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Rodrigo JP, López-Álvarez F, Medina JE, Silver CE, Robbins KT, Hamoir M, Mäkitie A, de Bree R, Takes RP, Golusinski P, Kowalski LP, Forastiere AA, Homma A, Hanna EY, Rinaldo A, Ferlito A. Treatment of the neck in residual/recurrent disease after chemoradiotherapy for advanced primary laryngeal cancer. Eur J Surg Oncol 2024; 50:108389. [PMID: 38728962 DOI: 10.1016/j.ejso.2024.108389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 04/09/2024] [Accepted: 05/03/2024] [Indexed: 05/12/2024]
Abstract
Concomitant chemoradiotherapy (CRT) is extensively used as primary organ preservation treatment for selected advanced laryngeal squamous cell carcinomas (LSCC). The oncologic outcomes of such regimens are comparable to those of total laryngectomy followed by adjuvant radiotherapy. However, the management of loco-regional recurrences after CRT remains a challenge, with salvage total laryngectomy being the only curative option. Furthermore, the decision whether to perform an elective neck dissection (END) in patients with rN0 necks, and the extent of the neck dissection in patients with rN + necks is still, a matter of debate. For rN0 patients, meta-analyses have reported occult metastasis rates ranging from 0 to 31 %, but no survival advantage for END. In addition, meta-analyses also showed a higher incidence of complications in patients who received an END. Therefore, END is not routinely recommended in addition to salvage laryngectomy. Although some evidence suggests a potential role of END for supraglottic and locally advanced cases, the decision to perform END should weigh benefits against potential complications. In rN + patients, several studies suggested that selective neck dissection (SND) is oncologically safe for patients with specific conditions: when lymph node metastases are not fixed and are absent at level IV or V. Super-selective neck dissection (SSND) may be an option when nodes are confined to one level. In conclusion, current evidence suggests that in rN0 necks routine END is not necessary and that in rN + necks with limited nodal recurrences SND or a SSND could be sufficient.
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Affiliation(s)
- Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, Oviedo, Spain.
| | - Fernando López-Álvarez
- Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, Oviedo, Spain
| | - Jesús E Medina
- Department of Otorhinolaryngology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Carl E Silver
- Department of Surgery, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
| | - K Thomas Robbins
- Department of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Marc Hamoir
- Department of Otorhinolaryngology, Head and Neck Surgery, UC Louvain, St Luc University Hospital and King Albert II Cancer Institute, Institut de Recherche Experimentale, 1200, Brussels, Belgium
| | - Antti Mäkitie
- Department of Otorhinolaryngology, Head and Neck Surgery, Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Robert P Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Pawel Golusinski
- Department of Otolaryngology and Maxillofacial Surgery, University of Zielona Gora, Department of Maxillofacial Surgery Poznan University of Medical Sciences, Poznan, Poland
| | - Luiz P Kowalski
- Head and Neck Surgery Department, University of Sao Paulo Medical School and Head and Neck Surgery and Otorhinolaryngology Department, AC Camargo Cancer Center, São Paulo, Brazil
| | | | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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Sánchez-Gómez S, Molina-Fernández E, Acosta Mosquera ME, Palacios-García JM, López-Álvarez F, Juana Morrondo MSD, Tena-García B. Tracheotomy versus tracheostomy, the need for lexicographical clarification. Acta Otorrinolaringol Esp (Engl Ed) 2024; 75:73-82. [PMID: 38224867 DOI: 10.1016/j.otoeng.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/25/2023] [Indexed: 01/17/2024]
Abstract
In the healthcare field, the terms "traqueotomía" and "traqueostomía" are frequently used, often leading to confusion among professionals regarding the appropriate definition for each term or which one should be considered more correct in specific cases. A search was conducted for the terms "traqueotomía" and "traqueostomía" in general Spanish-language dictionaries such as the Dictionary of the Royal Spanish Academy (DRAE) and the Historical Dictionary of the Spanish Language of the Royal Spanish Academy (DHLE), as well as for the English terms "tracheotomy" and "tracheostomy" in English general dictionaries like the Oxford Dictionary, the Cambridge Dictionary, and the Collins English Dictionary. Additionally, searches were performed in medical dictionaries in both Spanish, specifically the Dictionary of Medical Terms of the National Academy of Medicine (DTM), and English, including the Farlex Dictionary. The terms were also explored using the Google search engine. Definitions were analyzed from both lexicographical and etymological perspectives. Definitions found in general dictionaries, in both Spanish and English, were found to be imprecise, limited, and ambiguous, as they mixed outdated indications with criteria that deviated from etymology. In contrast, definitions in medical dictionaries in both languages were more aligned with etymology. "Traqueotomía" strictly identifies the surgical procedure of creating an opening in the anterior face of the trachea. "Traqueostomía" identifies the creation of an opening that connects the trachea to the exterior, involving a modification of the upper airway by providing an additional entry for the respiratory pathway. "Traqueostomía" becomes the sole means of entry to the airway in total laryngectomies. Both terms can be used synonymously when a traqueotomía culminates in a traqueostomía. However, it is not appropriate to use the term "traqueostomía" when the procedure concludes with the closure of the planes and does not result in the creation of a stoma. Traqueostomas can be qualified with adjectives indicating permanence (temporary/permanent), size (large/small), shape (round/elliptical), or depth, without being linked to any specific disease or surgical indication. Not all permanent traqueostomas are the result of total laryngectomies, and they do not necessarily have an irreversible character systematically.
