Benign Tumors and Lesions of the Larynx in Children

1979 ◽  
Vol 88 (4) ◽  
pp. 479-485 ◽  
Author(s):  
George T. Simpson ◽  
Trevor McGill ◽  
Gerald B. Healy ◽  
M. Stuart Strong
Keyword(s):  
Surgical Excision ◽  
Treatment Modalities ◽  
Surgical Approaches ◽  
Benign Tumors ◽  
Benign Lesions ◽  
Laryngeal Function ◽  
Safety And Efficacy ◽  
Elegant Method ◽  
Postoperative Findings ◽  
In Infants And Children

Benign lesions of the airway in infants and children may endanger the airway and compromise laryngeal function. The CO2 laser provides an elegant method of transoral surgical excision without compromising laryngeal function or airway competence. It avoids the risks of such other treatment modalities as external surgical approaches, prolonged steroid therapy, and radiation. It is applicable to a wide variety of lesions without the necessity of tracheotomy. Hospitalization is minimized. Ten cases are presented to show the wide applicability of this technique. Gross pathology and pre- and postoperative findings are demonstrated and discussed, as is the safety and efficacy of the laser soft-tissue interaction.

scholarly journals Surgical excision and postoperative radiotherapy for keloids

2019 ◽  
Vol 5 ◽  
pp. 205951311989111 ◽  
Author(s):  
Rei Ogawa ◽  
Mamiko Tosa ◽  
Teruyuki Dohi ◽  
Satoshi Akaishi ◽  
Shigehiko Kuribayashi
Keyword(s):  
Postoperative Radiotherapy ◽  
Surgical Excision ◽  
Surgical Approaches ◽  
Biologically Effective Dose ◽  
Body Site ◽  
Recurrence Rates ◽  
Radiation Technology ◽  
Safety And Efficacy ◽  
Higher Doses ◽  
Recurrence Sites

Keloids can be treated in a number of ways, including by surgery. Multiple studies now show that while surgical monotherapy associates with extremely high rates of recurrence (50%–80%), postoperative radiotherapy can significantly reduce these recurrence rates. Ongoing improvements in radiation technology have further increased the safety and efficacy of this combination protocol. Of the various radiotherapies that have been used in this setting, electron beam (β-ray) irradiation is currently the best due to its excellent dose distribution and safety. The maximal biologically effective dose (BED) for keloids is 30 Gy (using an estimated α / β ratio of 10); increasing the dose has no further benefits and elevates side effects. Over the last two decades, we have modified and then fine-tuned our radiotherapy protocol for keloid excision wounds. Thus, our early protocol was used for all body sites and consisted of 15 Gy/3 fr/3 days. We then customised the radiotherapy protocol so that body sites that are highly prone to recurrence (e.g. the anterior chest) receive higher doses while low recurrence sites like the earlobe receive a much smaller dose. More recently, we tweaked this body site-customised protocol so that fewer fractions are employed. Therefore, we currently apply 18 Gy/3 fr/3 days to high-recurrence sites, 8 Gy/1 fr/1 day to earlobes and 15 Gy/2 fr/2 days to other body sites. These radiotherapy protocol changes were accompanied by the evolution of body site-customised surgical approaches. As a result of these developments, our overall keloid recurrence rate is now below 10%.

scholarly journals Lingual Thyroid: A Case Series of Six Lingual Thyroid with Incidence and Different Treatment Modalities

2015 ◽  
Vol 6 (3) ◽  
pp. 103-108
Author(s):  
Yogesh Subhashsing Patil ◽  
Rashmi Prashant Rajashekhar ◽  
Nayanna Sanjay Karodpati ◽  
James Thomas
Keyword(s):  
Thyroid Gland ◽  
Case Series ◽  
Surgical Excision ◽  
First Trimester ◽  
Treatment Modalities ◽  
Surgical Approaches ◽  
Lingual Thyroid ◽  
Symptomatic Disease ◽  
Complete Surgical Excision ◽  
Radioiodine Ablation

