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Laryngo- Rhino- Otologie Jul 2017
Topics: Deglutition Disorders; Diagnosis, Differential; Drainage; Dyspnea; Fatal Outcome; Hematoma; Humans; Male; Middle Aged; Pharyngeal Diseases; Pharyngitis; Postoperative Complications; Status Epilepticus; Tomography, X-Ray Computed
PubMed: 28768357
DOI: 10.1055/s-0043-112162 -
La Tunisie Medicale Mar 2019Pharyngocutaneous fistula is the most frequent complication of primary and secondary laryngectomy and pharyngolaryngectomy. It has an important impact on the patient,...
INTRODUCTION
Pharyngocutaneous fistula is the most frequent complication of primary and secondary laryngectomy and pharyngolaryngectomy. It has an important impact on the patient, his entourage and the healthcare team. The risk factors for pharyngostoma are multiple and its treatment is not codified.
AIM
To identify the various factors that may predispose to this complication and to describe the different therapeutic means to control it.
METHODS
This retrospective study examined 68 cases of laryngeal cancer treated by total laryngectomy or pharyngolaryngectomy at Salah AzaŃ—ez's head and neck oncologic surgery department between 2015 and 2017.
RESULTS
Most of our patients were male (97%) who were major consumer of tobacco and alcohol. The most common stage were T4aN0M0 (34%) and T4aN1M0 (22%). Regarding treatment, we found that 73.5% of patients were operated on by total laryngectomy, 17.7% of patients were operated on by total pharyngolaryngectomy and 8.8% of patients were operated on by square laryngectomy. Pharyngostoma was diagnosed in 20.5% of cases within an average of 15 days. Among the risk factors studied, those that were statistically correlated with the occurrence of CPF in univariate studies were pre-laryngeal infiltration (p = 0.006), postoperative CRP level (p= 0.017), extension to piriform recess (p = 0.009), TNM stage (p=0.039), an associated thyroid surgery (p = 0.020) and pharyngeal closure under tension (p=0.000). In multivariate studies, five of the risk factors identified in the univariate analysis were found. This testifies to their major role as a risk factor for pharyngostoma. These factors were pre-laryngeal infiltration (p=0.001), postoperative CRP level (p=0.000), piriform recess involvement (p=0.004) Associated thyroid surgery (p=0.012) and pharyngeal closure under tension (p = 0.000).
CONCLUSION
By identifying predictive factors for pharyngostoma, we can identify patients in which this complication may occur and manage the medical care means to prevent it more efficiently.
Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Cutaneous Fistula; Female; Humans; Laryngeal Neoplasms; Laryngectomy; Larynx; Male; Middle Aged; Pharyngeal Diseases; Postoperative Complications; Retrospective Studies; Risk Factors; Tobacco Use Disorder
PubMed: 31729725
DOI: No ID Found -
The American Journal of Tropical... Mar 2019
Topics: Animals; Humans; Male; Middle Aged; Pharyngeal Diseases; Rhinosporidiosis; Rhinosporidium
PubMed: 30843506
DOI: 10.4269/ajtmh.18-0903 -
Diagnostic and Interventional Imaging Feb 2016
Topics: Humans; Lithiasis; Male; Middle Aged; Palatine Tonsil; Pharyngeal Diseases
PubMed: 26441018
DOI: 10.1016/j.diii.2013.02.017 -
Ear, Nose, & Throat Journal Aug 2018
Topics: Hernia; Humans; Laryngoscopy; Male; Music; Pharyngeal Diseases; Tomography, X-Ray Computed; Young Adult
PubMed: 30138513
DOI: 10.1177/014556131809700818 -
Current Opinion in Otolaryngology &... Dec 2016Pharyngoesophageal diverticuli such as Zenker's diverticulum are relatively rare diseases that may have a significant impact on a patient's quality of life. Open... (Review)
Review
PURPOSE OF REVIEW
Pharyngoesophageal diverticuli such as Zenker's diverticulum are relatively rare diseases that may have a significant impact on a patient's quality of life. Open surgical techniques have historically been the mainstay of treatment for Zenker's diverticuli and remain the preferred approach for many surgeons operating on Killian-Jamieson diverticuli (KJD) and pharyngoceles. However, advances in technology in recent decades have allowed for the development of successful endoscopic surgical techniques for the management of these conditions.
RECENT FINDINGS
Endoscopic management of Zenker's diverticulum with carbon dioxide laser-assisted diverticulotomy or endoscopic stapler-assisted diverticulostomy has gained wide acceptance in recent years. This is based on studies showing high rates of successful outcomes, low rates of complications and shorter operative time with an associated impact on overall cost and patient recovery. Endoscopic management of KJD and pharyngoceles has recently been described, but remains controversial with many surgeons preferring open surgical approaches for the ability to identify and protect the recurrent laryngeal nerve.
SUMMARY
Open and endoscopic techniques are accepted for the treatment of Zenker's diverticulum with open approaches remaining the traditional technique for management of non-Zenker's diverticulum. Further investigation of endoscopic approaches for management of KJD is necessary to assess safety and efficacy.
