Stenosis of the larynx and/or trachea presents perplexing problems. No one technique has proved totally satisfactory in management all varieties stenosis. Recent reports have described successful use CO2 laser endoscopic stenosis and trachea. Failures this need emphasis to assure appropriate selection therapeutic method. Retrospectively, 49 cases laryngeal stenosis, 6 tracheal 5 combined were studied (total 60 patients) following treatment at Boston University Affiliated Hospitals. Follow-up...

Recurrent respiratory papillomatosis is most common in childhood but it affects all age groups; represents a diathesis of the aerodigestive tract so that lesions amy develop at various sites - nares, lips, pharynx, nasopharynx, larynx, tracheobronchial tree, approximately one-third patients for one year or more; since relapses occasionally occur 2 to 20 years later, cure can never be assumed. At present time, management directed towards total ablation visble papilloma consistent with...

The sequence of histological change induced by CO2 laser irradiation was discussed in terms two factors: the physiomechanical factor and physiochemical factor. At sufficiently high heat energy levels, immediate findings are characterized crater formation resulting from rapid vaporization water ejection solid component. In vicinity edge, maximum tissue temperature rise is 65 degrees C above 32 ambient it decreases to primary within a distance 2 mm. healing process lesions proceeds with...

The CO2 surgical laser and microscope assembly have been used to excise carefully selected T1 carcinomas of the membranous portions cord. Healing has prompt return function satisfactory. General anesthesia suspension laryngoscopy provided excellent definitions lesions; a precise method dissection. Initial results long term will depend on accuracy with which margins tumor are defined presence or absence tendency larynx produce multicentric disease.

Forty patients with advanced head and neck cancer were treated combined Cis-platinum-Bleomycin chemotherapy. Cis-diammine dichloroplatinum (DDP) 120 mg/m2 iv was given after prehydration, mannitol diuresis on Day 1. On 3, an initial loading dose of Bleomycin 15 by rapid push followed continuous 24 hour intravenous infusion 3 through 10. DDP administered again 22. The evaluated for tumor response resectability between 29 to 35. Of 39 who evaluable, there 8 complete responses or CR (20%) 22...

Transoral excisional biopsy has been used in the evaluation and management of 103 T1 glottic cancers. A 3-year follow-up on these patients indicates that unequivocally established diagnosis stage disease it is adequate treatment for micro mini squamous cell cancers glottis which margins excision are clear. Excisional with positive larger tumors establishes absolute need radiotherapy. ideal verrucous carcinoma spindle carcinoma. Recurrent/residual after radiotherapy should be explored by may...

Relapse patterns in patients with locally advanced head and neck cancer who achieved complete remission were evaluated. After combined modality therapy induction chemotherapy followed by surgery and/or radiotherapy, 71 of 103 clinically free disease. The 5-year recurrence rate was estimated at 51%, a 39% local 26% distant failure 5 years. factors significantly affecting the relapse were: (1) site primary tumor (those oral cavity lesions more likely to fail locally, whereas hypopharynx had...

Seven cases of localized amyloidosis limited to structures the head and neck upper aerodigestive lower respiratory tracts evaluated treated at Boston University Hospitals in a recent 7-year period were reviewed. Negative Congo red staining abdominal adipose aspiration biopsy or rectal specimens established that was not systemic. Localized occurred discrete masses variety sites tract including orbit, nasopharynx, lips, floor mouth, tongue, larynx, tracheobronchial tree. Five patients required...

Endotracheal and endobronchial carbon dioxide laser surgery can be carried out using standard ventilating bronchoscopes, a recently developed endoscope attachment 50W CO 2 surgical unit. General anesthesia, nonflammable anesthetics, is delivered through the side arm of bronchoscope; tidal flow gases keeps trachea bronchi free steam smoke. The technique has been particularly helpful in bloodless removal recurrent papillomas from main stem ten children with tracheostomies. While three patients...

• We report here a case of an endotracheal tube fire occurring during carbon dioxide (CO₂) laser surgery in the path gases that support combustion. The was thought to be ignited by flaming tissue close proximity tip and not directly laser. Tubes 1 cm away from object repeatedly hit can easily indirectly. Aluminum-tape wrapping does prevent this complication. recommend caution when using CO₂laser combustible presence flammable objects. (<i>Arch Otolaryngol</i>106:639-641, 1980)

THE EARLY diagnosis and management of carcinoma the oral cavity pharynx continues to present a great challenge. Carcinoma in an early stage development is hard detect because lesion may be impalpable color changes not very different from surrounding mucosa. When tumor still intraepithelial, only evidence area "erosion" where thin covering layer keratin or flattened cells missing. Because cavity, pharynx, larynx often multicentric origin, it common find satellite tumors adjacent main mass;...

Since 1977, we have used induction chemotherapy (CT) plus radiation therapy (RT) with curative intent in 35 advanced head and neck cancer (Ca) patients who otherwise would required total laryngectomy. Fourteen had Ca of the larynx or supraglottic (SGL); 21 hypopharynx. In six. was Stage III; 26 it IV. Three II disease—2 pyriform sinus one patient SGL refused surgery. Chemotherapy consisted platinum (P) + bleomycin 18 until 1982, then P fluorouracil next 17 patients. Total response rate...

Surgery is the generally accepted treatment for rhinophyma. Problems associated with standard therapy include moderately profuse hemorrhage impairing accurate removal, and some difficulty in providing smooth demarcation between rhinophyma surrounding tissue. Four patients have been successfully treated carbon dioxide laser. Satisfactory cosmetic results were achieved all cases excellent hemostasis minimal morbidity. Complete healing takes three to four weeks, which similar conventional methods.

Meeting the exacting requirements for microsurgery of larynx is a challenge anesthesiologist. To accomplish, necessary dissection, otolaryngologist has several requirements. They are quiet relaxed field, excellent illumination with magnification, binocular vision depth perception, and, above all, an unobstructed field. The management anesthesia suspension on presents many problems, most vexing which fact that and anesthesiologist in competition access to patient's airway. In sharing this,...

Abstract Since 1972 we have been cautiously exploring the use of CO 2 laser in management carefully selected cases localized carcinoma oral cavity. At present time our experience is based on treatment 57 patients with cancer The has found to be an indispensable tool transoral T 1 carcinomas, multiple superficial carcinoma, extensive leukoplakia and verrucous carcinoma. allows precise excision lesion involved mucosa provides excellent specimen for histologic verification margins. morbidity...

Transoral epiglottis resection or partial supraglottic was done with the CO2 laser in 20 highly selected patients. Visualization best accomplished using Lynch suspension system, but satisfactory Jako-Pilling laryngoscope. The indications for this procedure were: 1. visualization of true vocal cords previously treated cancer patients whose obstructed indirect mirror examination, 2. removal obstructing benign epiglottic lesions, 3. as an excisional biopsy limited cancer, especially suprahyoid...

The CO2 laser was first introduced for surgery of the aerodigestive tract in 1971. Since that time, great advances application have been made both adult and pediatric population. Recent reports isolated complications appeared literature. However, a realistic complication rate large series patients has yet to be reported. This report relates combined experience authors total 4416 cases during 11-year period from 1971 1982. There were nine instances complications, representing 0.2%. These...