1/73. 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 = 1keywords = fistula (Clic here for more details about this article) |
2/73. Surgical management of acquired laryngopharyngeal fistulae.Pathological communication between the food and air passages in the neck region due to malignant disease is known. However, such a pathology arising as a result of a non malignant process is relatively uncommon, and only a handful of reports exists in the literature. The authors describe and discuss the management of two patients with laryngopharyngeal fistula of nonmalignant etiology.- - - - - - - - - - ranking = 2.5keywords = fistula (Clic here for more details about this article) |
3/73. Closure of an oropharyngocutaneous fistula in an irradiated patient. A case report.A case of oropharyngocutaneous fistula is presented in a preoperatively irradiated patient. A double-layer closure, using a modified Owens flap, was used to obtain a satisfactory result.- - - - - - - - - - ranking = 2.5keywords = fistula (Clic here for more details about this article) |
4/73. The use of a posterior-based tongue flap for the closure of a pharyngocutaneous fistula.The closure of a pharyngocutaneous fistula by the use of a posteriorly based tongue flap is described. The use of such a flap for this purpose has not been previously recorded in the literature.- - - - - - - - - - ranking = 2.5keywords = fistula (Clic here for more details about this article) |
5/73. Repair of the pharyngocutaneous fistula with a fasciocutaneous island flap pedicled on the superficial temporalis artery.The case of an 84-year-old man with a pharyngocutaneous fistula after radiotherapeutic treatment and total laryngectomy for a squamous cell carcinoma was reported. Treatment with local flaps failed and normal flaps were not likely to succeed because of general and locally poor conditions considering that intensive radiotherapy had been administered. We therefore decided to use a fasciocutaneous island flap from the temporoparietal region pedicled on the parietal branch of the superficial temporalis artery. We obtained efficient and stable repair of the lesion both from a cosmetic and a functional point of view. We were forced to use this procedure for lack of another choice; however, we think that this could become a useful option in covering substance loss in this area when simpler solutions are not available.- - - - - - - - - - ranking = 2.5keywords = fistula (Clic here for more details about this article) |
6/73. Acute tonsillitis complicated by retropharyngeal and thyroid abscess infected with de-repressed beta lactamase citrobacter mutans.An unusual presentation of acute tonsillitis complicated by retropharyngeal and thyroid abscess is reported. Spontaneous rupture of retropharyngeal abscess resulted in necrotic fistulae between the pharyngeal wall and the retropharyngeal space.- - - - - - - - - - ranking = 0.5keywords = fistula (Clic here for more details about this article) |
7/73. The surgical treatment of post-laryngectomy pharyngocutaneous fistulae.The repair of large post-laryngectomy pharyngocutaneous fistulae presents a challenge to the plastic surgeon. The radial forearm flap is ideally suited for the reconstruction of these large fistulae. With the help of a case report, this article highlights the etiology and management of large post-laryngectomy pharyngocutaneous fistulae.- - - - - - - - - - ranking = 3.5keywords = fistula (Clic here for more details about this article) |
8/73. Simultaneous surgical management of iatrogenic pharyngeal perforation and distal esophageal malignancy.Instrumental perforation of the pharynx with distal obstruction is a complex problem. A fistula is not likely to close in the presence of distal obstruction. The stenotic lesion needs to be treated in addition to the perforation. We report a 83-year-old female patient who underwent three-stage total esophagectomy and right cervical pharyngo-gastric anastomosis for iatrogenic pharyngeal perforation and distal esophageal malignancy. The radical surgical approach has the advantage of treating the immediate crisis due to perforation and also treating the stricture for which the esophagoscopy was originally performed.- - - - - - - - - - ranking = 0.5keywords = fistula (Clic here for more details about this article) |
9/73. Acute suppurative thyroiditis caused by an infected piriform sinus fistula with thyrotoxicosis.We report herein an unusual case of thyrotoxicosis caused by acute suppurative thyroiditis (AST) infected through a piriform sinus fistula (PSF). A 28-year-old man presented with pain over the thyroid gland and elevated serum thyroid hormone levels, a picture similar to subacute thyroiditis. A fine-needle aspiration biopsy from the left lobe showed neutrophil infiltration, and culture from the aspirate grew anaerobic peptostreptococcus. A neck computed tomography (CT) scan showed an abscess in the thyroid gland, and barium swallow revealed the presence of PSF. Appropriate antibiotic treatment ameliorated his symptoms of infection, followed by normalization of thyroid function. Three months later, he underwent fistulectomy and partial left lobectomy. The end of the PSF track was found in the left thyroid lobe. Thus infection of the thyroid gland through the infected PSF was likely the cause of supprative thyroiditis. The unusual clinical features of AST in this patient include the presence of severe thyrotoxicosis, relatively late onset (28-years-old) of infection despite the presence of congenital PSF, and the lack of acute inflammatory signs on the overlying skin of the thyroid gland. It is important to recognize this type of AST, since fistulectomy is required to prevent recurrent AST.- - - - - - - - - - ranking = 2.5keywords = fistula (Clic here for more details about this article) |
10/73. Repair of a pharyngo-cutaneous fistula.A method for closure of a midline pharyngo-cutaneous fistula by providing lining from an epidermal island on a cervical skin flap and outer cover from a split skin graft has been described. It can be useful in selected cases.- - - - - - - - - - ranking = 2.5keywords = fistula (Clic here for more details about this article) |
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