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1.
J Med Case Rep ; 18(1): 293, 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38886746

RESUMO

BACKGROUND: Gossypiboma, a retained surgical sponge with a foreign body reaction, is an unusual but serious complication seen in open abdominal surgeries. It is exceptionally rare following head and neck surgeries. Here, we present a case of Gossypiboma of the upper airway following tracheostomy. CASE PRESENTATION: A 32-year-old male presented with stridor and difficulty breathing one-month post-tracheostomy after a severe head injury following a road traffic accident. A neck radiograph was unremarkable, and a computed tomography (CT) scan of the neck showed a well-defined homogenous curvilinear membrane extending from the hypopharynx to the upper trachea. Bronchoscopic evaluation of the larynx and upper trachea revealed a retained surgical sponge, which was retrieved. The patient's breathing improved drastically post intervention. CONCLUSION: Gossypiboma may go undetected in radiographs and may also present atypically as a homogenous membrane on a CT scan of the neck. Though rare, retained surgical items can have profound medicolegal and professional consequences on physicians. Hence, a strong clinical suspicion and vigilance for gossypiboma is necessary for patients presenting with respiratory distress post-tracheostomy.


Assuntos
Corpos Estranhos , Laringe , Sons Respiratórios , Tampões de Gaze Cirúrgicos , Tomografia Computadorizada por Raios X , Traqueostomia , Humanos , Masculino , Sons Respiratórios/etiologia , Adulto , Tampões de Gaze Cirúrgicos/efeitos adversos , Corpos Estranhos/complicações , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/cirurgia , Laringe/diagnóstico por imagem , Laringe/lesões , Traqueostomia/efeitos adversos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Acidentes de Trânsito
2.
Vet Med Sci ; 10(4): e1478, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38885311

RESUMO

BACKGROUND/OBJECTIVES: The public perception relating to the welfare of horses involved with equestrian sports is associated with training methods used and the presentation of horses at events. In this context, very tight nosebands, which are intended to prevent the horse from opening its mouth, also attract a lot of attention. Various studies have evaluated the impact of tight nosebands on stress parameters, whereas the effect of tight nosebands on upper airway function is unknown. Therefore, the aim of the study was to use overground endoscopy to evaluate changes in pharyngeal and laryngeal function when a tight noseband is fitted. Moreover, the ridden horse pain ethogram (RHpE) was applied to investigate signs of discomfort (Dyson et al., 2018). STUDY DESIGN: A randomized, blinded, and prospective study was performed. METHODS: Sixteen warmblood horses consisting of twelve mares and four geldings with a mean age of 11.63 ± 3.53 years were ridden on 2 consecutive days with either loose or tight nosebands (two fingers or no space between bridge of the nose and noseband, respectively) and inserted endoscope in a random order. Videos were taken in a riding arena during a standardized exercise protocol involving beginner level tasks for 30 min in all gaits. For video analysis, freeze frames were prepared and analyzed at the beginning of the expiration phase. Pharyngeal diameter was measured using the pharynx-epiglottis ratio. Other findings (swallowing, pharyngeal collapse, soft palate movements, and secretion) were also evaluated. Moreover, the RHpE was applied. Descriptive statistics and generalized linear mixed effects models were used. Results with a p-value < 0.05 were considered statistically significant. RESULTS: While the pharynx-epiglottis ratio did not change significantly in horses ridden with loose versus tight nosebands, there was an increase in mean grade and total counts of parameters assessed in the pharyngeal region, for example, grade of secretion (1.5 [±SD 0.89] vs. 3.13 [±SD 0.96]; p = 0.0001), axial deviation of the aryepiglottic folds (0.29 [±SD 0.73] vs. 1.33 [±SD 1.44]; p = 0.01), and pharyngeal collapse (0.69 [±SD 0.87] vs. 1.88 [±SD 1.54]; p = 0.005) in horses ridden with tight nosebands. There was no RHpE score above 8 indicating musculoskeletal pain, but the RHpE scores were significantly higher in horses ridden with tight nosebands (p < 0.001). MAIN LIMITATIONS: Video quality was limited when horses showed large amounts of secretion. Another limitation was the small number of horses. CONCLUSIONS: Results add to the evidence obtained in other studies that tight nosebands do not only cause adverse reactions based on the RHpE score such as head behind the vertical or intense staring but also contribute to changes in the pharyngeal region, such as increased secretion and collapse of pharyngeal structures. This may provide further support for future decisions regarding regulations on nosebands.


