Since the last century, many physicians have been trying to utilize chemotherapy to replace conventional surgical treatment for cases of cancer of the oropharynx, larynx, and hypopharynx, which would otherwise be cand...Since the last century, many physicians have been trying to utilize chemotherapy to replace conventional surgical treatment for cases of cancer of the oropharynx, larynx, and hypopharynx, which would otherwise be candidates for total laryngectomy. Some authors claim that the preservation rate of the larynx increases after treatment by chemotherapy, which even may take the place of routine surgical methods. However, when calculated in a more rigorous way following accepted statistical methods, what they claim is questionable. As a result, the routine application of chemotherapy in its present form is not advisable for curable squamous cell carcinoma of the head and neck region. Further research is required to justify its benefit.展开更多
OBJECTIVE Functional neck dissection was first described by Bocca and Pignataro in 1967. It has been used in clinical practice for years, but remains controversial among neck-surgery experts. This study was designed t...OBJECTIVE Functional neck dissection was first described by Bocca and Pignataro in 1967. It has been used in clinical practice for years, but remains controversial among neck-surgery experts. This study was designed to evaluate indications and curative effects of functional-neck dissection (FND). METHODS One hundred and fifty-two cases which underwent FND were reviewed with an analysis of pathological specimens and follow-up datas. RESULTS The series of FND included 20 cases of tongue carcinoma, 23 cases of larynx carcinoma, 96 cases of thyroid papillary adenocarcinoma, 9 cases of follicular adenocarcinoma and 4 cases of medullary adenocarcinoma; the five-year recurrence rate for tongue carcinoma was 12.5%, 14.3%, 40.0% and for a larynx carcinoma was 20.0%, 16.7%, 50.0% in N0 stage, N1 stage, N2a stage, respectively. The 5-year recurrence rate of thyroid papillary adenocarcinoma was 6.5%, 7.1% in N1a, N1b, respectively. CONCLUSION Functional neck dissection is indicated in early and low malignant head and neck neoplasms and results in satisfactory curative effects.展开更多
Most patients lost their vocal ability after ablative surgery for the laryngeal cancer. Total laryngectomy has a history of over 100 years, hence many surgeons are accustomed to the en bloc organ resection and the los...Most patients lost their vocal ability after ablative surgery for the laryngeal cancer. Total laryngectomy has a history of over 100 years, hence many surgeons are accustomed to the en bloc organ resection and the loss of ability for communication after surgery. The recent advance of surgery introduces the concept and technique of radical cure and functional preservation of the cancer-afflicted-organ at same setting. For lesions of late T categories (T3, T4), the maintenance of normal function after wide resection to ensure radicality demands a special technique to repair the crippled larynx. For this purpose a local osteomuscular flap was designed to reconstruct a functioning larynx. The surgical manoeuvre was described and the result proved to be successful. The outcome of 138 patients with T3 and T4 laryngeal carcinomas following conservation laryngectomy was analyzed. The five-year survival rate was 69% for supraglottic type and 75% for glottic type. The quality of life was much improved.展开更多
文摘Since the last century, many physicians have been trying to utilize chemotherapy to replace conventional surgical treatment for cases of cancer of the oropharynx, larynx, and hypopharynx, which would otherwise be candidates for total laryngectomy. Some authors claim that the preservation rate of the larynx increases after treatment by chemotherapy, which even may take the place of routine surgical methods. However, when calculated in a more rigorous way following accepted statistical methods, what they claim is questionable. As a result, the routine application of chemotherapy in its present form is not advisable for curable squamous cell carcinoma of the head and neck region. Further research is required to justify its benefit.
文摘OBJECTIVE Functional neck dissection was first described by Bocca and Pignataro in 1967. It has been used in clinical practice for years, but remains controversial among neck-surgery experts. This study was designed to evaluate indications and curative effects of functional-neck dissection (FND). METHODS One hundred and fifty-two cases which underwent FND were reviewed with an analysis of pathological specimens and follow-up datas. RESULTS The series of FND included 20 cases of tongue carcinoma, 23 cases of larynx carcinoma, 96 cases of thyroid papillary adenocarcinoma, 9 cases of follicular adenocarcinoma and 4 cases of medullary adenocarcinoma; the five-year recurrence rate for tongue carcinoma was 12.5%, 14.3%, 40.0% and for a larynx carcinoma was 20.0%, 16.7%, 50.0% in N0 stage, N1 stage, N2a stage, respectively. The 5-year recurrence rate of thyroid papillary adenocarcinoma was 6.5%, 7.1% in N1a, N1b, respectively. CONCLUSION Functional neck dissection is indicated in early and low malignant head and neck neoplasms and results in satisfactory curative effects.
文摘Most patients lost their vocal ability after ablative surgery for the laryngeal cancer. Total laryngectomy has a history of over 100 years, hence many surgeons are accustomed to the en bloc organ resection and the loss of ability for communication after surgery. The recent advance of surgery introduces the concept and technique of radical cure and functional preservation of the cancer-afflicted-organ at same setting. For lesions of late T categories (T3, T4), the maintenance of normal function after wide resection to ensure radicality demands a special technique to repair the crippled larynx. For this purpose a local osteomuscular flap was designed to reconstruct a functioning larynx. The surgical manoeuvre was described and the result proved to be successful. The outcome of 138 patients with T3 and T4 laryngeal carcinomas following conservation laryngectomy was analyzed. The five-year survival rate was 69% for supraglottic type and 75% for glottic type. The quality of life was much improved.
