Surgical Treatment Modalities for Iatrogenic Anterior Glottic Stenosis

2018 ◽  
Vol 127 (12) ◽  
pp. 946-952 ◽  
Author(s):  
Yitan Cao ◽  
Guangbin Sun
Keyword(s):  
Surgical Treatment ◽  
Malignant Tumors ◽  
Anterior Commissure ◽  
Voice Quality ◽  
Clinical Information ◽  
Voice Handicap Index ◽  
Treatment Modalities ◽  
Type I ◽  
Laryngeal Surgery ◽  
Multi Speech

Objectives: The aim of this study was to describe common iatrogenic causes of anterior glottic stenosis and to investigate the surgical treatment outcomes of 3 different techniques aimed at repairing stenoses and preventing web reformation. Methods: Clinical information regarding patient demographics, presentation, etiology, treatment, and follow-up outcomes was obtained retrospectively through a review of patients’ records between April 2010 and April 2017. Voice quality was evaluated using grade, roughness, breathiness, asthenia, and strain scale and Voice Handicap Index scores. Objective acoustic parameters were collected using the Kay Elemetrics Multi-Speech program. Results: Twenty patients were included in the study. Causes of glottic web formation included chemoradiation therapy and previous laryngeal surgery for polyps or malignant tumors at the anterior commissure. Web lysis with a CO2 laser, intralaryngeal suturing, and keel placement were used in surgical treatment. Satisfactory results were achieved in 19 patients, and 1 recurrence was observed. Grade, roughness, breathiness, asthenia, and strain scale and Voice Handicap Index scores and objective voice variables for patients with Cohen type I or II webs improved significantly after the surgery. Conclusions: Treatment modalities for anterior glottic stenosis should be carefully chosen according to the etiology of the web, as well as the length and depth of the glottis involved.

Phonosurgical voice rehabilitation in patients with primary larynx cancer after laser cordectomy CO2

2017 ◽  
Vol 6 (1) ◽  
pp. 48-57
Author(s):  
Lech Chyczewski ◽  
Bożena Kosztyła-Hojna ◽  
Greta Berger
Keyword(s):  
Laryngeal Cancer ◽  
Vocal Fold ◽  
Speech Therapy ◽  
Anterior Commissure ◽  
Voice Quality ◽  
Life Quality ◽  
Voice Rehabilitation ◽  
Type I ◽  
Voice Preservation ◽  
Laser Cordectomy

The aim of the treatment of early laryngeal cancer is complete oncological cure and simultaneously voice and swallowing preservation. According to the European Laryngological Society (ELS) classification of CO2 laser cordectomy, full voice recovery is seen in subepithelial cordectomy (ELS Type I ) and near complete in subligamental cordectomy (ELS type II). Voice deterioration is usually seen after more extensive levels of cordectomy (ELS types III-V). Voice quality after microsurgical laser cordectomy depends on the presence or absence of synechiae in the anterior commissure and on the quantity of the removed thyro-arytenoid muscle. More extensive reduction of the vocal muscle quantity causes more intensive glottic incompetence. Contralateral healthy vocal fold, rudimentary, cicatrixial previously operated vocal fold and false ventricular folds may take part in postoperative supraglottic voice compensation. All patients should undergo speech and voice therapy after terminating the scaring process on the operated vocal fold. Patients routinely undergo a minimum of 6 months of voice rehabilitation which allows speech therapy to yield the best possible voice. Phonosurgical techniques i.e. medialization thyroplasty, augmentation techniques, Zeitels’s laryngoplasty or Lichtenberger’s technique in treatment of synechia in the anterior commissure are successfully performed to restore the vocal competence. Voice preservation after treatment of early laryngeal cancer of the vocal fold improves life quality of the patient.