Assuntos
Faringe , Animais , Cavalos/fisiologia , Feminino , Masculino , Estudos Prospectivos , Faringe/fisiologia , Nariz/fisiologia , Laringe/fisiologia , Condicionamento Físico Animal/fisiologia
4.
Sci Rep ; 14(1): 11945, 2024 05 25.
Artigo em Inglês | MEDLINE | ID: mdl-38789468

RESUMO

Understanding the mechanisms underlying dysphagia is crucial in devising effective, etiology-centered interventions. However, current clinical assessment and treatment of dysphagia are still more symptom-focused due to our limited understanding of the sophisticated symptom-etiology associations causing swallowing disorders. This study aimed to elucidate the mechanisms giving rise to penetration flows into the laryngeal vestibule that results in aspirations with varying symptoms. Methods: Anatomically accurate, transparent throat models were prepared with a 45° down flapped epiglottis to simulate the instant of laryngeal closure during swallowing. Fluid bolus dynamics were visualized with fluorescent dye from lateral, rear, front, and endoscopic directions to capture key hydrodynamic features leading to aspiration. Three influencing factors, fluid consistency, liquid dispensing site, and dispensing speed, were systemically evaluated on their roles in liquid aspirations. Results: Three aspiration mechanisms were identified, with liquid bolus entering the airway through (a) the interarytenoid notch (notch overflow), (b) cuneiform tubercle recesses (recess overflow), and (c) off-edge flow underneath the epiglottis (off-edge capillary flow). Of the three factors considered, liquid viscosity has the most significant impact on aspiration rate, followed by the liquid dispensing site and the dispensing speed. Water had one order of magnitude higher aspiration risks than 1% w/v methyl cellulose solution, a mildly thick liquid. Anterior dispensing had higher chances for aspiration than posterior oropharyngeal dispensing for both liquids and dispensing speeds considered. The effects of dispending speed varied. A lower speed increased aspiration for anterior-dispensed liquids due to increased off-edge capillary flows, while it significantly reduced aspiration for posterior-dispensed liquids due to reduced notch overflows. Visualizing swallowing hydrodynamics from multiple orientations facilitates detailed site-specific inspections of aspiration mechanisms.


Assuntos
Transtornos de Deglutição , Deglutição , Epiglote , Hidrodinâmica , Deglutição/fisiologia , Humanos , Transtornos de Deglutição/fisiopatologia , Viscosidade , Faringe , Modelos Anatômicos , Orofaringe , Laringe/fisiopatologia
5.
Vestn Otorinolaringol ; 89(2): 66-70, 2024.
Artigo em Russo | MEDLINE | ID: mdl-38805466

RESUMO

The literature review presents current data on the epidemiology, drug, and surgical treatment of laryngeal papillomatosis in adults. Possible prospects for further study of the prevalence and incidence of the disease and provoking factors of recurrence of the disease for the development of possible preventive measures are considered.


Assuntos
Neoplasias Laríngeas , Papiloma , Humanos , Neoplasias Laríngeas/epidemiologia , Neoplasias Laríngeas/cirurgia , Neoplasias Laríngeas/diagnóstico , Papiloma/epidemiologia , Papiloma/cirurgia , Papiloma/diagnóstico , Adulto , Prevalência , Incidência , Laringe/cirurgia , Laringe/patologia
6.
Vestn Otorinolaringol ; 89(2): 105-108, 2024.
Artigo em Russo | MEDLINE | ID: mdl-38805472

RESUMO

A clinical case of a rare malignant tumor of the larynx, carcinosarcoma, is described. The features of the clinical picture, diagnostic methods: instrumental and morphological are presented.


Assuntos
Carcinossarcoma , Neoplasias Laríngeas , Humanos , Carcinossarcoma/diagnóstico , Carcinossarcoma/patologia , Diagnóstico Diferencial , Neoplasias Laríngeas/diagnóstico , Neoplasias Laríngeas/patologia , Laringectomia/métodos , Laringoscopia/métodos , Laringe/patologia
7.
Vestn Otorinolaringol ; 89(2): 101-104, 2024.
Artigo em Russo | MEDLINE | ID: mdl-38805471

RESUMO

Laryngeal air cyst (laryngocele) is a rare disease that is an abnormal cystic expansion of the deep structures of the laryngeal ventricle. They can be accompanied by serious complaints, such as shortness of breath, difficulty breathing during exercise, as well as at rest with large cysts. Computed tomography is the most effective method for determining the type, localization and degree of laryngocele. Although surgical treatment is considered the method of choice in cases of laryngeal air cyst, the approach significantly depends on the size of the lesion.


