جستجوی مقالات مرتبط با کلیدواژه "hypopharynx" در نشریات گروه "پزشکی"

Concurrent chemo-radiation has proven to be beneficial in a majority of patients with locally advanced head and neck cancers. Despite modern techniques of radiation delivery, the trade-off is acute and entails late toxicities for a considerable number of patients. Very few studies have reported the outcomes of these patients. We aimed to prospectively assess and report the toxicities of patients undergoing definitive chemo-radiation by the volumetric modulated arc therapy (VMAT) for the treatment of advanced laryngeal and hypopharyngeal cancer. This prospective observational study was conducted in a single tertiary care center over a period of two years. We recorded acute and late toxicities during and after the treatment of patients with locally advanced laryngeal and hypopharyngeal cancer treated with definitive chemo-radiotherapy using VMAT. Chi square test and Fisher’s exact test were used for comparing the significance of outcome parameters with different variables. 28 patients who met the inclusion criteria were taken up for analysis. The median age was 59 years. The median treatment time was 48 days. The mean dose to parotid, superior, and mid constrictors was 32, 45, and 64 Grays (Gy). At completion, 7% of the patients had grade 3 or more dermatitis, 4% had grade 3 or higher mucositis, and no patient had grade 3 or higher xerostomia. Five patients treated for hypopharynx cancer developed strictures. Our results showed that concurrent chemo-radiotherapy using VMAT is a promising method of treatment for advanced laryngeal and hypopharyngeal squamous cell cancer with an acceptable toxicity profile.

Mandibular setback surgery is one of the common treatments in patients with mandibular prognathism. In this surgery, the mandible is placed backward from its original position, and as a result, the soft tissue, tongue, and hyoid bone are slightly displaced, all of which can affect the dimensions of the airway. Given that these changes in the dimensions of the airway can lead to obstructive sleep apnea, it is important to examine these changes and their stability. In this regard, cephalometric radiography can be used, which haslowcost and dose in comparison to 3D radiographs, to examine changes in airway dimensions. The aim of this study was to evaluate the short-term and long-term changes in airway dimensions following mandibular steback surgery with the help of cephalometric radiography.

The study was conducted by review method. Using the keywords ‘orthognathic surgery,’ ‘mandibular setback,’ ‘Malocclusion angle class III,’ ‘prognathism,’ ‘airway,’ ‘posterior airway space,’ ‘PAS,’ ‘pharyngeal space, ‘hypopharynx, a review of articles in PubMed and Embase databases, Google Scholar, and Cochrane databases was performed. The range of article searches was from 2000 to 2020.

The results of studies showed that in the first 6 months after surgery, the dimensions of the airway decrease, but over time, due to the adaptation of the surrounding tissues and relapse after surgery, there is an improvement in the dimensions of the airway; Also, the study of index-related breathing disorders during sleep disorders during sleep showed that this surgery does not necessarily lead to obstructive sleep apnea.

Radical laryngeal surgeries for extensive laryngeal and hypopharyngeal tumors often require a permanent tracheostomy, which has an immense impact on the quality of life of patients. A minimally invasive technique such as transoral laser microresection (TLM) followed by radiotherapy can preserve the functions of the voice and swallowing. The aim of this study is to evaluate the role of laser debulking in the treatment of carcinoma of the larynx and hypopharynx, to evaluate the response of the tumor to subsequent radiotherapy, and also to assess the usefulness of laser in avoiding tracheostomy and functional preservation of the voice and swallowing.
This prospective cohort study included patients with carcinoma of the larynx and hypopharynx unwilling to have definitive surgery and those medically unfit for radical surgery. The clinical profile of patients at presentation, tumor status following laser debulking, immediately after radiotherapy (RT), 6 weeks post RT, 3 months post RT, and at the end of study; short term complications associated with laser surgery; and usefulness of laser in avoiding tracheostomy and in functional preservation of the voice were evaluated.
There were 18 (90%) male patients and 2 (10%) female patients. Age ranged from 24 to 78 years with a mean age of 55. Hoarseness of voice was the most frequent presenting complaint (90%) followed by progressive dysphagia (45%), odynophagia (40%), otalgia (40%), and dyspnoea (25%). 11 (55%) patients had T3 tumors, while 6 (30%) were T2, and 3 (15%) were T4 lesions. 65% of patients were free of lymph node metastasis at presentation. 2 (10%) had N1 and 5 (25%) had N2 nodes. At presentation 10 (50%) patients had Stage III disease and 6 (30%) had stage IV disease. 13 patients (65%) had moderately differentiated squamous cell carcinoma. None of the risk factors and co-morbid illnesses showed any statistically significant difference among the tumor sites. Apart from the 2 (10%) patients who had residual disease, 2 (10%) patients developed a recurrent tumor in the course of their follow up. None had neck recurrence. Two patients underwent tracheostomy, before laser surgery, for compromised airway and both had recurrence of their tumor and continued to be on tracheostomy.
Laser debulking followed by radiotherapy is a viable alternative in the management of malignancies of the larynx and hypopharynx for those who refuse radical surgery and for those patients in whom radical open surgery is impractical due to physiological reasons such as advanced age and poor pulmonary reserve.

Foreign body ingestion is a common problem in otolaryngology. In this case report, we present a patient with fish bone ingestion with a unique route of extraction. A 50-year-old woman was presented with a complaint of odynophagia while eating fish. Rigid laryngoscopy revealed nothing except ecchymosis on the right pyriform sinus. We performed an axial neck computed tomography (CT) scan and found the fish- bone at the retropharyngeal space. After three days there was a tender bulging in the neck. We extracted the fish bone thorough a small incision on the neck. We recommend the performance of CT scan in patients with suspected hypopharyngeal and esophageal sharp foreign body impaction.