1/139. Congenital fistula of the palate.Four cases of congenital fistula of the palate are presented. All four patients had a fistula which was situated in the vault with a bifid uvula, submucous separation of the palatal muscles, deformities of the palatal plates and unilateral cleft lip. Velopharyngeal incompetence appeared in primarily treated children. The aetiology and surgical treatment of the congenital defect are discussed.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
2/139. The use of granulocyte colony stimulating factor to promote wound healing in a neutropenic patient after head and neck surgery.BACKGROUND: neutropenia and neutrophil dysfunction, in association with a variety of diseases, has been shown to play a role in poor wound healing. Wound breakdown with fistula formation in patients undergoing total laryngectomy results in significant morbidity and increased hospital stay. Although malnutrition, prior radiation, diabetes, and other diseases are recognized as factors predisposing patients with head and neck cancer to developing fistulas, neutrophil dysfunction should also be considered. Granulocyte colony stimulating factor (G-CSF) has been used successfully to treat neutropenia and neutrophil dysfunction. methods: This study was conducted as a case report. RESULTS: We present the first report of a neutropenic head and neck cancer patient with a persistent wound of 6 months' duration who showed dramatic improvement after treatment with G-CSF. CONCLUSION: We conclude that G-CSF may represent a useful adjunct in patients with persistent wound healing problems and neutropenia despite adequate treatment by conventional means. Further clinical experience with G-CSF in patients with delayed healing is indicated.- - - - - - - - - - ranking = 0.98389047431199keywords = cancer (Clic here for more details about this article) |
3/139. Intrathoracic application of the reverse latissimus dorsi muscle flap.The use of the reverse latissimus dorsi muscle flap based on its paraspinous perforators for posterior trunk wound coverage has been described previously. However, few studies have reported its intrathoracic application. In this study the authors present their experience in treating 3 patients with various intrathoracic defects using the reverse latissimus dorsi muscle flap. There were 1 male and 2 female patients who ranged in age from 4 to 74 years (mean, 49 years). The etiology included an infected aortic graft, a bronchopleural fistula, and a recurrent congenital diaphragmatic hernia. Follow-up ranged from 2 to 24 months. Successful outcomes were achieved in all 3 patients, and there was no recurrence or wound complication identified. Their results demonstrate the versatility and reliability of the reverse latissimus dorsi muscle flap in treating low posterior intrathoracic defects.- - - - - - - - - - ranking = 7keywords = muscle (Clic here for more details about this article) |
4/139. Utilization of muscle flaps in the treatment of bronchopleural fistulas.This paper reports the results of a series of 5 patients who underwent closure of persistent bronchopleural fistula using extrathoracic muscle flaps over a 6-year period. All patients had failed more conservative treatment. The surgeries were one- or two-stage procedures performed with the collaboration of cardiovascular and reconstructive surgical staffs. There were no associated mortalities. The muscle flaps utilized were the latissimus dorsi, serratus anterior, pectoralis major, pectoralis minor, and trapezius. The results have been encouraging and allowed the complete closure of the bronchopleural fistula in the majority of patients. The authors present the best management of this serious disease, as well as its pathophysiology and clinical aspects.- - - - - - - - - - ranking = 6keywords = muscle (Clic here for more details about this article) |
5/139. Successful high dose therapy for relapsed mediastinal large B cell lymphoma following surgical repair of anterior chest wall defect.We describe a man with relapsed large B cell mediastinal lymphoma and associated infected large anterior chest wall defect who required high dose salvage therapy for his underlying disease. An initial mediastinotomy wound, associated with recurrent sepsis, had developed into an abscess, then fistula and eventually a large anterior chest wall defect. Safe use of salvage chemotherapy required reconstructive surgery consisting of a pedicled muscle flap. The subsequent high dose chemotherapy was carried out without complications and 15 months later the patient is alive and well.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