Assuntos
Laringocele , Tomografia Computadorizada por Raios X , Humanos , Cistos/cirurgia , Cistos/diagnóstico , Doenças da Laringe/cirurgia , Doenças da Laringe/diagnóstico , Doenças da Laringe/fisiopatologia , Laringocele/cirurgia , Laringocele/diagnóstico , Laringoscopia/métodos , Laringe/cirurgia , Laringe/diagnóstico por imagem , Laringe/fisiopatologia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
8.
Acta Otorhinolaryngol Ital ; 44(Suppl. 1): S3-S11, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38745511

RESUMO

Objective: To evaluate the efficacy of transoral laser exoscopic surgery (TOLES) in a unicentric series of patients affected by benign and malignant glottic and supraglottic lesions, and compare outcomes with those of transoral laser microsurgery (TOLMS). Methods: To demonstrate the non-inferiority of TOLES in terms of operative time, margin status and complication rates, we compared outcomes of 93 patients treated by TOLES between July 2021 and July 2023 with those of a match-paired group of 107 historical patients treated by TOLMS. To perform a multiparametric ergonomic evaluation of TOLES vs TOLMS, we used observational methods for biomechanical overload risk assessment and wearable technologies comparing 15 procedures with TOLES vs a paired match of 13 surgeries performed with TOLMS by the same surgeon. Results: No significant differences were found in terms of surgical duration, positive margins, or complications between TOLES and TOLMS. Ergonomics assessment by inertial measurement units and electromyographic surface electrodes demonstrated a reduced biomechanical overload with TOLES compared to TOLMS. Conclusions: The many advantages of TOLES, such as its superior didactic value, better digital control of light even through small-bored laryngoscopes, improved binocular vision, and increase in surgical performance by 3 or 4-hand techniques, are difficult to be quantified. In contrast, its non-inferiority in terms of oncological results and better ergonomics compared to TOLMS are demonstrated herein.


Assuntos
Terapia a Laser , Microcirurgia , Humanos , Microcirurgia/métodos , Microcirurgia/instrumentação , Terapia a Laser/métodos , Terapia a Laser/instrumentação , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Boca , Neoplasias Laríngeas/cirurgia , Resultado do Tratamento , Cirurgia Endoscópica por Orifício Natural/métodos , Cirurgia Endoscópica por Orifício Natural/instrumentação , Ergonomia , Adulto , Laringe/cirurgia
9.
Laryngorhinootologie ; 103(S 01): S148-S166, 2024 May.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-38697146

RESUMO

The laryngotracheal junction is an anatomical region with special pathophysiological features. This review presents clinical pictures and malformations that manifest pre-dilectively at this localisation in children and adolescents as well as in adults. The diagnostic procedure is discussed. The possibilities of surgical reconstruction are presented depending on the pathology and age of the patient.


Assuntos
Laringe , Procedimentos de Cirurgia Plástica , Traqueia , Humanos , Traqueia/cirurgia , Traqueia/anormalidades , Laringe/cirurgia , Laringe/anormalidades , Adolescente , Criança , Procedimentos de Cirurgia Plástica/métodos , Adulto , Laringoestenose/cirurgia
10.
Sci Rep ; 14(1): 11457, 2024 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-38769365

RESUMO

To compare two different wavelengths of the surgical contact diode laser (CDL) for producing a posterior laryngofissure in in-vivo pigs. Anesthetized pigs underwent a tracheostomy and an anterior laryngofissure through a cervicotomy. They were randomly selected for the CDL wavelength and Power, according to the peak of Power set at device (980nm wavelength: Ppeak power of 10 W, 15 W, and 20 W, or 1470 nm wavelength: Ppeak 3 W, 5 W, 7 W, 10 W). At the end of the experiment, the laryngotracheal specimen was extracted and sent for histology and morphometry measurements (incision size, depth, area, and lateral thermal damage). Hemodynamic data and arterial blood gases were recorded during the incisions. Statistical analysis of the comparisons between the parameters and groups had a level of significance of p < 0.05. Twenty-six pigs were divided into CDL 980 nm (n = 11) and 1470 nm (n = 15). There was a greater incision area at the thyroid level in the 980 nm CDL and a wider incision at the trachea level, with a larger distance between mucosa borders. There were no significant differences in the area of lateral thermal damage between the two groups and neither difference among the power levels tested. Both wavelengths tested showed similar results in the various combinations of power levels without significant differences in the lateral thermal damage. The posterior laryngofissure incision can be performed by either of the wavelengths at low and medium power levels without great difference on lateral thermal damage.


