ISSN:0023-852X    

DOI:10.1288/00005537-197506000-00001

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

摘要:

AbstractA considerable body of literature advocates and defines treatment of vocal cord cancer with posterior extension by hemilaryngectomy. The present study was carried out to determine the feasibility of using a newly devised pedicle flap, composed of thyroid cartilage and inferior constrictor muscle, to replace the ablated arytenoid cartilage. Animal investigation revealed satisfactory viability of the pedicle flap in canines, and in humans, five patients with T2glottic carcinoma demonstrated excellent postoperative deglutition and return of voice. The results of the study indicate that this surgical technique merits consideration for its use in minimizing protracted glottic incompetence following hemilaryngectomy. The thyroid cartilage‐inferior constrictor muscle pedicle flap may also prove useful as partial cricoid replacement in selected cases of subglottic extension and in cricoid reconstruction following traum

ISSN:0023-852X    

DOI:10.1288/00005537-197506000-00002

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-197506000-00003

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-197506000-00004

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-197506000-00005

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-197506000-00006

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-197506000-00007

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

摘要:

AbstractThe reasons for irradiation failure in squamous cell carcinoma of the larynx can be1.Geographical miss because of undiagnosed extensions is the exception. Almost all of the recurrences were well within the treatment portals.2.Specific extensions with an unfavorable tumor bed. Extension of disease into poorly vascularized structures and/or deep infiltration with fixation are causes of failure.3.Low dose for the volume cancer. Higher doses delivered in longer treatment time are necessary for 90 percent control of bulky exophytic supraglottic lesions.4.Techniques which do not assure daily coverage of the tumor. With carefully drawn and checked anatomical portals, geographical misses should be nonexistent.5.Sigmoid response curve. There is an 85 percent control of the T1glottic tumors. The control rate is 90 percent of the T1and T2supraglottic tumors, and the 10 percent failures have no obvious explanation except that the plateau of the sigmoid response curve has been reached. A negligible yield would be obtained by increasing doses which would not be justified because of concomitant increase in frequency and severity of complications and lessening of the quality of voice.6.New cancer. Probably 25 percent of the so‐called recurrences on the vocal cords are actually new primary lesions.The ultimate failure rates respectively are 2 percent for T1lesions and 10 percent for T2lesions after a rescue surgical procedure. All patients with T1vocal cord lesions who did not experience a failure or a complication, have a normal voice. In the patients with T2lesions in whom the cancer had completely replaced the cord(s), some hoarseness is present; but most of these lesions would have been suitable only for a total laryngectomy.In the 15 failures in T1and T2supraglottic lesions, surgery was not attempted in only three patients, one of whom was salvaged by re‐irradiation. Following 12 laryngectomies there is only one definite failure and two patients died within two years NED locally. Except in the patients who had severe edema and/or necrosis, the voice has been normal or near normal. In patients with lesions of the suprahyoid epiglottis which had amputated the suprahyoid epiglottis swallowing difficulty has not develo

ISSN:0023-852X    

DOI:10.1288/00005537-197506000-00008

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-197506000-00009

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-197506000-00010

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY