Oral cavity colon adenocarcinoma metastases: case report with surgical approach and review of more than 30 years literature.

INTRODUCTION: Metastatic oral tumours are rare, contributing to 1% of all malignant oral cavity tumours. CASE REPORT: We report the case of a 59-year-old man with colon cancer at an advanced disease stage, with progression to the peritoneum and maxillary gingiva. Palliative surgery was indicated to improve the patient's quality of life. DISCUSSION: In a review of the literature, we compiled a list of 27 cases (including the present case) reflecting some 30 years of literature on oral cavity metastatic disease originating in colon cancer. CONCLUSION: Oral cavity metastasis should be taken into account in the differential diagnosis of a synchronous or metachronous oral cavity lesion. The therapeutic goal should include palliative alternatives when necessary. Intraoral reconstruction using local flaps may be a simple and reliable palliative resection option aimed at improving the patient's quality of life.

Pharyngeal closure after a total laryngectomy: mechanical versus manual technique.

OBJECTIVE: To verify the main advantages and drawbacks of mechanical suturing for pharyngeal closure after total laryngectomy versus a manual suturing technique. METHODS: A retrospective review was carried out of 126 total laryngectomies performed between 2008 and 2018. Manual closure was performed in 80 cases (63.5 per cent) and mechanical suturing was performed in 46 cases (36.5 per cent). RESULTS: Mechanical suturing was used significantly more frequently in patients with: glottic tumours (p = 0.008), less local tumour extension (p = 0.017) and less pre-operative morbidity (p = 0.014). There were no significant differences in the incidence of pharyngocutaneous fistula between the manual suture group (16.3 per cent) and the mechanical suture group (13.0 per cent) (p = 0.628). None of the patients treated with mechanical suturing had positive surgical margins. Cancer-specific survival for the mechanical suture group was higher than that for the manual suture group (p = 0.009). CONCLUSION: Mechanical suturing of the pharynx after total laryngectomy is an oncologically safe technique if used in suitable cases.

[Cervical metastasis of squamous cell carcinoma of unknown origin: experience at Hospital de Sant Pau, Barcelona, Spain]. / Metástasis cervical de carcinoma escamoso sin primario conocido: experiencia en el HSCSP.

Between 1984 and 1992, 18 cases of cervical metastasis of squamous cell or anaplastic carcinoma (1% of all head and neck tumors) were seen at the Hospital de la Santa Creu i Sant Pau (Barcelona, Spain). Fifteen patients underwent radical surgery: 1 N1, 4 N2A and 10N3, N1 and N2A patients underwent surgery followed by radiotherapy. The 10 N3 patients began with neoadjuvant chemotherapy (cisplatin and 5-fluorouracil), then 8 had radical neck dissection and 2 had palliative radiotherapy. The primary tumor was found in 11%. The 5-year survival rate was 40% in N1+2A and 11% in N3. Chemotherapy did not improve survival in advanced disease, but it facilitated neck dissection and selection of the group with the prognosis.

[Laryngocele: clinical and therapeutic study of 60 cases]. / Laringoceles: estudio clínico y terapéutico de 60 casos.

Sixty patients with laryngocele were diagnosed in the last seven years: 25 of them without previous laryngeal pathology (group A) and the rest 35 with laryngeal or pharyngeal cancer (group B). The laryngocele was unilateral in the majority of the 25 patients of group A (68%). The internal laryngoceles were the most common type (63%). The initial symptom was hoarseness in 56% of these patients and 20% developed, in their evolution, an acute respiratory distress. The diagnosis was clinical in 16 patients and radiological in the rest. Endoscopically marsupialization with laser-CO2 was performed to remove internal laryngoceles. The mixed and external laryngoceles were completely removed via an external cervical approach without the need to perform any thyrotomy. The diagnosis was radiological by CT in the 35 patients of the group B. In 30 of them the CT was performed to evaluate the local extension of the laryngeal or pharyngeal cancer before its treatment. Supraglottic carcinoma was the most common laryngeal tumor (50%). The anatomic relationship between laryngocele and laryngeal cancer was ipsilateral to each other only in 50% of the patients. In the other 5 patients, no laryngocele was found in the radiological study previous to the treatment of the laryngeal or pharyngeal cancer. The diagnosis was made after chemotherapy and/or radiotherapy treatment.

[Active duration: new parameters in quantitative assessment of post-caloric nystagmus]. / Duración activa: un nuevo parámetro en la valoración cuantitativa del nistagmo postcalórico.

This study describes a new parameter for quantifying the post-caloric nystagmus, the active duration, or the total periods where appropriate nystagmic response existed due to caloric stimulation. On a pathological population of 211 cases, the new parameter records a diagnostic sensitivity of 56% for the canal paresis and 59% for the directional preponderance, improving the sensitivity levels corresponding to the duration of the response according to classical criterion. Being easy to calculate, the active duration parameter is considered to be appropriate for the quantity valoration of the post-caloric nystagmus by means of computerized technics.

[Synchronous carcinomas of the upper aerodigestive tract: a diagnostic and therapeutic problem]. / Carcinomas sincrónicos de vías aerodigestivas superiores: un problema diagnóstico y terapéutico.

Patients with epithelial cancer of the upper aerodigestive tract are at increased risk of a new epithelial cancer developing in the same upper aerodigestive tract, in the oesophagus, or in the lung. We studied the cases seen at our Hospital in the last seven years. The clinical characteristics, the diagnosis and the treatment of 38 patients with synchronic epithelial cancer of the upper aerodigestive tract, oesophagus and lung, were reviewed.

[Vocal rehabilitation of the laryngectomized patient using tracheo-esophageal puncture and phonatory prosthesis]. / Rehabilitación vocal del laringectomizado mediante punción traqueoesofágica y prótesis fonatoria.

We present the results of 25 tracheo-esophageal punctures (20 primary and 5 secondary) followed by insertion of a voice prosthesis, as a method of voice restoration after total laryngectomy. This method is compared with the other three commonly used (tracheo-esophageal fistuloplasty, esophageal voice, and electrolarynx), and a personal variation (Burgués) of the primary tracho-esophageal puncture technique is presented.

[Cancer of the hypopharynx: clinical and epidemiological data on 41 cases]. / Cáncer de hipofaringe: datos clínicos y epidemiológicos de 41 casos.

The clinical and epidemiological data of 41 hypopharyngeal neoplasms diagnosed at the Department of Otolaryngology, Hospital de "La Santa Cruz y San Pablo", Barcelona, are analysed according to eleven computerized parameters. Our results are compared with those appeared in the literature. Though the are close similarities with regard to incidence, sex, tobacco and alcohol consumption, presentation, and histology, our patients are younger and in a better condition than it is generally accepted.