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Biomedical subjects

C Gavilán

Publications and source records attributed to C Gavilán.

At least 19 recordsLinked to original sources
PubMed1996

Supraglottic laryngectomy: functional and oncologic results.

Between January 1980 and December 1989, 110 patients with squamous cell carcinoma of the supraglottis were treated with supraglottic laryngectomy and neck dissection. The stage distribution was stage I 23%, II 34%, III 15%, and IV 28%. Adjuvant radiotherapy (5,000 to 6,500 cGy) was given to all pN+cases. All patients were followed until death or for a minimum of 36 months, with an average of 65 months. Decannulation was achieved in 96% of the cases, with only 1 patient undergoing total laryngectomy because of aspiration. The average hospital stay was 22 days. Arytenoid edema was a frequent cause of delayed decannulation in patients undergoing radiotherapy. The overall 3-year survival was 78%, with 10 patients dying of unrelated causes. Local control was 94.6% and regional control was 83.6%. No significant difference was found in survival according to T stage, but survival rate was significantly influenced by N stage.

Adult↗
PubMed1992

Functional neck dissection: three decades of controversy.

Functional neck dissection (FND) is a neck-functional, tumor-radical approach for the management of the neck in patients with head and neck cancer. Based on the anatomic knowledge of the lymphatic compartments of the neck, FND is a different surgical technique rather than a modification of the classic procedure described by Crile. From an oncologic viewpoint, FND is a relatively safe operation to treat the cervical spread from head and neck cancer as long as the indications and technical details are carefully followed. In this report, based on our experience with more than 1,000 FNDs, we analyze the history and the philosophy of the operation.

Argentina↗
PubMed1991

Complications following thyroid surgery.

The incidence of severe complications following thyroid gland surgery is a major reason to recommend total thyroidectomy or a less radical procedure in treating thyroid gland diseases. A retrospective study on 335 thyroidectomies was performed to assess the incidence of postoperative complications. Rates for hypocalcemia were based on patients undergoing bilateral procedures (n = 185) and on nerves at risk for recurrent laryngeal nerve injury (n = 513). Permanent hypocalcemia (8%) and unilateral laryngeal nerve injury (2.3%) were the major complications, with 0.8% having fatal complications. The achievement of long-term normal serum calcium levels has been the most frequent complication. Recurrent laryngeal nerve injury had a significant relationship with secondary procedures, histologic findings, and no nerve identification during surgery. In our series, major complications can be blamed on technical pitfalls, even in the hands of experienced surgeons.

Adolescent↗
PubMed1991

Life-threatening cervico-mediastinal haematoma after carotid sinus massage.

Retropharyngeal and cervico-mediastinal haematomas are rare but potentially fatal entities. The potential for airway compression necessitates rapid assessment and treatment. A cervico-mediastinal haematoma following carotid sinus massage which required cervical drainage is presented. This is a life-threatening event demanding a high index of suspicion. A review of the literature and indications for treatment are discussed.

Adult↗
PubMed1990

Ossifying hemangioma of the temporal bone.

Intratemporal vascular tumors are more frequent than has previously been noted. Despite their small size, hemangiomas of the temporal bone are extremely aggressive and produce severe neural deficits. The term ossifying hemangioma is used to denote an intratemporal vascular tumor characterized by new bone formation, which is responsible for the typical honeycomb appearance of these tumors on high-resolution computed tomographic scans. Early resection offers the best chance for good facial recovery in patients with vascular tumors of the temporal bone involving the facial nerve. Our case report supports this observation and emphasizes the importance of incorporating these tumors in the differential diagnosis of patients with persistent facial paralysis.

Adult↗
PubMed1989

[Prognostic study of Bell's facial paralysis].

A prospective study was carried out to objectively quantify the most important predictor factors in idiopathic facial paralysis (Bell's palsy). Step-wise discriminant analysis was applied to data prospectively obtained from 570 patients with Bell's palsy treated in the ENT Department of La Paz Hospital between January 1983 and January 1986. In all, 37 variables were studied in each patient. With data obtained from these variables a linear discriminant function was obtained, with an overall accuracy of 95%. The rate of correct prediction is 95.8% for patients with an expected complete facial recovery, and 90.9% for the group of patients with an expected recovery of less than 100%. The discriminant function obtained is a well adaptable method for routine practice in order to objectively assess the prognosis of patients with Bell's palsy. Prognosis is one of the most challenging problems concerning idiopathic facial paralysis. The early determination of prognosis in Bell's palsy is the necessary basis for assessing the effect of different therapeutic approaches. A number of methods and parameters are used in the prognostic evaluation of Bell's palsy. To know the exact weight of each one of these factors in the determination of the course of the disease we have performed an statistical study by means of discriminant analysis (DA).

Adult↗
PubMed1989

Five-year results of functional neck dissection for cancer of the larynx.

