1/27. Laryngeal diversion and tracheotracheal speech fistula for chronic aspiration.Intractable aspiration is a life-threatening problem and often requires a procedure for blocking or separating the larynx from the bronchial tree. The disadvantage of these techniques is a compromise of phonation. We report the use of a speech fistula after laryngotracheal diversion to restore voice. It allows for the definitive treatment of aspiration, while maintaining the use of the vocal folds for phonation.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
2/27. Photodynamic therapy: a case series demonstrating its role in patients receiving mechanical ventilation.Photodynamic therapy (PDT) has long been used to treat cancers within the tracheobronchial tree. There have been many reports about the use of PDT for the treatment of carcinoma in situ and for obstructive endobronchial lesions. PDT has not been previously reported in patients receiving mechanical ventilation. PDT offers the advantages of a relatively short duration of treatment, a low side effect profile, and relatively low risk when compared to Nd-YAG laser in patients receiving mechanical ventilation. We report the first successful use of PDT to wean patients from mechanical ventilation.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
3/27. hemoptysis as an unusual presenting symptom of invasion of a descending thoracic aortic aneurysmal dissection by lung cancer.A 70-year-old woman with a known chronic dissecting aneurysm of the descending thoracic aorta presented with new-onset back pain and hemoptysis. The hemoptysis was thought to be the result of invasion of the bronchial tree by the aneurysm. During surgical repair, a lesion that appeared to be a pulmonary abscess was discovered to be adhering to the aortic tissue, and the patient underwent a localized pulmonary resection. The pathology report of the surgical specimens revealed squamous cell carcinoma of the lung with infiltration of the aortic wall. The patient died of lung cancer 6 months later. hemoptysis was an unusual presentation in a case of lung cancer that had invaded a stable chronic aortic aneurysm.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
4/27. Four case reports of families with esophageal cancer in a high-risk region on the Guangdong Chaoshan coast of china.Four families with a history of esophageal cancer were studied and their family trees analyzed. All the families had lived in Chaoshan for about 20 generations, speak Chanshan dialect, and generally have a predilection for drinking scalding Gong Fu tea and eating pickled Chinese cabbage. The majority of the esophageal cancer patients of the first generation were diagnosed 40 or 50 years ago after presenting with the typical symptom of dysphagia, whereas patients of the second and third generations were diagnosed mainly by means of radiography and pathology. The ratio of male to female patients was 14:5, which corresponds to that in the general population. The average age at occurrence of esophageal carcinoma in the patients studied was lower than in the general population and had progressively decreased from generation to generation.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
5/27. Panendoscopy and synchronous second primary tumors in head and neck cancer patients.endoscopy techniques are used to diagnose and to determine the extent and exact location of malignancies in the head and neck region, bronchial tree and esophagus. Panendoscopy is used to find the primary tumor in the case of metastatic disease from unknown primaries or to detect a simultaneous second primary tumor at the time of diagnosis of a malignancy in the upper aerodigestive tract (UADT). The value of panendoscopy has been debated lately because of the relatively small proportion of malignant findings and because of the lack of convincing data concerning its effect on survival rates. However, despite the relatively low proportion of positive findings, their significance is often crucial for the individual patient. The significant number of late metachronous, second primaries, especially in the lungs, also emphasizes the importance of follow-up endoscopies. This study consists of 203 consecutive patients with squamous cell cancer (SCC) of the upper aerodigestive tract who underwent panendoscopy in Turku University Central Hospital as part of the initial diagnostic workup from 1992-1999. Eight patients with synchronous second primaries were found to represent a prevalence of 3.9%, and in addition, 19 patients with metachronous tumors were diagnosed. In the case reports we illustrate the importance of some of these findings.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