ABSTRACT Objectives Lingual thyroid (LT) is a rare embryological anomaly and originates from failure of the thyroid gland to descend from the foramen cecum to its normal eutopic prelaryngeal site. Lingual thyroid is the most frequent ectopic location of the thyroid gland. Its clinical incidence varies between 1:4000 and 1:10000. The purpose of this case series was to discuss a series of cases of LT gland its incidence, clinical presentation, sex ratio, age group, endocrine status, radiological features and appropriate surgical approaches. Materials and methods Six patients of LT were diagnosed who presented to our institution in a period of 6 months out of 225 thyroid cases, out of 14539 outpatient department (OPD) patients. The LT is often asymptomatic but may cause dysphagia, dysphonia with stomatolalia, upper airway obstruction and hemorrhage, often with hypothyroidism. Treatment of a LT depends on the severity of symptoms, the age of the patient, any precipitating factors, such as puberty or pregnancy. Result Relevant demographic, clinic-pathological and radiological data were recorded. Four of six were treated conservatively. One underwent complete surgical excision and one pregnant lady in first trimester kept under observation and regular follow-up. Conclusion We found female predominance than male with ratio of 5:1. Our study had high prevalence of LT of 1:2400. Thyroid scintigraphy plays the most important role in diagnosing LT, but ultrasonography contributes as well. In cases of symptomatic disease, surgery is the treatment of choice, followed by radioiodine ablation and levothyroxine suppression therapy in more refractory cases. How to cite this article Patil YS, Rajashekhar RP, Karodpati NS, Thomas J. Lingual Thyroid: A Case Series of Six Lingual Thy-roid with Incidence and Different Treatment Modalities. Int J Head Neck Surg 2015;6(3):103-108.

Current Strategies in the Management of Spinal Metastatic Disease

Swiss Surgery ◽  
2003 ◽  
Vol 9 (2) ◽  
pp. 55-62 ◽  
Author(s):  
Bartanusz ◽  
Porchet
Keyword(s):  
Spinal Cord ◽  
Surgical Techniques ◽  
Cord Compression ◽  
Treatment Modalities ◽  
Surgical Approaches ◽  
Spinal Stabilization ◽  
Management Algorithm ◽  
Specific Manner ◽  
Extensive Surgery ◽  
Selection Of

The treatment of metastatic spinal cord compression is complex. The three treatment modalities that are currently applied (in a histologically non-specific manner) are surgery, radiotherapy and the administration of steroids. The development of new spinal instrumentations and surgical approaches considerably changed the extent of therapeutic options in this field. These new surgical techniques have made it possible to resect these tumours totally, with subsequent vertebral reconstruction and spinal stabilization. In this respect, it is important to clearly identify those patients who can benefit from such an extensive surgery. We present our management algorithm to help select patients for surgery and at the same time identifying those for whom primary non-surgical therapy would be indicated. The retrospective review of surgically treated patients in our department in the last four years reveals a meagre application of conventional guidelines for the selection of the appropriate operative approach in the surgical management of these patients. The reasons for this discrepancy are discussed.

scholarly journals Management of extra-abdominal fibromatosis in a musculoskeletal tumour centre in Hong Kong

2021 ◽  
pp. 221049172198908
Author(s):  
Lam Wei Sze Yvette ◽  
Fong Sin Tak ◽  
Mak Ka Lok
Keyword(s):  
Watchful Waiting ◽  
Surgical Excision ◽  
Treatment Modalities ◽  
Management Approach ◽  
Conservative Approach ◽  
Management Options ◽  
Musculoskeletal Tumour ◽  
Female Predominance ◽  
Tumour Location ◽  
Marginal Status

Introduction: Fibromatosis is a benign disease yet prone to recurrence. The best treatment option remains controversial. The purpose of this study was to analyse the management approach in our musculoskeletal tumour centre. Materials and Methods: Thirty-four patients with extra-abdominal fibromatosis referred to our centre between 2000 to 2018 were included. Patients’ demographics, tumour location and size, year of diagnosis, treatment modalities, surgical margins, recurrence, and subsequent management were analysed. Results: Patients mostly presented in the second and third decade, with female predominance. Twenty-seven patients underwent excision. Other management options included ‘watchful waiting’, pharmacological treatment and radiotherapy. Recurrence rate was 51.9%. There was no statistically significant relationship between marginal status and recurrence. Conclusion: We report our experiences on management of fibromatosis, with strategy shifted from early excision to a conservative approach over the years. Surgical excision is still indicated in some situations. Tumour recurrence is not rare but second excision is not always necessary.