Two hundred forty-two patients with a diagnosis of epidermoid carcinoma of the larynx were studied. All of them underwent surgery. One hundred sixty-one patients underwent functional neck dissection, with a total of 206 performed. Thirty-three patients underwent classic radical neck dissection, with a total of 35 performed. The overall 5-year neck tumor recurrence rate in the necks with functional neck dissection was 3.4%. Recurrences developed in 5.7% of fields protected by radical neck dissection. The overall recurrence rate in the surgically unprotected necks was 6.2%. Our results confirm that functional neck dissection is the procedure of choice in cases with NO disease and in cases with mobile nodes. From the oncologic viewpoint, functional neck dissection is a safe technique to treat the cervical spread from cancer of the larynx as long as its indications and technical characteristics are carefully observed.

Adult↗
PubMed1988

Bilateral simultaneous Bell's palsy. Two cases following herpes simplex gingivostomatitis.

Bilateral simultaneous Bell's palsy (BSBP) is an infrequent clinical presentation. Two patients with BSBP following a recent herpes simplex gingivostomatitis are described. From a clinical point of view, these cases support the concept that Bell's palsy may be a partial manifestation of a generalized polyneuropathy, and most probably caused by a reactivated latent herpes simplex virus.

Adolescent↗
PubMed1987

Hemangiopericytoma of the trachea.

Malignant neoplasms of the trachea are rare lesions, with no more than 400 cases documented in the literature. Only three tracheal hemangiopericytomas have been reported. We present the fourth case of such a tumour occurring in the trachea. After the first surgical resection the tumour recurred twice in a period of 10 months. The last cervicotomy performed for local recurrence showed wide cervical and mediastinal involvement of the tumour, not resectable surgically. Emphasis is placed on the surgical, pathologic and ultramicroscopic findings.

Biopsy↗
PubMed1987

Discriminant analysis in predicting survival of patients with cancer of the larynx or hypopharynx.

In order to assess the feasibility of computer-assisted prognostication, step-wise discriminant analysis was applied to data retrospectively obtained from 243 patients who underwent surgery for cancer of the larynx. In all, 62 variables were studied in each patient. Ninety-four out of 243 patients had complete information on the 62 variables studied. With data from these 94 patients a linear discriminant function was obtained, with an overall accuracy of 87.2%. The rate of correct prediction was 84.6% for cancer recurrence, and 88.2% for survival without recurrence. Only 11 variables of the 62 used for analysis were necessary to obtain these results. This paper confirms the usefulness of multivariate analysis in clinical practice.

Carcinoma, Squamous Cell↗
PubMed1986

Recurrent laryngeal nerve. Identification during thyroid and parathyroid surgery.

Intraoperative identification of the recurrent laryngeal nerve (RLN) is mandatory in surgery of the thyroid and parathyroid glands to avoid surgical damage. Several methods have been proposed for identifying and localizing the RLN based on vocal cord motion produced by electrical stimulation of the nerve. Most of them require complex instrumentation, while others are in contradiction with anatomical basis. We present a safe and simple method for identifying the RLN during thyroid and parathyroid gland surgery, which requires no additional surgical instruments and can be performed as a routine procedure. Nonetheless, thorough knowledge of cervical anatomy still remains the most important point in this surgery.

Edema↗
PubMed1986

Methylene blue infusion for intraoperative identification of the parathyroid glands.

Identifying the parathyroid glands is of fundamental importance in thyroid and parathyroid surgery. We found that intravenous infusion of methylene blue was beneficial in intraoperative identification of the parathyroid glands in patients undergoing surgery for hyperparathyroidism as well as total and bilateral subtotal thyroidectomy. The technique is safe and easy to use, and it clearly reduces the operative time. We suggest that it be used routinely in thyroid and parathyroid surgery.

Adult↗
PubMed1985

Vestibular response in denatured rape oil intoxication.

During the spring of 1981 a massive intoxication broke out in Spain, which is presently attributed to the ingestion of denatured rape oil, and which has been called 'Toxic Syndrome' (TS). We studied 51 patients affected by the TS one year after the onset of their disease, analyzing their vestibular responses in the caloric test with the help of an analog-digital computer. A significant decrease in the number of nystagmic beats of the affected patients can be observed, while the rest of the parameters studied show similar values to those found simultaneously in 30 normal subjects. It is suggested that these differences are yet another manifestation of the polyneuropathy found in intoxication by denatured rape oil.

Adolescent↗
PubMed1985

Facial electroneurography: results on normal humans.

Electroneurography (ENoG) is one of the tests recently introduced for the clinical analysis of facial paralysis. Right-left facial differences, test-retest variability and differences between the first and the last CAPs after 25 consecutive stimuli were studied in 24 normal subjects. Significant inter-subject right-left differences were not found. Intra-subject results show an average variation of 25 per cent in the amplitude between either side of the face. Test-retest variability is minimal both for the amplitude and for the latency (3.15 per cent and 1.9 per cent respectively). No differences in amplitude or in latency were found between the first and last compound action potentials gathered after 25 consecutive stimuli.

Action Potentials↗