RESUMO
OBJECTIVES: In this study, we aimed to analyze the oncologic and functional outcomes of supraglottic laryngectomy. PATIENTS AND METHODS: Medical records of 91 cases (85 males, 6 females; mean age 55.4 years; range 30 to 75 years) who underwent surgery due to early supraglottic laryngeal cancer in our clinic were retrospectively analyzed. Statistical analysis was performed using chi-square test and Fisher's exact test. Mean values were estimated by means of t-test, while survival curves were drawn using Kaplan-Meier method. RESULTS: With respect to oncologic assessment, disease-free survival rate was 81%, the rate of regional recurrence was 6%, the rate of local recurrence was 8%, the rate of distant metastasis was 7% and the rate of occult neck metastasis was 25%. Metastatic neck disease and extracapsular invasion in the lymphatic ganglia were found to be the most critical parameters in terms of survival. With respect to functional assessment, the mean time of decannulation was 41 days, while the mean time of nasogastric tube removal was 19 days. It was observed that cases with a Forced Expiratory Volume in 1 second (FEV-1) of <75% experienced more aspiration-related problems. The functional outcomes were worse in the cases who underwent bilateral neck dissection and postoperative radiotherapy. CONCLUSION: Open surgery is a more effective treatment modality in the early supraglottic tumors in terms of oncologic and functional outcomes. It should be continued to be use as an alternative method to the novel and expensive technologies including transoral robotic surgery or transoral laser surgery.
Assuntos
Carcinoma de Células Escamosas/cirurgia , Neoplasias Laríngeas/cirurgia , Laringectomia/métodos , Recidiva Local de Neoplasia/epidemiologia , Adulto , Idoso , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/patologia , Intervalo Livre de Doença , Epiglote/patologia , Feminino , Neoplasias de Cabeça e Pescoço/secundário , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Neoplasias Laríngeas/epidemiologia , Neoplasias Laríngeas/patologia , Neoplasias Pulmonares/secundário , Masculino , Pessoa de Meia-Idade , Esvaziamento Cervical/estatística & dados numéricos , Gradação de Tumores , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Radioterapia Adjuvante , Aspiração Respiratória/epidemiologia , Aspiração Respiratória/etiologia , Estudos RetrospectivosRESUMO
Post-tonsillectomy hemorrhage is a relatively common complication but life-threatening bleedings are rare. In this paper, we present a case who had undergone tonsillectomy with bipolar diathermy in an another hospital and who was referred to our clinic following a massive hemorrhage from the tonsil bed on the 27th postoperative day. Upon determining that the bleeding was caused by the necrosis of the internal carotid artery, the ligation of the internal carotid artery was performed.