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Cesare Piazza

Publications and source records attributed to Cesare Piazza.

22 records · Page 2Linked to original sources
PubMed2003

Preoperative and postoperative voice in Tis-T1 glottic cancer treated by endoscopic cordectomy: an additional issue for patient counseling.

Radiotherapy contends with endoscopic surgery for the role of treatment of choice for Tis-T1 glottic cancer. The amount of vocal cord to be surgically removed logically depends on the surface and deep extension of the neoplasm. Thus, a prerequisite for proper management includes an analysis of the voice changes after each of the progressive types of cordectomy described in the European Laryngological Society Classification. Between January 1998 and December 2000, 89 patients with glottic cancer (8 Tis, 63 T1a, 18 T1b) underwent different types of endoscopic cordectomy. Perceptual analysis (GRBAS scale); objective analyses of jitter, shimmer, and noise-to-harmonics ratio; and subjective (Voice Handicap Index) evaluation of voice were performed in 51 patients. Statistical evaluation of preoperative and postoperative objective results by analysis of covariance, as well as perceptual and subjective data, showed significant voice improvement after type I and II cordectomies, with the voice attaining nearly normal parameters. By contrast, after type III, IV, and V cordectomies, the vocal outcome was not significantly different from the preoperative pattern. It can therefore be concluded that type I and II resections, whenever indicated, are adequate procedures even for professional voice users. By contrast, accurate counseling is mandatory before type III, IV, and V cordectomies.

Aged↗
PubMed2002

Idiopathic subglottic stenosis: management by endoscopic and open-neck surgery in a series of 30 patients.

We describe our experience in the diagnosis and treatment of idiopathic subglottic stenosis (ISS), a rare pathological entity involving the subglottic larynx and the first tracheal rings and affecting virtually only females. Its diagnosis can be made only after the exclusion of all other known causes of subglottic stenosis. In a 17-year period, between January 1986 and June 2002, 30 patients were admitted and treated for ISS at the Department of Otolaryngology and/or the Center for Respiratory Endoscopy and Laser Therapy, the University of Brescia, Italy. Clinical, endoscopic and surgical records were retrospectively analyzed with particular emphasis on treatment (endoscopic versus open-neck procedures) and follow-up. Based on our experience, we can define endoscopic treatment by carbon dioxide or Nd:YAG laser-assisted dilatation and scar tissue resection with or without airway stenting as the treatment of choice for the initial management of ISS. After repeated endoscopic failures, open-neck surgery by laryngoplasty or laryngotracheal resection and anastomosis is strongly recommended, particularly for complex lesions longer than 1 cm.

Adult↗
PubMed2002

Internal jugular vein patency after lateral neck dissection: a prospective study.

In spite of anatomical preservation of the internal jugular vein (IJV), an occlusion rate of the vessel of up to 30% has been documented after selective or modified radical neck dissections. The aim of the present prospective study was to evaluate the patency of the IJV following selective lateral neck dissection (LND) in 34 patients affected by squamous cell carcinoma of the upper aerodigestive tract who underwent surgery concomitantly on the primary site and the neck. Eighteen patients received unilateral and 16 bilateral LND, for a total of 50 IJVs. Postoperative radiotherapy on the neck was delivered in four patients with histologic evidence of micro-extracapsular spread; the impact of this variable on IJV patency was assessed by the Fisher test. A preoperative baseline study of vein patency and flow by ultrasonography (US) was obtained. Postoperative controls were scheduled at 1 week, 1 month and 3 months following surgery. No patient developed either wound infection or a pharyngocutaneous fistula, and no signs or symptoms of IJV occlusion were observed during the postoperative course. At the first US control, 25 IJVs (50%) did not present any alteration in patency, and 23 (46%) and 2 (4%) had a reduced or absent flow, respectively. At the second and third controls, 33 (66%) and 45 (90%) of the IJVs presented with normal flow, respectively. At the end of the study, none of the patients showed evidence of occlusion. Postoperative radiotherapy did not have a statistically significant impact on IJV patency ( P=0.09). In conclusion, long-term IJV occlusion after LND has to be considered an exceedingly rare event with negligible morbidity. However, alterations of IJV flow frequently occur in the immediate postoperative course.

Adult↗