Vocal Fold Atrophy and its Surgical Treatment

1996 ◽  
Vol 105 (3) ◽  
pp. 182-188 ◽  
Author(s):  
Nobuhiko Isshiki ◽  
Kazuhiko Shoji ◽  
Hisayoshi Kojima ◽  
Shigeru Hirano
Keyword(s):  
Decision Making ◽  
Surgical Treatment ◽  
Vocal Fold ◽  
Voice Quality ◽  
Vocal Folds ◽  
Decision Making Process ◽  
Type I ◽  
Vocal Fold Atrophy ◽  
The Voice ◽  
Type I Thyroplasty

The effectiveness of surgical treatment for vocal fold atrophy of various causes was examined. Type I thyroplasty was performed on 31 patients with vocal fold atrophy, often bilaterally and occasionally combined with type III thyroplasty. Of these 31 patients, 3 patients underwent the operation twice, for a total of 34 operations. The surgery was found to be effective in improving the voice quality and the ease of phonation. When a scar or sulcus was present, the results were not as satisfactory. The intraoperative decision-making process as to which procedure to perform is extremely important for achieving an optimal voice, and should be based on the intraoperative voice quality, fiberoptic findings, and manual tests. In operations for vocal fold atrophy in which the vocal folds are mobile, a silicone shim should be firmly fixed to prevent migration. Overcorrection is generally recommended. No complications were encountered. It was often the increased ease of phonation rather than the improved voice quality that patients appreciated after surgery.

Cystic dilation of the ventriculus terminalis

2012 ◽  
Vol 17 (1) ◽  
pp. 86-92 ◽  
Author(s):  
Mario Ganau ◽  
Andrea Talacchi ◽  
Paolo C. Cecchi ◽  
Claudio Ghimenton ◽  
Massimo Gerosa ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Status ◽  
Relevant Literature ◽  
University Hospital ◽  
Neurological Deficits ◽  
Herniated Disc ◽  
Treatment Modalities ◽  
Consecutive Series ◽  
Type I

Object The ventriculus terminalis, an embryological remnant consisting of the ependymal-lined space of the conus medullaris, can occasionally become symptomatic after cystic dilation. In the existing literature, consisting of 32 cases, the preferred type of management (conservative vs surgical) is still debated. The object of this study was to report the surgical results in a consecutive series of 10 adult patients with cystic dilation of the ventriculus terminalis (CDVT), to match them with data retrieved from the relevant literature, and specifically to validate a new recent clinical classification. Methods The authors reported 13 new cases of CDVT treated in the Department of Neurosurgery at University Hospital in Verona, Italy. Treatment modalities and clinical and radiological outcomes, both early and at follow-up, were analyzed and compared with a preoperative classification of clinical presentation, as established by de Moura Batista and colleagues (2008). Results Surgical treatment seemed to guarantee the resolution of CDVT. Dorsolumbar laminotomy, myelotomy, and cystic drainage were performed in 10 patients. Patients with Type I symptoms (nonspecific complaints) often presented with comorbidities (herniated disc or facet hypertrophy) confusing their clinical status. The surgical treatment of patients with Type I symptoms promoted good results only if the diagnosis of CDVT was definitive and symptoms had rapidly evolved. In patients with Type II (focal neurological deficits) and III (sphincter disturbances) symptoms, surgical treatment sustained improvement even at the late follow-up. Conclusions While confirming the usefulness of de Moura Batista and colleagues' classification in its impact on prognosis, the authors propose a revision of the classification with subgroups Type Ia (nonspecific symptoms without clear relation to CDVT), which is best treated conservatively, and Type Ib (rapid onset and invalidating unspecific complaints without comorbidities), which may benefit from surgical evacuation.

scholarly journals Multidimensional Voice Quality Evaluation After Transoral CO2 Laser Cordectomy: A Prospective Study

