Analysis of survival of 137 patients with oral cancerBackground: Oral cancer accounts for 1% of cancer mortality. It is more common in men but its frequency is increasing in women due to their growing smoking habits. Aim: To report the experience in the management of a cohort of patients with oral cancer. Material and Methods: Review of medical records of patients with oral cancer treated between 1989 and 2004. Demographic and clinical data were recorded and survival was determined examining death certifi cates or information obtained from the medical records. Results: Data from 137 patients aged 61 ± 14 years (98 males) was analyzed. Global survival fi ve years survival was 57%. Survival for stages I, II, III and IV was 86, 67, 52 and 51% respectively. Conclusions: The survival of these patients is very similar to that reported abroad.
El nuevo coronavirus (SARS-CoV-2), causante de la enfermedad COVID-19, es una pandemia con alta morbimortalidad mundial. Uno de los factores más importantes es su alta tasa de transmisibilidad por gotitas, aerosoles y fómites. La tendencia actual es al aumento progresivo de pacientes contagiados en nuestro país y, por consiguiente, de mayor cantidad de enfermos en unidades de cuidados intensivos (UCI) con uso de ventilación mecánica invasiva (VMI). La traqueostomía (TQT) se utiliza en pacientes críticos para facilitar la VMI a largo plazo y el destete de la ventilación. Una TQT temprana, definida como la realizada en los primeros 7 días después de la intubación orotraqueal (IOT) se asocia a una reducción en el tiempo de la VMI, mortalidad y permanencia en UCI. La TQT es una técnica quirúrgica con alta generación de aerosoles la cual implica medidas especiales frente a la realización de ésta en pacientes con COVID-19. Para limitar el contagio del SARS-CoV-2 en los trabajadores de salud es necesario el uso de elementos de protección personal (EPP) adecuados según la intervención a realizar. Es por esta razón que en el presente artículo se propone utilizar el acrónimo C-O-RO-NA para no olvidar elementos y pasos fundamentales al momento de realizar esta técnica, minimizando de esta manera el contagio en los trabajadores de salud.
Osteosarcoma of the head and neck area. Analysis of 12 patients Background: Less than 10% of osteosarcomas are located the head and neck region, mainly affecting the mandible and maxillary region. Aim: To analyze the therapeutic modality, types of reconstruction, surgical complications and survival of patients treated for osteosarcoma of the head and neck. Material and Methods: Review of medical records of 12 patients aged 17 to 34 years (6 women) treated for osteosarcoma of the head and neck between september 1998 and may 2009. Results: The localization of the tumor was maxillary in eight, mandibular three and ethmoidal in one patient. According to histologic grade, seven tumors were grade 1, four were grade 2 and one was grade 3. Adjuvant and neoadjuvant chemotherapy were administered to all and seven patients, respectively. The surgical treatment for maxillary tumors was maxillectomy. A reconstruction with rectum abdomini free fl ap was done in four patients and with dermoepidermic graft and an obturator prosthesis in three. In one patient, the defect was covered with a dental prosthesis. Treatment for mandibular tumors was mandibular excision. A reconstruction with peroneal free fl ap was performed in two patients and with an iliac crest graft in one. The ethmoidal tumor was resected and covered with local fl aps. There were four complications. Two patients had a cutaneous fi stula, one patient had a free fl ap partial atrophy and one patient had surgical site infection. Two patients who had positive margins died from local recurrence. Of the 10 patients with negative margins, seven are alive without recurrence, one died due to the disease, one has disseminated disease and one died from another cause. Conclusions: Our results in the treatment of head and neck osteosarcomas are consistent with published data.
trans-oral robotic surgery for tongue cancer background: The traditional treatment of oropharyngeal cancer was based mainly in radio and chemotherapy, aiming to avoid organ excisions. However, the adverse effects of these therapies prompted the development of new therapies. Among these, trans-oral robotic surgery (TORS) has promising results. case reports: We report two patients operated using this technique. An 82 years old woman treated for a tumor in the base of the tongue six years ago with radiotherapy. A new lesion in the tongue was found and excised by TORS uneventfully. The pathology report confirmed the complete excision of the malignant lesion. A 57 years old male with a history of palate cancer treated with radiotherapy in 1990. In 2013 a submandibular mass was biopsied confirming the presence of a squamous carcinoma metastasis. During a bilateral suprahyoid dissection, a tumor in the base of the tongue was found. In a second intervention the tumor was excised by TORS. The pathology reports tumor free borders but near the lesion. Postoperative radiotherapy was recommended.
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