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Biomedical subjects

D P Porto

Publications and source records attributed to D P Porto.

9 recordsLinked to original sources
PubMed1989

Postirradiation sarcomas of the head and neck.

We discuss four cases of postirradiation sarcomas of the head and neck. Two cases were metachronous sarcomas that appeared after operation and irradiation for primary sarcomas, 1 case was a mandibular malignant fibrous histiocytoma that developed on the opposite side of the jaw from a malignant histiocytic neoplasm that was irradiated 8 years previously, and 1 case was a laryngeal tumor that appeared 5 years after combined operative and radiation therapy for a laryngeal squamous carcinoma. Immunohistochemical studies more precisely defined and classified these tumors, and assisted in determining a therapeutic protocol. The therapy for postirradiation sarcomas includes extirpative operation when possible, but the role of chemotherapy is uncertain. The aggressive behavior of these neoplasms was attested to by the death of three patients within 18 months of their operations.

Adult↗
PubMed1987

Rhabdomyolysis in the patient undergoing head and neck surgery.

Rhabdomyolysis is increasingly recognized as a cause of acute renal failure. Though often the result of extensive trauma, rhabdomyolysis may also appear in the postoperative period. We describe three recent cases in patients undergoing head and neck surgery. Early diagnosis is based on laboratory and clinical examination. Treatment aimed at renal hyperperfusion with hydration and diuretics may prevent nephrotoxic reaction.

Adult↗
PubMed1987

Frontal sinus fractures. Analysis of treatment results.

A retrospective study of 112 consecutive patients with frontal sinus fractures who were available for follow-up is presented. Significant complications are possible, especially with fracture of the posterior sinus wall. When indicated, the sinus is reconstructed with wire using free denuded fragments if available. Severe complications in displaced posterior wall fractures were less common when treatment was by sinus obliteration than by cranialization. Computed tomography has improved the evaluation, especially when a posterior wall fracture is suspected.

Anti-Bacterial Agents↗
PubMed1987

Oral cavity reconstruction using the free radial forearm flap.

While a number of flaps are available that can "plug the hole" created by the resection of an oral cavity malignancy, the final functional and cosmetic result is often far from satisfactory. The ideal flap for this area should provide a one-stage, reliable reconstruction (regardless of previous surgery or irradiation) with the options of thin pliable skin and/or vascularized bone. Donor-site morbidity must be acceptable. In our experience, the free radial forearm flap best approaches these ideals. Unfortunately, it has received relatively little attention in the otolaryngology literature. The results of using 15 of these flaps to reconstruct 14 oral cavity defects are reported here. Despite the fact that most of the reconstructions were performed in older patients who had undergone irradiation (nine of 14) and previous surgical treatment (ten of 14), there were no flap failures. Hospital stays were short (less than two weeks), cosmetic results were good, and all but one patient had resumed oral intake by the time of hospital discharge. The specific applications and limitations of this flap are emphasized so that the reader can better understand its role in head and neck reconstructive surgery.

Adult↗
PubMed1986

Long-term results with nasofrontal duct reconstruction.

The findings and results of 50 consecutive nasofrontal duct reconstructions are analyzed and presented. Postoperative recurrence of frontal sinus disease occurred in 14% of the cases and there were no significant postoperative or intraoperative complications. There was no instance of failure in patients with a history of trauma to the nasofrontal duct and only two recurrences in patients with mucocele or pyocele. Nasofrontal duct reconstruction offers more direct access to the ethmoid cell system than osteoplastic flap obliteration. In addition, it is a lesser procedure with fewer complications. The physiologic function of the sinus is restored without the risk of burying disease. Nasofrontal duct reconstruction is an effective option for the treatment of chronic frontal sinus disease if the sinus mucosa is not irreversibly damaged.

Adult↗
PubMedDate not supplied

Emergency management of carotid artery rupture.

Rupture of the carotid artery has been one of the most feared postoperative complications in head and neck cancer patients. Traditional management of carotid artery rupture has been disappointing, and morbidity and mortality have been high. Experience with carotid artery rupture at the authors' institution over the past 20 years has been reviewed. The current method of management seems to result in a decreased number of neurologic sequelae and episodes of rebleeding. Of the last 23 carotid ruptures encountered, four occurred while the patient was at home. Two patients had neurologic complications, and there were two deaths. Only one episode of rebleeding occurred. All patients except one were discharged from the hospital. These patients were managed according to an established protocol, and the results of the authors' experience are reported and analyzed. Preoperative preparation prior to ligation is explained, and prognostic indicators and risk factors are reviewed.

Adult↗
PubMedDate not supplied

Neuroendocrine carcinoma of the larynx.

Neoplasms of the larynx showing neuroendocrine differentiation are uncommon, with less than 100 previously reported cases. These tumors encompass subcategories that have been designated heretofore as "malignant carcinoid" and "oat cell carcinoma" and have been associated with ectopic production of neuropeptides and biogenic amines. We report a case of neuroendocrine carcinoma that arose in the epiglottis in an elderly man, metastasized widely, and was responsible for death. Immunohistochemical studies showed the presence of serotonin, calcitonin, ACTH, met-enkephalin, chromogranin, and neuron-specific enolase within tumor cells, although clinical endocrinopathy was absent. This case is used as a focus for discussion of the spectrum of neuroendocrine tumors of the head and neck, including recommended treatment approaches for such neoplasms.

Carcinoid Tumor↗
PubMedDate not supplied

Infantile lobar emphysema.

Infantile lobar emphysema is a symptom complex representing a spectrum of diseases characterized by overdistention of a pulmonary lobe by a check valve mechanism. The earlier in life infantile lobar emphysema presents, the more severe are the symptoms. Half of the cases appear in the first 4 weeks of life. The chest radiograph is the best diagnostic tool but can be misinterpreted. Computed tomography sometimes discloses the cause, which appears to be bronchial obstruction in 25% of cases. The bronchial obstruction may be due to intrinsic defects or to extrinsic compression. Bronchoscopy should be performed only in certain cases and then only with careful anesthetic management.

Bronchi↗