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Affiliation(s)
- Serafín Sánchez-Gómez
- Servicio de Otorrinolaringología, Hospital Universitario Virgen Macarena, Sevilla, Spain.
| | - Elena Molina-Fernández
- Servicio de Otorrinolaringología, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | | | - Fernando López-Álvarez
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Beatriz Tena-García
- Servicio de Otorrinolaringología, Hospital Universitario Virgen Macarena, Sevilla, Spain
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Costales-Marcos M, López-Álvarez F, Núñez-Batalla F, Moreno-Galindo C, Álvarez Marcos C, Llorente-Pendás JL. Reply to the Letter “Comments on Peritonsillar Infections: A Prospective Study of 100 Consecutive Cases”. Acta Otorrinolaringologica (English Edition) 2013. [DOI: 10.1016/j.otoeng.2013.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Costales-Marcos M, López-Álvarez F, Núñez-Batalla F, Moreno-Galindo C, Álvarez Marcos C, Llorente-Pendás JL. Peritonsillar Infections: Prospective Study of 100 Consecutive Cases. Acta Otorrinolaringologica (English Edition) 2012. [DOI: 10.1016/j.otoeng.2012.01.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Costales-Marcos M, López-Álvarez F, Núñez-Batalla F, Moreno-Galindo C, Alvarez Marcos C, Llorente-Pendás JL. [Peritonsillar infections: prospective study of 100 consecutive cases]. Acta Otorrinolaringol Esp 2012; 63:212-7. [PMID: 22425204 DOI: 10.1016/j.otorri.2012.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Revised: 12/23/2011] [Accepted: 01/02/2012] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Peritonsillar infection is the most frequent complication of acute tonsillitis. Peritonsillar infections are collections of purulent material, usually located between the tonsillar capsule and the superior constrictor of the pharynx. Peritonsillar infection can be divided into abscess and cellulitis. MATERIAL AND METHODS We prospectively analysed the clinical data from 100 patients with peritonsillar infection from 2008 to 2010. The diagnosis of abscess or peritonsillar cellulitis was primarily based on obtaining pus through fine-needle aspiration. RESULTS Seventy-seven per cent of patients had no history of recurrent tonsillitis and 55% were receiving antibiotic treatment. Sixty-two cases were peritonsillar abscess and the rest were cellulitis. Trismus, uvular deviation and anterior pillar bulging were statistically associated with peritonsillar abscess (P<.005). All patients were admitted to hospital and treated with puncture-drainage, intravenous antibiotics (amoxicillin/clavulanate in 83% of cases) and a single dose of steroids. All patients were discharged on oral antibiotic therapy. The mean length of hospital stay was 3 days and the recurrence rate was 5%. CONCLUSIONS Due to the absence of clinical practice guidelines, there are different therapeutic protocols. According to our experience, puncture-aspiration and administration of intravenous antibiotics is a safe, effective way to treat these patients. To determine the efficacy and safety of outpatient management, controlled studies would be needed.
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Affiliation(s)
- María Costales-Marcos
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Principado de Asturias, España.
