Search

Background: The standard treatment for patients with early vocal cord carcinoma has been radiotherapy. In recent years, encouraging results with CO2 laser surgery has changed our treatment strategy in selective cases. During the past four years at the Rabin Medical Center we have treated patients with carcinoma of the vocal cord using CO2 laser surgery., Purpose: We conducted a retrospective study to investigate the results of the Head and Neck Surgery department with CO2 laser treatment for squamous cell carcinoma of the vocal cord during early stages (T1, T2) without radiotherapy., Materials and Methods: Twenty one patients with carcinoma of the vocal cords in early stages were treated with CO2 laser. Nineteen patients suffered from stage T1 carcinoma located in one vocal cord, three of these patients suffered from involvement of the anterior commissure and one patient also had involvement with the anterior part of the second vocal cord. Two patients with carcinoma in stage T2, one with involvement of the ventricular band and one with limited movement of the vocal cord. The follow-up period for the patients ranged from one month to four years., Results: Only one patient in stage T1 developed local recurrence after half a year, no patients died during the follow-up., Conclusion: Careful patient selection with endoscopic staging also during the biopsy, removal of the carcinoma in free border, strict follow-up and stroboscopic examination are essential to secure good results in the treatment of CO2 laser for early stages of vocal cord carcinoma.

Unlabelled: We reviewed the records of 38 patients aged 16 to 76 years with isolated sphenoid sinus disease who were treated by intranasal endoscopic sphenoidotomy at our hospital during the period 1992-1997. Diagnosis was made on the basis of history rigid nasal endoscopy and computed tomography (CT) scan of the sinuses. Headache was the main symptom in 29 (76%) patients. Other complaints were rhinitis, cough, nasal obstruction and nasal bleeding. Sphenoidotomy was performed endoscopically, directly through the area of the natural ostium. Acute or chronic sinusitis was found in 57% of the patients, cysts in 13%, polyps in 10%, mucocele in 8%, and fungal infection, pituitary adenoma, inverted papilloma and adenocarcinoma, in 3% each. Surgical results were excellent. The endoscopic approach proved to be both safe and effective., Conclusion: Sphenoid sinus disease is mostly inflammatory in origin. The endoscopic approach to the sphenoid sinus is currently the most appropriate method of surgery for an isolated sphenoid lesion.

Maxillary sinus cysts are common lesions usually found in routine x-rays of the teeth and sinuses. Although most patients are asymptomatic, there may be headache or periorbital or facial pain. Traditionally, these cysts have been treated by puncture and aspiration, or excision via intranasal antrostomy or Caldwell-Luc operation 23 patients with maxillary sinus cysts who presented with facial pain were treated by endoscopic surgery. During followup of 1 year the cyst recurred in only 1 of the patients (after 2 months). We recommend endoscopic removal of maxillary sinus cysts as the treatment of choice.

Of the 720 patients with thyroid cancer we saw from 1953 to 1989, 49 were younger than 20 years at diagnosis, and the female/male ratio was 4.4:1. The histologic type was papillary in 34, follicular in 14 and medullary in 1. Initial treatment in 41 was total or near-total thyroidectomy, and in 8 hemithyroidectomy. 23 underwent neck dissection in addition to thyroidectomy. 49% of those who underwent total thyroidectomy had foci of bilateral thyroid carcinoma on serial histological section. Local and distant relapse of thyroid carcinoma occurred in 4 of the 8 who underwent hemithyroidectomy, but in only 1 of the 41 who underwent total thyroidectomy. Our recommendations include total thyroidectomy, radioiodine therapy, and modified neck dissection when neck metastases are presented.