Assuntos
Laringe , Lasers Semicondutores , Animais , Suínos , Laringe/cirurgia , Terapia a Laser/métodos , Traqueia/cirurgia
11.
PLoS One ; 19(5): e0300672, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38743725

RESUMO

The larynx undergoes significant age and sex-related changes in structure and function across the lifespan. Emerging evidence suggests that laryngeal microbiota influences immunological processes. Thus, there is a critical need to delineate microbial mechanisms that may underlie laryngeal physiological and immunological changes. As a first step, the present study explored potential age and sex-related changes in the laryngeal microbiota across the lifespan in a murine model. We compared laryngeal microbial profiles of mice across the lifespan (adolescents, young adults, older adults and elderly) to determine age and sex-related microbial variation on 16s rRNA gene sequencing. Measures of alpha diversity and beta diversity were obtained, along with differentially abundant taxa across age groups and biological sexes. There was relative stability of the laryngeal microbiota within each age group and no significant bacterial compositional shift in the laryngeal microbiome across the lifespan. There was an abundance of short-chain fatty acid producing bacteria in the adolescent group, unique to the laryngeal microbiota; taxonomic changes in the elderly resembled that of the aged gut microbiome. There were no significant changes in the laryngeal microbiota relating to biological sex. This is the first study to report age and sex-related variation in laryngeal microbiota. This data lays the groundwork for defining how age-related microbial mechanisms may govern laryngeal health and disease. Bacterial compositional changes, as a result of environmental or systemic stimuli, may not only be indicative of laryngeal-specific metabolic and immunoregulatory processes, but may precede structural and functional age-related changes in laryngeal physiology.


Assuntos
Laringe , Microbiota , RNA Ribossômico 16S , Animais , Feminino , Masculino , Laringe/microbiologia , Camundongos , RNA Ribossômico 16S/genética , Fatores Etários , Envelhecimento/fisiologia , Bactérias/classificação , Bactérias/genética , Fatores Sexuais , Camundongos Endogâmicos C57BL
12.
BMJ Case Rep ; 17(5)2024 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-38740444

RESUMO

With the advancements in the medical field, many innovations in medical devices have happened. Using a surgical stapler to close the laryngectomy defect without opening the pharynx is particularly advantageous in a total laryngectomy (TL). However, performing the tracheoesophageal puncture (TEP) during stapler closure of the larynx has not been widely advocated, due to the fear of complications related to the procedure.We treated two male patients with advanced glottic malignancy who underwent a TL. To restore their ability to speak, we performed a primary TEP and immediate voice prosthesis placement. After the TEP, we closed the larynx using a stapler. The surgical technique used in this procedure has been thoroughly explained.The use of a surgical stapler for pharyngeal closure during a TL has several advantages, particularly with regard to the duration of surgery. The current techniques appear to be promising in reducing TEP-related complications during stapler-assisted laryngeal closure.


Assuntos
Neoplasias Laríngeas , Laringectomia , Punções , Traqueia , Humanos , Masculino , Laringectomia/métodos , Laringectomia/efeitos adversos , Neoplasias Laríngeas/cirurgia , Punções/métodos , Traqueia/cirurgia , Esôfago/cirurgia , Grampeadores Cirúrgicos , Idoso , Pessoa de Meia-Idade , Laringe/cirurgia , Grampeamento Cirúrgico/métodos , Laringe Artificial
13.
J Acoust Soc Am ; 155(5): 3206-3212, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38738937

RESUMO

Modern humans and chimpanzees share a common ancestor on the phylogenetic tree, yet chimpanzees do not spontaneously produce speech or speech sounds. The lab exercise presented in this paper was developed for undergraduate students in a course entitled "What's Special About Human Speech?" The exercise is based on acoustic analyses of the words "cup" and "papa" as spoken by Viki, a home-raised, speech-trained chimpanzee, as well as the words spoken by a human. The analyses allow students to relate differences in articulation and vocal abilities between Viki and humans to the known anatomical differences in their vocal systems. Anatomical and articulation differences between humans and Viki include (1) potential tongue movements, (2) presence or absence of laryngeal air sacs, (3) presence or absence of vocal membranes, and (4) exhalation vs inhalation during production.