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López-Álvarez F, Bernardo-Corte MJ, Gómez-Martínez JR, Suárez-Nieto C. Unilateral Agenesis of the Internal Carotid Artery. Acta Otorrinolaringologica (English Edition) 2012. [DOI: 10.1016/j.otoeng.2012.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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López-Álvarez F, Gómez-Martínez JR, Suárez-Nieto C, Llorente-Pendás JL. Schwannoma of the larynx. An infrequent laryngeal tumour. Acta Otorrinolaringol Esp 2011; 64:157-60. [PMID: 22197446 DOI: 10.1016/j.otorri.2011.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2011] [Revised: 10/20/2011] [Accepted: 10/25/2011] [Indexed: 10/14/2022]
Abstract
Schwannomas are benign tumours, rare among tumours of the larynx. They normally present as supraglottic masses (because they may arise from the internal branch of the superior laryngeal nerve), most commonly involving aryepiglottic folds or false vocal folds. Most patients present with a globus sensation, dysphagia or hoarseness. Conservative surgery is the treatment of choice. We report a case of a laryngeal asymptomatic neuroma that was diagnosed accidentally in an imaging test. Complete excision of the tumour was performed through a transoral CO₂ laser microsurgery without resorting to a tracheotomy. We discuss the clinical, pathologic and imaging findings and the management of this neoplasm. We also try to update the knowledge on the management of these tumours.
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Affiliation(s)
- Fernando López-Álvarez
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
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López-Álvarez F, Rodrigo JP, Llorente-Pendás JL, Suárez-Nieto C. Cirugía transoral LASER CO2 en tumores avanzados de faringe y laringe. Acta Otorrinolaringológica Española 2011; 62:95-102. [DOI: 10.1016/j.otorri.2010.09.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Accepted: 09/03/2010] [Indexed: 11/15/2022]
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López-Álvarez F, Bernardo-Corte MAJ, Gómez-Martínez JR, Suárez-Nieto C. Unilateral agenesis of the internal carotid artery. Acta Otorrinolaringol Esp 2011; 63:72-4. [PMID: 21288497 DOI: 10.1016/j.otorri.2010.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Revised: 11/22/2010] [Accepted: 11/28/2010] [Indexed: 11/28/2022]
Abstract
Unilateral agenesis of the internal carotid artery (ICA) is an extremely rare anomaly. Diagnosis is often incidental in a radiological examination. Recognition of this anomaly has important clinical implications because other life-threatening conditions can be associated and it must be taken into account when planning carotid surgery. We report a case of 64-year-old man with agenesis of the ICA.
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Affiliation(s)
- Fernando López-Álvarez
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Principado de Asturias, España.
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López-Álvarez F, Rodrigo JP, Llorente-Pendás JL, Suárez-Nieto C. Transoral laser microsurgery in advanced carcinomas of larynx and pharynx. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/s2173-5735(11)70018-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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López-Álvarez F, Llorente-Pendás JL, Suárez-Fente V, Suárez-Nieto C. Neck mass with infrequent origin. Acta Otorrinolaringologica (English Edition) 2011. [DOI: 10.1016/s2173-5735(11)70011-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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López-Álvarez F, Llorente-Pendás JL, Suárez-Fente V, Suárez-Nieto C. [Neck mass with infrequent origin]. Acta Otorrinolaringol Esp 2010; 62:65-7. [PMID: 20097322 DOI: 10.1016/j.otorri.2009.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Accepted: 12/03/2009] [Indexed: 10/19/2022]
Abstract
We report the case of a 67-year-old male diagnosed with prostate adenocarcinoma, who referred dysphagia, dysphonia and noticed the appearance of a laterocervical mass. A CT scan revealed an osteolytic soft tissue neck lesion, which was resected. Its anatomical-pathological study was compatible with metastasis of prostate adenocarcinoma.
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Affiliation(s)
- Fernando López-Álvarez
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Principado de Asturias, España. flopez
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Suárez-Fente V, Luis Llorente-Pendás J, Gómez-Martínez J, Amando García-González L, López-Álvarez F, Suárez-Nieto C. Tumores primarios del espacio parafaríngeo. Nuestra experiencia en 51 pacientes. Acta Otorrinolaringológica Española 2009. [DOI: 10.1016/s0001-6519(09)70313-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Suárez-Fente V, Llorente-Pendás JL, Gómez-Martínez J, García-González LA, López-Álvarez F, Suárez-Nieto C. Primary tumours of the parapharyngeal space. Our experience in 51 patients. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/s2173-5735(09)70093-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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