Canadian journal of otolaryngology最新文献

Four patients with severe thermal burns showed Gentamicin cochlear toxicity. The hearing loss ranged from moderate to severe and was progressive in the three patients that were followed. These side effects were seen even with only topical application of Gentamicin to large surface burns of the body. All patients had an associated loss of bestibular function. None of the patients during treatment with Gentamicin was in renal failure. These finding are discussed in the light of current knowledge of Gentamicin toxicity, blood levels, and absorption from surface burns of the body.

This paper deals with the limitations of conservation surgical therapy for cancer in various sites. The detailed techniques are not included in this paper, but rather its pathophysiological approach to partial surgery. The technique has been reported many times previously.

The ninettenth reported case of chemodectoma of the larynx is presented and its management discussed. Some reflections on the laryngeal paraganglia are made and the past literature is reviewed.

Adenocarcinomas make up less than one per cent of laryngeal malignancies. Nonspecific adenocarcinomas and adenoid cystic carcinomas comprise most of the glandular neoplasms. Adenoid cystic carcinoma has a slight preponderance in females, and often follows a long course similar to this tumor when it occurs in salivary glands. The nonspecific adenocarcinomas occur predominately in males and have a low survival with most patients dying within two years. Less common adenocarcinomas include oncocytoid carcinoma, mucoepidermoid carcinoma, and metastatic adenocarcinoma.

Of the 6,067 malignant laryngeal tumors treated at the Ear, Nose and Throat Clinical Hospitals in Yugoslavia, a total of 20 were sarcoma. Eighteen of these patients were men. The most frequent forms were chondrosarcoma and fusocellular sarcoma - four cases of each. A survival rate of more than five years was seen in only four patients (one fibrosarcoma, two lymphosarcomas, and one chondrosarcoma).

A carefully planned clinical program of combined pre-operative radiation and surgery has been conducted by the Department of Otolaryngology at The Mount Sinai Hospital for 14 years in an effort to improve the survival rate for advanced cancer of the larynx and laryngopharynx. An extensive histopathological study of resected larynges and radical neck specimens was undertaken in 1961 in order to determine the effects of pre-operative radiation. A very careful statistical analysis has been made of the survival experience of this series of cases. The three and five year survival rates have been computed by the actuarial method. The histopathological study entailed a serial section study of 26 larynges and 21 radical neck dissection specimens. These studies have been most informative as to the nature of the radiobiologic process involved in the destruction of laryngeal cancer. In addition, the study has been revealing as to the ability of radiation to sterilize cancer in the neck specimens. The clinical correlate of this histologic finding has been the observation of reduced cervical recurrences in patients treated with combined therapy. In conclusion, our statistics seem to indicate that our combined therapy method has improved the survival rates of patients with advanced cancer of the larynx and laryngopharynx.

The changes seen by light and electron microscopy in the differentiation of squamous carcinoma are described. The grading of the differentiation of squamous carcinomas by overall impression and by quantitative methods are discussed. Reasons are given for retaining the former in the assessment of prognosis. Other differentiating phenomena, particularly retention of basement membrane in the formation of rounded rather than jagged growing edges, are discussed. The differentiating effect of radiation on squamous carcinomas is discussed as a means of assessing the efficacy of the radiation. A similar differentiating effect of bleomycin, a cytotoxic drug, on human squamous carcinoma is described. Using electron microscopical criteria belomycin also increases differentiation of a transplanted, experimental, poorly differentiated squamous carcinoma and human laryngeal carcinoma cells in tissue culture. The significance and possible practical utilization of this phenomenon are discussed.