6/27. An unusual way of tracheal stoma cleaning could end up with foreign body aspiration in a laryngectomized patient.We report a case of a laryngectomized patient who accidentally aspirated a wooden stick through his tracheal stoma in highly unusual circumstances. He was in a habit of cleaning secretions of upper airway with a wooden stick covered with cotton on the tip soaked in olive oil, via tracheostomy. After applying topical aerolized lidocaine spray through the tracheostomy stoma a flexible video-brochoscopy was performed and a tree twig over 11 cm in length was removed. The patient's symptoms were resolved by a bronchoscopy. With experience and availability of accessories, the removal of the foreign body using flexible bronchoscope under local anesthesia can be performed safely and successfully. This case suggests that the physicians and otolaryngologists should educate their laryngectomized patients about stomal care and discuss any potential life-threatening situation they might encounter.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
7/27. Squamous cell carcinoma of the distal common bile duct.CONTEXT: Squamous cell carcinoma of the biliary tree is rare. Although few cases of squamous cell carcinoma of the intrahepatic bile-duct and gallbladder have been reported, until today, only four cases of squamous cell carcinoma of the extrahepatic bile duct have been reported in the literature. CASE REPORT: We present a case of squamous cell carcinoma of the distal common bile duct presenting with obstructive jaundice in a 60-year-old male which was successfully managed by a Whipple's pancreaticoduodenectomy. CONCLUSION: Squamous cell carcinoma of the distal bile duct without lymph node metastasis can be managed by pancreaticoduodenectomy alone.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
8/27. Occult stenosis of the common carotid artery complicating mandibular reconstruction with a fibular free flap.An unsuspected severely stenosed common carotid artery that compromised a free flap for mandibular reconstruction is described. To our knowledge no one has advocated the assessment of the carotid tree before transfer of free tissue. We suggest that patients with several risk factors for peripheral vascular disease should have colour flow duplex imaging of the carotid system if transfer of free tissue is being considered.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
9/27. Posterior stabilisation of a malignant cervico-thoracic vertebral bone defect.Oesophageal cancer is frequently complicated by malignant fistulae. necrosis of the tumour following radiotherapy or chemotherapy may lead to the development of fistulae between the oesophagus and adjacent tissues and organs. We report the expansion of an extra-luminal oesophageal cancer after resection, invading the cervico-thoracic spine, fortunately without neurological deficit, and leading to instability and formation of a malignant fistula linking the tracheo-bronchial tree to the subarachnoidal space. To prevent imminent paraplegia and to alleviate severe pain, we rigidly stabilised the spine at the cervico-thoracic junction using an angle-stable system through a single posterior approach. Further postoperative follow-up revealed no signs of neurological deterioration. Cervico-thoracic stability was preserved until the patient died nearly five months postoperatively. This case shows that posterior stabilisation and decompression may be a palliative option for patients with imminent paraplegia and severe pain due to advanced tumour infiltration of the cervico-thoracic spine.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
10/27. Squamous carcinoma of the lung in a nonirradiated, nonsmoking patient with juvenile laryngotracheal papillomatosis.Juvenile laryngotracheal papillomatosis (JLTP)--a disease characterized by the growth of multiple, recurrent, koilocytolic papillomas of the upper respiratory tree--occurs in 1,500 to 2,000 infants and children in the united states every year. In rare instances, the papillomas, which are thought to be caused by a human papillomavirus (HPV), may extend into the distal bronchi and lungs. They are often excised surgically or by laser resection, but may regress spontaneously. patients who receive radiation or cytotoxic drugs for this condition, or subsequently become smokers, may be predisposed to the development of bronchopulmonary carcinoma. Only six cases of bronchopulmonary carcinoma arising in persons with a history of JLTP but no history of these predisposing factors have been reported. Herein, we report the occurrence of squamous carcinoma of the left lung in a 28-year-old woman with JLTP since the age of 2 1/2 years. The carcinoma as well as randomly chosen papillomas excised over a period of years demonstrated positive nuclear staining for papillomavirus structural antigen. This is consistent with the current belief that human papillomavirus may be an important factor in the development of squamous carcinomas in various anatomic locations.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
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