Fifty-two patients with laryngeal cancer who underwent radical neck dissections were studied to provide further information on the prognosis of various clinical and histopathological parameters. Extracapsular spread (ECS) was found in 31% of patients with N1 nodes, and in 60% of patients with histopathologically positive nodes. The 5-year survival rate of histopathological findings was as follows: patients with no pathological evidence of neck metastasis (81%), patients with neck metastasis confined to the lymph node (no ECS) (76%), and patients with ECS (17%). The difference in survival rate between patients with no ECS and patients with ECS was statistically significant (P = .001). Staging classification, T-stage classification, the number of malignant nodes, the diameter of malignant nodes, and combined therapy had no prognostic importance. The most significant factor was the presence of extracapsular spread.
The therapeutic procedures with Celestin dilator were performed on postoperative strictures of the Hypopharynx and Esophagus.Twenty trans-oral dilatation procedures were performed on 9 patients with esophageal strictures.For the case of the hypopharyngeal and esophageal stricture,success rates for this technique averaged 77.7% defined as the resolution of dysphagia and besides X-ray examination showed obviously the dilatation.Efficacy of the dilatation was influenced by the local condition of disease,but strictures with a diameter as small as 4 mm and as long as 12 mm could be fully expended with a single treatment.With multiple applications,these procedures can be extended to treat strictures with a diameter of 2 mm and a total length of up to 22 mm. In one of the nine patiants,there was a complication of a small perforation in the postoperative suture,but it naturally closed one week late.It is cosidered,that in this case,the procedure was performed too early after operation.If the procedure is performed at least 30 days after operation,and the stricture isn't excessively dilated,it will be possible to avoid complications.The procedures with Celestin dilator can be safely and easily applied to esophageal strictures of a variety of causes,with a high degree of clinical success.Celestin dilator treatment for the hypopharyngeal and esophageal strictures must,however,be coupled with appropriate medical management to optimize the clinical response.
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