Horizontal supraglottic laryngectomy and supracricoid partial laryngectomy give the same swallowing results. The presence of both arytenoids does not influence the final outcome compared to patients in whom only 1 arytenoid is preserved. Postoperative radiotherapy only influences the swallowing function.
Parapharyngeal space (PPS) tumors are rare and benign in 80% of cases. Since surgeons first resected this anatomical region, the surgical approach to PPS bulks has been a hot topic due to their shape and the important structures involved. We present a series of patients treated with a transcervical or transcervical-transparotid approach to benign PPS tumors without mandibulotomy. Between May 2003 and March 2009, 18 patients (11 male and 7 female) with benign PPS tumors underwent a surgical resection, avoiding mandibulotomy. Average age of the patients was 49 years (range 3-76), average tumor size was 5.5 × 4 × 3 cm and histological examination of the resected tumors showed: seven pleomorphic adenomas of the deep parotid lobe, four schwannomas, two mycobacteriosis, two paragangliomas of the vagus nerve, one lipoma, one neurofibroma and one cavernous hemangioma. Seven patients underwent a transcervical approach, while 11 patients underwent a transcervical-transparotid approach. Excision of benign PPS tumors is possible without mandibulotomy even in the case of a large tumor mass, but exposure with the mandible in situ is certainly poor. Avoiding mandibulotomy reduces patient morbidity and hospital stay. In our experience, mandibulotomy can be avoided in most cases of benign PPS tumors leaving this procedure for malignant tumors or in patients with very poor exposure
Objectives
To describe how the retrotympanic structures could influence the visibility of the round window niche and the round window membrane during cochlear implant surgery, and to investigate if a round window approach is possible even in cases with unfavourable anatomy.
Methods
Video recordings from 37 patients who underwent cochlear implantation were reviewed. The visibility of the round window niche and round window membrane at different timepoints was assessed according to a modified version of the Saint Thomas Hospital classification. The structures that concealed the round window niche and round window membrane were evaluated.
Results
After posterior tympanotomy, 54 per cent of cases had limited exposure (classes IIa, IIb and III) of the round window niche. After remodelling the retrotympanum, round window niche visibility significantly increased, with 100 per cent class I and IIa cases. Following remodelling of the round window niche, visibility of more than 50 per cent of the round window membrane surface was achieved in 100 per cent of cases.
Conclusion
Remodelling the retrotympanum and the round window niche significantly increased exposure of the round window niche and round window membrane respectively, allowing round window insertion in all cases.
IntroductionPro-inflammatory states of the large bowel have a multifactorial aetiology, including metabolism, atherogenesis, and psychological determinants. Inflammation plays a role in depressive and anxiety disorders, is tightly associated with early pro-atherogenetic alterations and metabolic dysregulation, and is also a key factor for the development of colorectal cancer.AimTo investigate the association between pro-atherogenetic factors, metabolic status, psychological assessment and presence of colorectal adenomas.MethodsCase-control study, approved by the local Ethic Committee. Patients aged 40 or more and undergoing colonoscopy for positive faecal blood test and/or abdominal symptoms, with a negative history for neoplasia or inflammatory bowel diseases, were enrolled. For each patient the following data were collected: waist and hip circumferences, BMI, arterial pressure, fasten serum glycemia, current medications. Beside colonoscopy, carotid intima-media thickness (IMT) was assessed by means of echographic evaluation. Psychometric assessment included HADS, TCI, IMSA, SF-36. Statistics performed with SigmaPlot v.12 Platform.ResultsPreliminary results are available for 18 patients (male/female 8/10) Mean age 62.6 ± 8.4. Ten patients had at least one adenoma, 8 patients had no lesions. The following differences were noticeable: HADS-depression (mean ± SD) adenoma vs. no-adenoma: 4.9 ± 3.2 vs. 1.7 ± 1.8 (P < .01); IMT median value adenoma vs. no-adenoma: 793 vs. 638 micrometers (P = .04); Body weight (mean ± SD) adenoma vs. no-adenoma: 66.4 ± 8.7 kg vs. 80.9 ± 15.3 kg (P = .03); waist circumference (mean ± SD) adenoma vs. no-adenoma: 105.2 ± 13.4 cm vs. 89.5 ± 4.7 cm (P < .01).ConclusionsPreliminary data from PNEI-MO Research Group support the relation between systemic inflammation, psychological status and development of precancerous colorectal cancer lesions. Depression seems associated with the presence of colorectal adenomas.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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