2020 ◽  
Vol 100 (1_suppl) ◽  
pp. 27S-32S
Author(s):  
Yaniv Hamzany ◽  
Lise Crevier-Buchman ◽  
Jérôme R. Lechien ◽  
Gideon Bachar ◽  
Daniel Brasnu ◽  
...  
Keyword(s):  
Voice Quality ◽  
Voice Handicap Index ◽  
Glottic Cancer ◽  
Type I ◽  
Quality Changes ◽  
Early Glottic Cancer ◽  
Maximum Phonation Time ◽  
Group 2 ◽  
Laser Cordectomy ◽  
Group 1

Objective: To investigate voice quality changes of patients treated by transoral laser cordectomy (TLC) for early glottic cancer according to the type of cordectomies. Methods: A total of 164 consecutive male patients with an early glottic cancer were prospectively recruited from the Department of Otolaryngology—Head and Neck Surgery of the Georges Pompidou European Hospital. Depending on the tumor characteristics, patients benefited from type I to VI CO2 cordectomy regarding the European Laryngological Society classification. The following voice quality outcomes were pre- to postoperatively assessed: voice handicap index (VHI), perceptual grade of dysphonia, roughness, breathiness, maximum phonation time, and acoustic parameters. Results: Fifty-five patients with Tis, T1, or T2 vocal fold cancer completed the study (mean age: 61.7 years). Of these patients, 34 and 21 composed group 1 (types I-III TLC) and group 2 (types IV-VI TLC), respectively. Voice handicap index, grade of dysphonia, and breathiness significantly improved from pre- to 3- and 6-month posttreatment in group 1. In group 2, only VHI significantly improved from pre- to 3- and 6-month posttreatment. Acoustic and aerodynamic measurements did not change throughout the postoperative course. Patients with types I to III TLC exhibited better postoperative voice outcomes compared to those treated by types IV to VI TLC. Conclusion: Irrespective to the types of TLC, the subjective voice quality of patients treated by CO2 laser cordectomy for early glottic cancer significantly improved from pre- to 3- and 6-month posttreatment. The usefulness of aerodynamic and acoustic measurements as postoperative outcomes of voice quality changes remain controversial and require future studies considering multidimensional assessment of voice.

Health-related quality of life one year after surgical treatment of the type I chronic aortic dissection

2019 ◽  
Vol 38 (1) ◽  
Author(s):  
Oksana Kamenskaya ◽  
Asya Klinkova ◽  
Irina Loginova ◽  
Alexander Chernyavskiy ◽  
Dmitry Sirota ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Aortic Dissection ◽  
Type I ◽  
Health Related Quality ◽  
Chronic Aortic Dissection ◽  
Related Quality ◽  
Health Related ◽  
One Year

ROLE OF ULTRASOUND IN THE DETECTION OF RECURRENT OVARIAN CANCER

2020 ◽  
Vol 6 (1) ◽  
pp. 23-31
Author(s):  
M. Alisherova ◽  
◽  
M. Ismailova
Keyword(s):  
Ovarian Cancer ◽  
Surgical Treatment ◽  
Reproductive System ◽  
Malignant Tumors ◽  
Recurrent Ovarian Cancer ◽  
Primary Diagnosis ◽  
Female Reproductive System

Currently, there are no standard approaches to monitoring patients with ovarian cancer (OC). While the role of ultrasound (US) has been identified in the primary diagnosis of OS, it is still controversial during the subsequent surgical treatment of OC. In world statistics, ovarian cancer is consistently among the four main localizations of malignant tumors of the female reproductive system, along with tumors of the breast, body and cervix.

scholarly journals Comprehensive analyses of competing endogenous RNA networks reveal potential biomarkers for predicting hepatocellular carcinoma recurrence

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ping Yan ◽  
Zuotian Huang ◽  
Tong Mou ◽  
Yunhai Luo ◽  
Yanyao Liu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Malignant Tumors ◽  
Expression Profiles ◽  
Clinical Information ◽  
Gene Expression Omnibus ◽  
The Cancer Genome Atlas ◽  
High Rate ◽  
Competing Endogenous Rna ◽  
Tissue Samples ◽  
Potential Biomarkers