Topics: Diverticulum; Endoscopy; Humans; Laser Therapy; Pharyngeal Diseases; Zenker Diverticulum
PubMed: 27636983
DOI: 10.1097/MOO.0000000000000309 -
The Journal of Laryngology and Otology Jul 2016A systematic review was performed to evaluate the safety and efficacy of different therapeutic interventions available for the management of isolated cricopharyngeal... (Review)
Review
OBJECTIVE
A systematic review was performed to evaluate the safety and efficacy of different therapeutic interventions available for the management of isolated cricopharyngeal dysfunction.
METHODS
Studies were identified using the following databases: Ovid (Medline, Embase), the Cochrane Library, PubMed and Google Scholar. An initial search identified 339 articles. All titles and abstracts were reviewed. Fifty-six relevant articles were inspected in more detail; of these, 47 were included in the qualitative analysis.
RESULTS
No relevant randomised trials were found. A range of case series were used to perform a qualitative analysis. Botulinum toxin A injection and cricopharyngeal dilatation were associated with a higher risk of recurrence, but appear to be more suitable in elderly and co-morbid patients. In those patients requiring formal myotomy, endoscopic approaches appear to be as effective but less morbid when compared with classical open surgery.
CONCLUSION
There is good evidence for the safety and efficacy of the different therapeutic options for isolated cricopharyngeal dysfunction. However, further studies are required to compare the efficacy of the various treatment modalities.
Topics: Botulinum Toxins, Type A; Deglutition Disorders; Dilatation; Humans; Injections, Intramuscular; Laryngoscopy; Neuromuscular Agents; Pharyngeal Diseases; Pharyngeal Muscles
PubMed: 27194375
DOI: 10.1017/S0022215116007994 -
Forensic Science, Medicine, and... Sep 2019An 86-year-old woman with a history of angioedema was found dead at her home address. She had recently complained of a swollen tongue. At autopsy the tongue was grossly...
An 86-year-old woman with a history of angioedema was found dead at her home address. She had recently complained of a swollen tongue. At autopsy the tongue was grossly edematous, protruding from the mouth. There was also marked edema of the tonsillar fossae, epiglottis and glottic inlet, causing critical obstruction. Histology of the tongue and upper airway demonstrated marked submucosal edema. Death was attributed to upper airway obstruction due to angioedema of the tongue, oropharynx and glottic inlet. Angioedema is characterized by localized non-pitting edema of the deep dermis and subcutaneous/submucosal tissues. It may be acute or chronic, acquired or inherited. Sudden death may result from critical airway occlusion, although both stroke and ischemic heart disease are known to occur. Post mortem genetic testing for hereditary variants can be conducted for SERPING1 gene and F12 gene/THR328 mutations.
Topics: Aged, 80 and over; Airway Obstruction; Angioedema; Edema; Epiglottis; Fatal Outcome; Female; Humans; Laryngeal Diseases; Oropharynx; Palatine Tonsil; Pharyngeal Diseases; Tongue Diseases
PubMed: 30390279
DOI: 10.1007/s12024-018-0045-0 -
The Veterinary Clinics of North... Apr 2015This article reviews dorsal displacement of the soft palate (DDSP) and nasopharyngeal cicatrix. Palatial instability results in exercise intolerance and upper... (Review)
Review
This article reviews dorsal displacement of the soft palate (DDSP) and nasopharyngeal cicatrix. Palatial instability results in exercise intolerance and upper respiratory noise in performance horses. Palatial instability can progress to DDSP either permanently or only during exercise. There have been advancements related to the etiopathogensis, diagnosis, and treatment of DDSP. The laryngeal tie-forward has gained popularity and is the most widely accepted treatment option for this condition, either alone or in combination with other procedures. Nasopharyngeal cicatrix affects a small geographic region. Diagnosis is definitively made via endoscopy. The most effective treatment of this condition is a permanent tracheostomy.
Topics: Animals; Endoscopy; Horse Diseases; Horses; Pharyngeal Diseases; Tracheostomy; Treatment Outcome
PubMed: 25600454
DOI: 10.1016/j.cveq.2014.11.001 -
International Journal of Nanomedicine 2022Pharyngocutaneous fistula is the most common complication after total laryngectomy and is difficult to heal. Although conservative treatment and surgical repair are... (Review)
Review
Pharyngocutaneous fistula is the most common complication after total laryngectomy and is difficult to heal. Although conservative treatment and surgical repair are effective, they often take longer and additional trips to the operating room, which undoubtedly increases the financial burden on patients. Especially in combination with diseases such as diabetes and hypertension, which affect the efficacy of surgery. Adding growth factors into the repair material can promote fibroblast proliferation, angiogenesis, and accelerate wound healing. A substantial number of studies have shown that a type of nanoscale extracellular vesicle, called exosomes, facilitates organization repair by promoting blood vessel production, protein polysaccharides, and collagen deposition, thereby representing a new type of cellular therapy. At present, there is little research on the application of exosomes in pharyngocutaneous fistula regeneration after total laryngectomy. In this review, we summarize the biological characteristics of exosomes and their application in biomedical science, and highlight their application prospects in pharyngocutaneous fistula regeneration after total laryngectomy.
Topics: Cutaneous Fistula; Exosomes; Humans; Laryngeal Neoplasms; Laryngectomy; Pharyngeal Diseases
PubMed: 36118178
DOI: 10.2147/IJN.S372042