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Volume 106, Issue 11
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[in Japanese]2003 Volume 106 Issue 11 Pages 1073-1077
Published: November 20, 2003
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESS -
Yukio Ohmae, Mutsumi Sugiura, Manabu Mogitate2003 Volume 106 Issue 11 Pages 1078-1083
Published: November 20, 2003
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSThe purpose of this study was to investigate the clinical value of assessing Pharyngeal swallowing clicited by fluid infusion Videoendoscopic examinations were performed in 126 patients with dysphagia, after injecting a fluid infusion into the pharyngeal cavity Blue dye fluid was instilled into the unilateral valleeula through a catheter that was inserted into the biopsy channel of an endoseope Pharyngeal swallowing elicited by the fluid infusion was classified according to 5 grades: grade I. normal pharyngeal swallowing; grade lla, laryngeal penetration before the triggering of pharyngeal swallowing; grade llb, pharyngeal residue after swallowing; grade lla+b; and grade III, no the pharyngeal swallowing. The recovery rates for oral intake using several approaches for dysphagia were 98% in grade I patients and 75% in grade IIb patients. However, the oral intake of food was more difficult in grade IIa, grade IIa+b and grade III patients. These results suggest that the classification of dysphagia based on the triggering and output situation of pharyngeal swallowing may be a useful guideline for demonstrating impaired oral food intake. We conclude that videoendoscopic examination using a fluid infusion is a valuable method for evaluating pharyngeal swallowing minus the influence of bolus transport from oral cavity to the pharynx.View full abstractDownload PDF (1226K) -
Yoichiro Tomiyama, Jun-ichi Yoshida, Yuichiro Honjo, Shinji Otozai, Ke ...2003 Volume 106 Issue 11 Pages 1084-1092
Published: November 20, 2003
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSOne-hundred and four patients with previously untreated tongue cancer seen in our department between 1986 and 1998 were enrolled in a clinical study. The DNA ploidy patterns observed in fresh frozen specimens obtained from 41 patients were analyzed, and prognostic factors were investigated.
According to the TNM classification (UICC 1997), 43 patients had stage I tumors, 29 had stage II tumors, 17 had stage III tumors, and 15 had stage IV tumors. The 5 year cause-specific survival rates for each stage were 94.7%, 64.4%, 50.0% and 45.7%, respectively. The most frequent cause of death associated with the original disease was the recurrence of the disease in cervical lymph nodes (19/27, 70.4%). The occurrence of late cervical metastasis was high among patients with a T2N0 disease. Patients with stage II disease should undergo elective neck dissection or be carefully monitored using ultrasonography.
Among the 41 cases in which the DNA ploidy pattern was analyzed, diploid patterns were found in 30 cases and aneuploid patterns were found in 11.The 5-year cause-specific survival rate and the 5-year locoregional control rate were significantly lower for the aneuploid cases ( 18.2%, 38.9%) than for the diploid cases (66.5%, 69.8%) (p=0.0003, p=0.0339). The incidence of distant metastasis was significantly higher among the aneuploid cases (6/11, 54.5%) than among the diploid cases (3/30, 10.0%) (p=0.0058). The poidy pattern, as determined by flow cytomet is DNA analysis, may reflect the malignancy grade of tongue cancers.View full abstractDownload PDF (875K) -
Hiroyuki Yamada, Shin-ichiro Nishii, Shigetoshi Sakabe, Ryoji Ishida2003 Volume 106 Issue 11 Pages 1093-1100
Published: November 20, 2003
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSEsophageal speech is the first choice for vocal rehabilitation in laryngectomized patients. However, shunt speech is a needed alternative for patients who cannot succeed at esophageal speech. Many kinds of voice prostheses, with good results, have been reported. Provox was selected for 15 laryngectomized patients who were treated in our department. Voice rehabilitation was successful in 13 patients. However, removal of the prosthesis was required in one patient because of stomal stenosis. Voice rehabilitation was not successful in one patient who exhibited esophageal stenosis. The rate of voice rehabilitation was not influenced by the extent of surgery, the dose of radiation, etc., The maximum phonation time was more than 10 minutes in the 13 patients who succeeded at shunt speech. Prosthetic rehabilitation was requested by two patients who had been successful at esophageal speech. These results suggest that prosthetic voice rehabilitation may be indicated for a wide range of conditions.View full abstractDownload PDF (1408K) -
Akihiro Shiotani, Koji Araki, Kazuhisa Moro, Asako Ikeda, Keisuke Okub ...2003 Volume 106 Issue 11 Pages 1100-1103
Published: November 20, 2003
Released on J-STAGE: March 19, 2008
JOURNAL FREE ACCESSA supracricoid laryngectomy with cricohyoidoepiglouopexy (CHEP) consists of the resection of the whole thyroid cartilage and paraglottic space, while preserving the cricoid cartilage, the hyoid bone, most of the epiglottis and the arytenoids. Laryngeal reconstruction is achieved be suturing the cricoid cartilage and the hyoid bone. This procedure is mainly indicated for large T2 glotiic carcinomas and provides a complete resection and laryngeal preservation without requiring a permanent tracheostomy. Although bilateral arytenoids arc usually preserved to ensure better laryngeal function after CHEP, we unavoidably had to remove the arytenoid on the tumor-bearing side during a complete resection performed in a 56-year-old male with a rT2 tumor who had undergone radiation and demonstrated impaired vocal fold motion. Despite the resection of one arytenoid, the final laryngeal function proved to be satisfactory.
CHEP should be utilized as an alternative surgical modality for conventional vertical partial laryngectomies or total laryngectomies. CHEP with the total removal of the arytenoid on the tumor bearing side may be a useful laryngeal preservation procedure for the treatment of patients with glottic carcinoma associated with an impaired vocal fold motion or a fixed vocal fold.View full abstractDownload PDF (1548K)
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