Abstract Background Hepatocellular carcinoma (HCC) is one of the most common and deadly malignant tumors, with a high rate of recurrence worldwide. This study aimed to investigate the mechanism underlying the progression of HCC and to identify recurrence-related biomarkers. Methods We first analyzed 132 HCC patients with paired tumor and adjacent normal tissue samples from the Gene Expression Omnibus (GEO) database to identify differentially expressed genes (DEGs). The expression profiles and clinical information of 372 HCC patients from The Cancer Genome Atlas (TCGA) database were next analyzed to further validate the DEGs, construct competing endogenous RNA (ceRNA) networks and discover the prognostic genes associated with recurrence. Finally, several recurrence-related genes were evaluated in two external cohorts, consisting of fifty-two and forty-nine HCC patients, respectively. Results With the comprehensive strategies of data mining, two potential interactive ceRNA networks were constructed based on the competitive relationships of the ceRNA hypothesis. The ‘upregulated’ ceRNA network consists of 6 upregulated lncRNAs, 3 downregulated miRNAs and 5 upregulated mRNAs, and the ‘downregulated’ network includes 4 downregulated lncRNAs, 12 upregulated miRNAs and 67 downregulated mRNAs. Survival analysis of the genes in the ceRNA networks demonstrated that 20 mRNAs were significantly associated with recurrence-free survival (RFS). Based on the prognostic mRNAs, a four-gene signature (ADH4, DNASE1L3, HGFAC and MELK) was established with the least absolute shrinkage and selection operator (LASSO) algorithm to predict the RFS of HCC patients, the performance of which was evaluated by receiver operating characteristic curves. The signature was also validated in two external cohort and displayed effective discrimination and prediction for the RFS of HCC patients. Conclusions In conclusion, the present study elucidated the underlying mechanisms of tumorigenesis and progression, provided two visualized ceRNA networks and successfully identified several potential biomarkers for HCC recurrence prediction and targeted therapies.

scholarly journals Is it possible to estimate the need for surgical management in patients with a tubo-ovarian abscess at admission? A retrospective long-term analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Murat Gözüküçük ◽  
Esra Gülen Yıldız
Keyword(s):  
Surgical Treatment ◽  
Antibiotic Therapy ◽  
Treatment Failure ◽  
Medical Treatment ◽  
Length Of Hospital Stay ◽  
Treatment Modalities ◽  
Laboratory Findings ◽  
Factors Affecting ◽  
Laboratory Infection ◽  
Major Factors

Abstract Background This study aimed to determine the possible prognostic factors correlated with the treatment modalities of tubo-ovarian abscesses (TOAs) and thus to assess whether the need for surgery was predictable at the time of initial admission. Materials and methods Between January 2012 and December 2019, patients who were hospitalized with a TOA in our clinic were retrospectively recruited. The age of the patients, clinical and sonographic presentation, pelvic inflammatory risk factors, antibiotic therapy, applied surgical treatment, laboratory infection parameters, and length of hospital stay were recorded. Results The records of 115 patients hospitalized with a prediagnosis of TOA were reviewed for the current study. After hospitalization, TOA was ruled out in 19 patients, and data regarding 96 patients was included for analysis. Twenty-eight (29.2%) patients underwent surgical treatment due to failed antibiotic therapy. Sixty-eight (70.8%) were successfully treated with parenteral antibiotics. Medical treatment failure and need for surgery were more common in patients with a large abscess (volume, > 40 cm3, or diameter, > 5 cm). The group treated by surgical intervention was statistically older than the patients receiving medical treatment (p < 0.05). Conclusions Although the treatment in TOA may vary according to clinical, sonographic, and laboratory findings; age of patients, the abscess size, and volume were seen as the major factors affecting medical treatment failure. Moreover, TOA treatment should be planned on a more individual basis.

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