scholarly journals An Exceptional Case of Intraparotid Plexiform Neurofibroma Originating from Autonomic Fibers of the Auriculotemporal Nerve

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Sarantis Blioskas ◽  
Sotiris Sotiriou ◽  
Katerina Rizou ◽  
Triantafyllia Koletsa ◽  
Petros Karkos ◽  
...  
Keyword(s):  
Parotid Gland ◽  
Plexiform Neurofibroma ◽  
Surgical Excision ◽  
Neurofibromatosis Type ◽  
Exceptional Case ◽  
Benign Tumors ◽  
First Case ◽  
Superficial Lobe ◽  
The Right ◽  
Auriculotemporal Nerve

Plexiform neurofibromas are benign tumors that tend to occur in patients suffering from neurofibromatosis type 1 (NF-1). This report addresses a rare case where the tumor affected the parotid gland, deriving almost exclusively from the peripheral portion of the facial nerve. A 6-year-old male was referred to us complaining about a gradually enlarging swelling over the right parotid area. Imaging localized the lesion to the superficial lobe of the parotid gland, suggesting a neurofibroma. Cosmetic disfigurement and a functional deficit led us to perform complete surgical resection. Meticulous surgical dissection as well as auriculotemporal nerve origin made complete extirpation possible with almost zero morbidity and ensured alleviation of both aesthetic impairment and pain. This is the first case of an intraparotid PN in a pediatric NF-1 patient, which originated from branches of the auriculotemporal nerve and particularly from fibers of the autonomic nervous system. Radical surgical excision was decided according to established decision-making algorithms.

Zosteriform Nevus Comedonicus

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2609-2612
Author(s):  
Babbita S ◽  
Thillaikkarasi A ◽  
Sathyanarayanana R ◽  
Narasimhalu CRV ◽  
Sulochana Sonti
Keyword(s):  
Topical Therapy ◽  
Treatment Options ◽  
Neck Region ◽  
Surgical Excision ◽  
Hair Follicles ◽  
Treatment Modalities ◽  
Developmental Defect ◽  
Linear Distribution ◽  
Head And Neck Region ◽  
Typical Morphology

Nevus comedonicus is an uncommon cutaneous developmental defect of follicular apparatus characterized by unilateral and linear distribution of bundles of dilated hair follicles filled with keratin plugs. It is usually seen on the head and neck region, trunk and upper arm. This condition may be present at birth or can occur later in life. The term nevus comedonicus is a misnomer as there are no true comedones and is better termed as follicular keratotic nevus. It is also known as nevus zoniforme or nevus acneiformis unilateralis. There are two types of nevus comedonicus, namely inflammatory and non-inflammatory (non-pyogenic). When nevus comedonicus is manifested with other extracutaneous symptoms, it is termed as nevus comedonicus syndrome. Diagnosis is mainly clinical, based on history and typical morphology. As the disease runs a benign course, no aggressive treatment is required. Patients seek treatment, especially for cosmetic purposes and inflammatory type of lesions. Various treatment modalities like topical therapy, surgical excision, lasers are available and treatment options are individualized based on the size and extent of the lesion. We herein present a case of unilateral nevus comedonicus with no systemic associations in a 30-year-old female on her lower limb which is not a common site of occurrence.

Efficacy of Different Treatment Modalities for Eye Cancer in Bovines

2021 ◽  
Author(s):  
M. Prasanna Lakshmi ◽  
P. Veena ◽  
R.V. Suresh Kumar ◽  
D. Rani Prameela ◽  
K. Jagan Mohan Reddy
Keyword(s):  
Squamous Cell Carcinoma ◽  
Growth Factor ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Dietary Habits ◽  
Growth Factor Receptor ◽  
Surgical Excision ◽  
Treatment Modalities ◽  
Treatment Protocols ◽  
Hereditary Factors