Assuntos
Pan troglodytes , Acústica da Fala , Fala , Humanos , Animais , Pan troglodytes/fisiologia , Fala/fisiologia , Língua/fisiologia , Língua/anatomia & histologia , Vocalização Animal/fisiologia , Especificidade da Espécie , Medida da Produção da Fala , Laringe/fisiologia , Laringe/anatomia & histologia , Fonética
14.
J Exp Biol ; 227(7)2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38563308

RESUMO

Vocalisations play a key role in the communication behaviour of many vertebrates. Vocal production requires extremely precise motor control, which is executed by superfast vocal muscles that can operate at cycle frequencies over 100 Hz and up to 250 Hz. The mechanical performance of these muscles has been quantified with isometric performance and the workloop technique, but owing to methodological limitations we lack a key muscle property characterising muscle performance, the force-velocity relationship. Here, we quantified the force-velocity relationship in zebra finch superfast syringeal muscles using the isovelocity technique and tested whether the maximal shortening velocity is different between males and females. We show that syringeal muscles exhibit high maximal shortening velocities of 25L0 s-1 at 30°C. Using Q10-based extrapolation, we estimate they can reach 37-42L0 s-1 on average at body temperature, exceeding other vocal and non-avian skeletal muscles. The increased speed does not adequately compensate for reduced force, which results in low power output. This further highlights the importance of high-frequency operation in these muscles. Furthermore, we show that isometric properties positively correlate with maximal shortening velocities. Although male and female muscles differ in isometric force development rates, maximal shortening velocity is not sex dependent. We also show that cyclical methods to measure force-length properties used in laryngeal studies give the same result as conventional stepwise methodologies, suggesting either approach is appropriate. We argue that vocal behaviour may be affected by the high thermal dependence of superfast vocal muscle performance.


Assuntos
Tentilhões , Laringe , Animais , Feminino , Masculino , Músculo Esquelético/fisiologia , Tentilhões/fisiologia , Contração Muscular/fisiologia
15.
Science ; 384(6693): 295-301, 2024 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-38669574

RESUMO

Airway neuroendocrine (NE) cells have been proposed to serve as specialized sensory epithelial cells that modulate respiratory behavior by communicating with nearby nerve endings. However, their functional properties and physiological roles in the healthy lung, trachea, and larynx remain largely unknown. In this work, we show that murine NE cells in these compartments have distinct biophysical properties but share sensitivity to two commonly aspirated noxious stimuli, water and acid. Moreover, we found that tracheal and laryngeal NE cells protect the airways by releasing adenosine 5'-triphosphate (ATP) to activate purinoreceptive sensory neurons that initiate swallowing and expiratory reflexes. Our work uncovers the broad molecular and biophysical diversity of NE cells across the airways and reveals mechanisms by which these specialized excitable cells serve as sentinels for activating protective responses.


Assuntos
Trifosfato de Adenosina , Laringe , Células Neuroendócrinas , Reflexo , Traqueia , Animais , Camundongos , Células Neuroendócrinas/metabolismo , Laringe/fisiologia , Trifosfato de Adenosina/metabolismo , Reflexo/fisiologia , Traqueia/inervação , Traqueia/citologia , Deglutição , Pulmão/fisiologia , Expiração/fisiologia , Água/metabolismo , Células Receptoras Sensoriais/fisiologia , Camundongos Endogâmicos C57BL
16.
J Exp Zool B Mol Dev Evol ; 342(4): 342-349, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38591232

RESUMO

Wolves howl and dogs bark, both are able to produce variants of either vocalization, but we see a distinct difference in usage between wild and domesticate. Other domesticates also show distinct changes to their vocal output: domestic cats retain meows, a distinctly subadult trait in wildcats. Such differences in acoustic output are well-known, but the causal mechanisms remain little-studied. Potential links between domestication and vocal output are intriguing for multiple reasons, and offer a unique opportunity to explore a prominent hypothesis in domestication research: the neural crest/domestication syndrome hypothesis. This hypothesis suggests that in the early stages of domestication, selection for tame individuals decreased neural crest cell (NCCs) proliferation and migration, which led to a downregulation of the sympathetic arousal system, and hence reduced fear and reactive aggression. NCCs are a transitory stem cell population crucial during embryonic development that tie to diverse tissue types and organ systems. One of these neural-crest derived systems is the larynx, the main vocal source in mammals. We argue that this connection between NCCs and the larynx provides a powerful test of the predictions of the neural crest/domestication syndrome hypothesis, discriminating its predictions from those of other current hypotheses concerning domestication.


