are a type of glomus tumor, which are soft tissue neoplasms of mesenchymal origin that result from undifferentiated smooth muscle. In this report, we describe a case of an ear lobule glomangioma that was treated with surgical excision. Laryngoscope, 2023.
RESUMEN
BACKGROUND: A 270-degree partially tubed pectoralis major myocutaneous flap (PMMF) is an excellent option for total circumferential pharyngoesophageal defects in patients who are not candidates for more complex reconstructions. METHODS: Patients undergoing circumferential pharyngoesophageal reconstruction with partially tubed PMMF were reviewed. End points were stricture, fistula, resumption of oral intake, perioperative death, and recurrence. RESULTS: Eleven patients underwent 270-degree PMMF for reconstruction: 6 (55%) were men and 5 (45%) were women (mean, 62 years; range, 42-78 years). Three patients (27%) developed fistulas and 2 (18%) developed stenosis. Ten patients (91%) were able to resume adequate nutrition via oral intake. There were no perioperative deaths. CONCLUSIONS: Patients with severe comorbidities, metastatic disease, a lack of donor vessels, or a potentially hostile abdomen may not be ideal candidates for free tissue transfer. For these patients, partially tubed PMMF using the prevertebral fascia provides a reliable alternative for reconstruction with excellent functional results.
Asunto(s)
Carcinoma de Células Escamosas/cirugía , Neoplasias Laríngeas/cirugía , Colgajo Miocutáneo/trasplante , Músculos Pectorales/trasplante , Neoplasias Faríngeas/cirugía , Faringe/cirugía , Procedimientos de Cirugía Plástica/métodos , Adulto , Anciano , Esófago/cirugía , Femenino , Humanos , Laringectomía , Masculino , Persona de Mediana Edad , Faringectomía , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Deliberative decision strategies have historically been considered the surest path to sound decisions; however, recent evidence and theory suggest that affective strategies may be equally as effective. In four experiments we examined conditions under which affective versus deliberative decision strategies might result in higher decision quality. While consciously focusing on feelings versus details, participants made choices that varied in complexity, in extent of subsequent conscious deliberation allowed, and in domain. Results indicate that focusing on feelings versus details led to superior objective and subjective decision quality for complex decisions. However, when using a feeling-focused approach, subsequent deliberation after encoding resulted in reduced choice quality. These results suggest that affective decision strategies may be more effective relative to deliberative strategies for certain complex decisions.