Background: Bovine ocular squamous cell carcinoma also called cancer eye, represents the most economically important neoplasm in large animals. Hereditary factors, environmental factors (e.g: latitude, altitude, exposure to sunlight), lack of eyelid pigmentation, age and dietary habits have all been reported to play a role in the etiopathogenesis of bovine ocular squamous cell carcinoma. In addition, in cattle the etiology has been linked to a number of viral agents, especially bovine papilloma virus and bovine herpes virus type 1 and 5. Nevertheless, ultraviolet light, viruses and circumocular pigmentation are the major epidemiologic risk factors for the development of the tumor. The efficacy of different treatment modalities for eye cancer in bovines was studied.Methods: All the animals were divided in to four groups of six animals each. Surgical excision, intra lesion BCG vaccine, surgery with auto vaccine and surgery with mitomycin was the treatment protocols followed. Immunohistochemical studies were conducted to know the rate of proliferation of bovine ye cancer. Immunopositive reaction was observed against Vascular Endothelial Growth Factor and Epidermal Growth Factor Receptor in all the cases.Result: The benefits of different treatment modalities depended on nature, type, location and extensiveness of tumor. Early detection and aggressive treatment were essential in the successful management of these tumors. A multimodal treatment approach was recommended with surgery, immunotherapy and chemotherapy in providing 100% disease free interval.

scholarly journals Role of Adjuvant Radiosurgery after Thoracoscopic Microsurgical Resection of a Spinal Schwannoma

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Toba N. Niazi ◽  
Christian A. Bowers ◽  
Meic H. Schmidt
Keyword(s):  
Stereotactic Radiosurgery ◽  
Treatment Modality ◽  
Surgical Excision ◽  
Primary Treatment ◽  
Benign Tumors ◽  
Noninvasive Treatment ◽  
Thoracic Spinal ◽  
Primary Treatment Modality ◽  
Microsurgical Resection ◽  
Spinal Schwannoma

Stereotactic radiosurgery to benign tumors of the spine has not been advocated as a primary treatment modality because of the favorable prognosis for these lesions after gross-total resection. There is even less evidence regarding its use as an adjuvant to neurosurgical resection of benign recurrent spinal disease. We describe the case of a 30-year-old man with a thoracic spinal schwannoma who had an interval increase of his lesion five months after thoracoscopic microsurgical resection. The patient opted for noninvasive stereotactic radiosurgery in lieu of additional surgical excision and has had stable disease 15 months after radiosurgical treatment with the linear accelerator (LINAC) system. In this setting, stereotactic radiosurgery provided a useful adjunct to thoracoscopic microsurgical resection. Future Class I and II evidence should be sought to evaluate the utility of stereotactic radiosurgery as a primary treatment modality or as an adjuvant for microneurosurgical resection of benign spinal lesions in patients who want noninvasive treatment after disease recurrence or who harbor medical comorbidities that would preclude them from being safe surgical candidates.

scholarly journals Giant Ocular Surface Squamous Neoplasia Wrapping Almost the Whole Cornea: A Case Report

2020 ◽  
Vol 42 (2) ◽  
pp. 94-96
Author(s):  
Poonam Shrestha ◽  
Mukesh Pandey
Keyword(s):  
Ocular Surface ◽  
Histopathological Examination ◽  
Promising Result ◽  
Intraepithelial Neoplasia ◽  
Surgical Excision ◽  
Treatment Modalities ◽  
Ocular Surface Squamous Neoplasia ◽  
History Of ◽  
Grade 3 ◽  
Clinical Pictures

Ocular surface squamous neoplasia (OSSN) includes the dysplastic lesions involving the epithelium of conjunctiva and cornea with various clinical pictures. Histopathological examination of the excised tissue is the benchmark for diagnosis. Surgery, chemotherapy, immunotherapy are the various treatment modalities which in combination shows promising result. We present here a case of 83 years old female patient with history of fleshy mass covering the cornea and the patient was diagnosed clinically as ocular surface squamous neoplasia. Patient underwent surgical excision of the mass followed by cryotherapy. Histopathological examination revealed conjunctival intraepithelial neoplasia of grade 3. Six months after treatment the patient is completely tumor free with no recurrence.

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