Laringectomía horizontal supraglótica láser CO2: nuestra experiencia en seis años / CO2 laser surgery of supraglottic carcinoma: Our experience over 6 years

Introducción y objetivos: El objetivo del estudio es analizar los resultados oncológicos y funcionales de la microcirugía láser en el tratamiento del carcinoma supraglótico de laringe. Material y métodos: Cincuenta y tres pacientes fueron incluidos en este estudio retrospectivo entre el año 2000 y 2006. El periodo de seguimiento fue superior a 2 años y la media fue de 49 meses. Resultados: La extensión tumoral fue T1 en 12 pacientes (22,6%), T2 en 37 (69,8%) y T3 en 4 pacientes (7,5%). En 47 pacientes (88,7%) se realizaron vaciamientos cervicales ganglionares. Diecinueve pacientes (35,8%) recibieron radioterapia (RT) postoperatoria. Las estimaciones de la supervivencia causa-específica con el método de Kaplan-Meier fueron de 80%, 74,11% y 65% a los 2, 3 y 5 años, respectivamente. La preservación de la función laríngea fue posible en el 90,56% (48 de 53) y el control local fue del 81,13%. Durante el periodo de seguimiento 13,2% de los pacientes desarrollaron recidiva local, 11,3% recidiva regional y 5,7% recidiva locorregional. Los pacientes comenzaron a deglutir de forma temprana tras la cirugía con un tiempo medio de 5,83 días y la estancia media hospitalaria fue de 14,69 días. El 20,75% sufrieron neumonía y el 11,32% hemorragia. Únicamente un paciente (1,88%) precisó una laringectomía total por imposibilidad para la deglución. Conclusiones: Con una selección cuidadosa de pacientes, la laringectomia supraglótica con láser es un tratamiento seguro y efectivo para el cáncer supraglótico de laringe (AU)

Introduction and objetives: The study goal was to analyze the oncologic and functional outcomes of transoral laser microsurgery in the treatment of carcinoma of the supraglottic larynx. Material and methods: A total of 53 patients were included in this retrospective review between 2000 and 2006. The follow-up period was more than 2 years and the mean follow-up for all patients was 49 months. Results: Tumour extension was as follows: T1 in 12 (22.6%), T2 in 37 (69.8%) and T3 in 4 (7.5%). Forty-seven patients (88.7%) had neck dissections. Nineteen patients (35.8%) received adjuvant radiotherapy. Kaplan-Meier estimates for disease-specific survival were 80%, 74.11% and 65%, at 2, 3 and 5 years, respectively. The overall functional laryngeal preservation rate was 90.56%. (48 of 53), and local control 81.13%. During follow up, 13.2% of patients developed local recurrence, 11.3% regional recurrence and 5.7% loco-regional recurrence. Patients started swallowing early after surgery, with a mean time of 5.83 days, and the mean hospital stay was 14.69 days. Complications included 20.75% who suffered pneumonia and 11.32% with bleeding. Only one patient (1.88%) received total laryngectomy due to the impossibility of swallowing. Conclusions: With careful selection of patients, laser supraglottic laryngectomy is a safe and effective treatment for cancer of the supraglottic larynx (AU)

CO2 laser surgery of supraglottic carcinoma: our experience over 6 years.

INTRODUCTION AND OBJECTIVES: The study goal was to analyze the oncologic and functional outcomes of transoral laser microsurgery in the treatment of carcinoma of the supraglottic larynx. MATERIAL AND METHODS: A total of 53 patients were included in this retrospective review between 2000 and 2006. The follow-up period was more than 2 years and the mean follow-up for all patients was 49 months. RESULTS: Tumour extension was as follows: T1 in 12 (22.6%), T2 in 37 (69.8%) and T3 in 4 (7.5%). Forty-seven patients (88.7%) had neck dissections. Nineteen patients (35.8%) received adjuvant radiotherapy. Kaplan-Meier estimates for disease-specific survival were 80%, 74.11% and 65%, at 2, 3 and 5 years, respectively. The overall functional laryngeal preservation rate was 90.56%. (48 of 53), and local control 81.13%. During follow up, 13.2% of patients developed local recurrence, 11.3% regional recurrence and 5.7% loco-regional recurrence. Patients started swallowing early after surgery, with a mean time of 5.83 days, and the mean hospital stay was 14.69 days. Complications included 20.75% who suffered pneumonia and 11.32% with bleeding. Only one patient (1.88%) received total laryngectomy due to the impossibility of swallowing. CONCLUSIONS: With careful selection of patients, laser supraglottic laryngectomy is a safe and effective treatment for cancer of the supraglottic larynx.

[Obstructive sleep apnoea syndrome in children]. / Síndrome de apnea obstructiva en niños.

Obstructive sleep apnoea syndrome is a well-known clinical entity in adults but until now it has been less well studied in children. In recent years there has been a dramatic increase in the recognition of sleep disorders in children. Our goal is to analyze scientific data published in the last few years. We reviewed published articles regarding paediatric obstructive sleep apnoea syndrome and extracted the clinical symptoms, diagnosis and treatment options. In conclusion, the natural course and long-term prognosis of childhood obstructive sleep apnoea syndrome are not well-known and further studies are needed in this area.

Síndrome de apnea obstructiva en niños / Obstructive sleep apnoea syndrome in children

El síndrome de apnea obstructiva del sueño es una entidad bien conocida en adultos, pero hasta ahora ha sido menos estudiada en niños. Recientemente se ha producido un importante incremento en el reconocimiento de los trastornos del sueño en la etapa infantil. Nuestro objetivo es analizar los estudios científicos publicados en los últimos años. Hemos revisado artículos publicados acerca del síndrome de apnea obstructiva en edad pediátrica y hemos estudiado la sintomatología, el diagnóstico y las opciones de tratamiento. En conclusión, el curso natural y el pronóstico a largo plazo del síndrome de apnea obstructiva en la infancia no son bien conocidos, por lo que se necesitan más estudios en esta área (AU)

Obstructive sleep apnoea syndrome is a well-known clinical entity in adults but until now it has been less well studied in children. In recent years there has been a dramatic increase in the recognition of sleep disorders in children. Our goal is to analyze scientific data published in the last few years. We reviewed published articles regarding paediatric obstructive sleep apnea syndrome and extracted the clinical symptoms, diagnosis and treatment options. In conclusion, the natural course and long-term prognosis of childhood obstructive sleep apnoea syndrome are not well-known and further studies are needed in this area (AU)