Assuntos
Domesticação , Laringe , Crista Neural , Vocalização Animal , Animais , Crista Neural/fisiologia , Vocalização Animal/fisiologia , Laringe/fisiologia , Laringe/anatomia & histologia , Animais Domésticos
17.
Acta Otolaryngol ; 144(3): 243-249, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38662869

RESUMO

BACKGROUNDS: Larynx transplantation has been successfully performed four times, in 1998, 2010, 2015 and 2023 remained the ultimate goal of voice, feeding and breathing rehabilitation. OBJECTIVE: Immunosuppressive protocols used during the previous successful larynx allotransplantation are detailed. MATERIAL AND METHODS: A systematic review of the literature on PUBMED/Medline, Cochrane and Embase was conducted. Articles relating to actual human larynx transplantations were included. RESULTS: Bibliography search gathered N = 10 publications related to the performance and follow-up of human laryngeal transplantations. N = 8 publications were included corresponding to N = 3 actual human larynx transplantations performed in 1998 and 2010 in the USA and in 2015 in Poland. Immunosuppression protocols, induction and maintenance strategies, rejection monitoring and history of all the three previous laryngeal grafts were detailed. CONCLUSIONS: Beyond the surgical prowess, larynx transplantation is feasible and associated with a reasonably successful outcome when compared to other solid organ transplants. Immunosuppressive regimen protocols and technologies for the monitoring of the organ viability have evolved. SIGNIFICANCE: The reevaluation of this surgical option serves as the reminder of the critical necessity to implement a meticulous immunosuppression protocol when transplanting this inherently immunogenic composite organ, the larynx.


Assuntos
Imunossupressores , Laringe , Humanos , Laringe/transplante , Imunossupressores/uso terapêutico , Terapia de Imunossupressão/métodos , Rejeição de Enxerto/prevenção & controle , Rejeição de Enxerto/imunologia
18.
Science ; 384(6693): 269-270, 2024 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-38669581
19.
Laryngorhinootologie ; 103(4): 318-319, 2024 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-38565112
20.
Sci Rep ; 14(1): 7761, 2024 04 02.
Artigo em Inglês | MEDLINE | ID: mdl-38565603

RESUMO

Prognostic factors for overall survival (OS), percutaneous endoscopic gastrostomy (PEG) dependency, and long-term speech rehabilitation via voice prosthesis (VP) after laryngectomy for laryngeal or hypopharyngeal cancer were investigated in a retrospective population-based study in Thuringia, Germany. A total of 617 patients (68.7% larynx; hypopharynx; 31.3%; 93.7% men; median age 62 years; 66.0% stage IV) from 2001 to 2020 were included. Kaplan-Meier and Cox multivariable regression analyses were performed. 23.7% of patients received a PEG. 74.7% received a VP. Median OS was 131 months. Independent factors for lower OS were stage IV (compared to stage II; hazard ratio [HR] = 3.455; confidence interval [CI] 1.395-8.556) and laryngectomy for a recurrent disease (HR = 1.550; CI 1.078-2.228). Median time to PEG removal was 7 months. Prior partial surgery before laryngectomy showed a tendency for independent association for later PEG removal (HR = 1.959; CI 0.921-4.167). Postoperative aspiration needing treatment was an independent risk factor (HR = 2.679; CI 1.001-7.167) for later definitive VP removal. Laryngectomy continuously plays an important role in a curative daily routine treatment setting of advanced laryngeal or hypopharyngeal cancer in Germany. Long-term dependency on nutrition via PEG is an important issue, whereas use of VP is a stable long-term measure for voice rehabilitation.


Assuntos
Neoplasias Hipofaríngeas , Neoplasias Laríngeas , Laringe , Masculino , Humanos , Pessoa de Meia-Idade , Feminino , Laringectomia , Estudos Retrospectivos , Neoplasias Hipofaríngeas/cirurgia , Neoplasias Laríngeas/cirurgia , Laringe/cirurgia , Resultado do Tratamento
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