6/139. Fatal hemorrhage complicating carcinoma of the esophagus. Report of four cases.Four cases of esophageal carcinoma complicated by fatal hemorrhage are reported. All four patients had recently completed radiation therapy. An aortoesophageal fistula was present in two cases; fibrinoid necrosis of the esophageal arteries was present in the other two. The esophageal tumor was localized in two cases and had disappeared in one case. In one patient it had metastasized widely. Ninety-nine other reports of esophageal cancer and fatal hemorrhage are reviewed from the literature. Aortoesophageal fistula was the cause of hemorrhage in 78 cases. Occlusion of the vasa vasorum by thrombosis, inflammation, neoplastic cells or radiation injury appears to be the cause of aortic necrosis and fistula formation. Prompt surgical approach, if possible, should be used to control hemorrhage, as the primary tumor may be localized to the esophagus only.- - - - - - - - - - ranking = 0.49194523715599keywords = cancer (Clic here for more details about this article) |
7/139. Non-malignant tracheo-gastric fistula following esophagectomy for cancer.Two cases of neoesophago-tracheal fistula are described. After esophagectomy for cancer a fistula developed between the trachea and the pulled-up stomach probably because of the ischaemic effect of the tracheostomy tube. At single stage repairs, the fistulae were divided and the gastric defects were closed directly. In one case, tracheal resection and anastomosis was necessary. The defect on the membranous trachea in both cases was patched with an autologous fascia lata graft. A left pectoralis major muscle flap was interposed between the suture lines to prevent recurrence of the fistula. Treatment of this potentially life-threatening and rare condition yielded excellent results.- - - - - - - - - - ranking = 3.45972618578keywords = muscle, cancer (Clic here for more details about this article) |
8/139. Nearly fatal complications of cervical lymphadenitis following BCG immunotherapy for superficial bladder cancer.This report describes the case of a 68-year-old man with bilateral cervical lymphadenitis and chorioretinitis due to bacille Calmette-Guerin (BCG), originating from BCG immunotherapy for treatment of superficial bladder cancer 2 years ago. During antimycobacterial therapy a fistula between the right-sided lymph node and an aneurysm of the carotid artery developed. This led to life-threatening spontaneous bleeding which required vascular graft surgery. Like other known systemic side effects, cervical lymphadenitis may also occur following intravesical BCG immunotherapy, and life-threatening complications cannot be excluded despite adequate medical treatment.- - - - - - - - - - ranking = 2.45972618578keywords = cancer (Clic here for more details about this article) |
9/139. The use of a Dumon stent for the treatment of a bronchopleural fistula.We report the successful management of a bronchopleural fistula with bronchial stent placement combined with irrigation of the empyema cavity. A bronchopleural fistula occurred in a 67-year-old man after a right upper lobectomy for lung cancer. Resuturing of the bronchial stump plus omental wrapping and subsequent closure of the open stump with a pedicled flap of intercostal muscle were not effective. Consequently, we placed a Dumon stent in the right main bronchus to close the stump.- - - - - - - - - - ranking = 1.491945237156keywords = muscle, cancer (Clic here for more details about this article) |
10/139. Inserting a percutaneous endoscopic gastrostomy tube via a cervical fistula formed after major surgery on a patient with a head and neck tumor.SUMMARY: Several percutaneous endoscopic gastrostomy techniques have been devised so far to provide enteral nutrition for patients with head and neck cancer, because no single technique is adequate for all. Anatomic and functional deficits caused by advanced tumor extension or by surgery or irradiation often hinder traditional peroral gastroscopy. Transnasal, laryngoscopically guided, or intraoperative gastroscopic procedures are useful technical methods for percutaneous endoscopic gastrostomy placement. This article introduces a new method of gastroscopy, as yet unpublished. After total laryngectomy and partial pharyngectomy, the remaining narrow hypopharyngeal lumen often is insufficient for peroral gastroscopy. However, coexisting cervical pharyngocutaneous fistula can provide an approach and route for percutaneous endoscopic gastrostomy. The procedure was carried out successfully with no complications.- - - - - - - - - - ranking = 0.49194523715599keywords = cancer (Clic here for more details about this article) |
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