\s=b\ Tracheoesophageal puncture was performed in ten of our patients undergoing extended laryngopharyngectomy. Three fistulas were allowed to close, and two patients were dissatisfied with their results, which allowed for an overall 50% success rate in this subgroup. The resultant voice was objectively compared with similar groups of patients undergoing primary and secondary tracheoesophageal puncture after standard laryngectomy. There was no significant difference in maximum phonation time, average speaking intensity, and average fundamental frequency between these groups. However, the maximum intensity and average intensity were significantly lower for the flap group. Our results indicate that tracheoesophageal puncture should be attempted in patients undergoing the extended procedure, notwithstanding a lower expected success rate.
This prospective study, performed from 1991 to 1996, analyzes the differences in oncological safety, functional utility, and surgical morbidity in 14 advanced lesions of the larynx (10 T3 and 4 T4; 7 N+) and 40 pyriform sinus lesions (1 T2, 20T3, and 19 T4; 29 N+) subjected to Pearson near-total laryngectomy. The laryngeal cancer patients healed much faster, with a minimal wound complication rate of 28%, in comparison to the 68% rate encountered in the pyriform sinus cases (p < .05). The 3-year disease-free survival rate for the laryngeal cancers was 74%, while the 5-year survival rates for pyriform sinus cases were 66% for medial wall lesions and 54% for lateral wall lesions. Lung-powered shunt speech deemed qualitatively superior by acoustic analysis was obtained in 81% of the individuals (93% in laryngeal cases and 76% in pyriform sinus cases). Aspiration-free deglutition was achieved by 90% over periods ranging from 15 to 30 days. This study conclusively attests to the therapeutic efficacy of near-total laryngectomy for advanced lesions of the larynx and pyriform sinus that are unsuitable for radiotherapy, that are deemed too large or risky (because of aspiration) for partial laryngectomy, and that in the past would have merited total laryngectomy.
Aim:The aim of our study is to compare the efficacy of ultra-violet light (U-V light) and direct current glow discharge in disinfecting Candida Albicans coated elastomeric impression material.Materials and Methods:Two hundred and forty samples of addition silicone material in the form of circular discs measuring (diameter-30 mm, thickness-3 mm) were prepared. Samples were divided into four groups namely A, B, C, D, with each group containing 60 samples. All samples in each group were sub grouped as follows for exposure time 15, 30, 60, 90, 120 and 180 s respectively. Group A samples were exposed to U-V light with 8 watts. Group B samples were exposed to U-V light with 16 watts. Group C samples were exposed to U-V light with 24 watts. Group D samples were exposed to direct current glow discharge. After exposure, the impression material was swabbed on sabourauds dextrose agar (SDA) plates and incubated at 37°C for 48 h. The total number of colonies indicating the number of C. Albicans that survived the direct current glow discharge and U-V light treatment was then determined using a microscope.Results and Conclusion:Group A samples exhibited proportionate decrease in the number of colonies with each greater time of exposure. Group B samples exhibited proportionate decrease in the number of colonies with each greater time of exposure. Group C samples exhibited total absence of C. Albicans colonies at 90 s exposure. In Group D samples there was a proportionate decrease in number of C. Albicans colonies with exposure to direct current glow discharge for more seconds. Hence, this study reveals that exposure to U-V light drastically reduced the C. Albicans colonies compared with exposure to direct current glow discharge. It was observed that with greater wattage of U-V light tube in U-V light unit chamber, greater decrease in colony count was observed in lesser time of exposure.
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