Surendra Narne

Primary Laryngeal Malignant Fibrous Histiocytoma: Review of the Literature and Report of Seven Cases

After describing 4 new cases of malignant fibrous histiocytoma of the larynx (3 cases had been recently published), the authors review the literature, from which it appears that 16 such lesions of the larynx have been reported (including their 7 cases). Malignant fibrous histiocytoma usually occurs in the soft tissues, tendons and joints of the upper and lower extremities, and is uncommon in the head and neck — though not exceptional. The lesion is a mesenchymal tumor probably of histiocytic origin and may be divided into 6 subtypes, i.e., pleomorphic, fibrous, giant cell, angiomatoid, myxoid and inflammatory, to be distinguished on the basis of the predominant feature. The tumor has an aggressive biologic behavior as it tends to recur and to metastasize to distant organs. The treatment of choice is surgery and adjuvant combination chemotherapy which at times may improve the survival rate.

Long-term survival in response to combined chemotherapy and radiotherapy in laryngeal small cell carcinoma.

Fourteen patients with small cell carcinoma of the larynx are studied. This represents the largest series, from a single institution, reported in the literature. This neoplasm is usually highly aggressive and the prognosis very poor, but, in our experience, combined chemo- and radiotherapy can significantly improve the clinical course of the disease. Three of six patients who received this combined modality treatment are still clinically disease-free more than six years after the initial diagnosis.

Repair of a recurrent benign Tracheoesophageal fistula with a Gore-Tex membrane

A case is reported of a recurrent postintubation tracheoesophageal fistula treated with the interposition of a Gore-Tex patch between the trachea and the esophagus.

Endoscopic stapler-assisted Zenker's diverticulotomy: Which is the best operative facility?

Despite great changes in treatment for Zenkers diverticulum, endoscopic stapler‐assisted diverticulotomy (ESD) has not yet been included on the lists of possible day‐case procedures, and determining the best operative facility is still a matter of debate. The aim of this article was to evaluate the safety and feasibility of endoscopic treatment for patients with Zenkers diverticulum on a planned 24‐hour‐stay basis.

Ethmoid osteoma with frontal and orbital extension: Endoscopic removal and reconstruction

Conclusions Endoscopy provides a safe and effective way of treating craniofacial bony benign lesions. This approach permits not only complete removal of the tumour, but also reconstruction of the bony boundaries as necessary. Objective Osteoma is a rare, osteogenic tumour that usually grows slowly and asymptomatically. It is the most frequent benign neoplasm of the nose and paranasal sinuses. Orbital extension is a rare event that can give rise to ocular signs and symptoms; in such a case treatment is mandatory, although debate persists regarding the optimal approach. Material and methods We report the case of a bulky fronto–ethmo–orbital osteoma that was treated using an endoscopic trans-nasal approach. The medial wall of the orbit was repaired by means of an implant of porous polyethylene endoscopically positioned using an “underlay” technique. The surgical technique is described and the reasons for the endoscopic choice are also discussed. Results Fifteen days after the operation the patient reported complete resolution of craniofacial pain. Nasoendoscopy showed complete integration of the polyethylene implant in the healing tissue 4 weeks after surgery. A CT scan performed 6 months postoperatively showed good ventilation of the sinonasal cavity and effective reconstruction of the medial orbital wall.

The importance of acoustic impedance measurements in middle ear pathology during acute viral respiratory illness in the first year of life

The very high incidence of ME pathology in epidemic bronchiolitis prompted the systematic use of impedance measurement tests in a study of the otitic process. Data were assembled of 44 children admitted to the paediatric clinic with acute viral respiratory infection (in the last year). On account of the high incidence (97%), the precocity of occurrence (1-12 months), the slow rehabilitation and the frequency of relapses, the ME pathology in these children indicates the importance of a correct approach to the problems of relapsing otitis in infants. Patients were treated with aerosol therapy (mucolytic substance), nasal drops (with vasoconstrictors), and only in very serious cases with antibiotics. For the latter, cortisonic therapy is inadvisable, while it is absolutely necessary to follow up with periodic controls until the tympanogram becomes normal. The impedance findings (prevalent type B curves, with inability to evoke the stapedius reflex, over periods of several months) and their resolution in type AC or C curves led us to consider not only the organic problem, but also the functional hearing problem during the first year of life, and the possible longterm repercussion.