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D P Vrabec

Publications and source records attributed to D P Vrabec.

At least 19 recordsLinked to original sources
PubMed1991

Radiotherapy. The mainstay in the treatment of early glottic carcinoma.

Early squamous cell carcinoma of the glottis may be effectively treated with surgery or radiation therapy. Controversy exists as to whether radiation therapy effects survival at the expense of vocal function by ultimately requiring more total laryngectomies for salvage of local tumor recurrence. This study reviewed the medical records of 185 patients with T1 or T2, NO invasive squamous cell carcinoma of the glottis treated with primary radiation therapy between 1969 and 1984. All patients were followed up for a minimum of 5 years after completion of therapy. One hundred sixty-one patients met the criteria for local control analysis. Radiation therapy controlled disease in 93% (105 of 113) of patients with T1 lesions and 73% (38 of 48) of those with T2 tumors. Ultimate control of disease for T1 and T2 lesions, including surgical salvage, was 111 (98%) of 113 and 44 (92%) of 48 patients, respectively. The rate of successful surgical salvage was 75% (T1) and 70% (T2). The T2 lesions with impaired vocal cord mobility or anterior commissure disease were identified as being at increased risk for recurrence after primary radiation therapy. Overall voice preservation was 90%. Our data demonstrate that radiation therapy effects disease-free survival rates that are comparable to those produced by surgery, without sacrificing voice. Although a small percentage of patients with selected early glottic lesions may be more effectively treated with primary conservation surgery, these data do not support a change in philosophy concerning primary treatment of early glottic cancer with radiation therapy.

Carcinoma, Squamous Cell↗
PubMed1989

Uvulopalatopharyngoplasty: postoperative management and evaluation of results.

Since the earliest report of success with the uvulopalatopharyngoplasty (UPPP) operation, several authors have reported less than optimal results in their experience with the procedure. Part of the difficulty in evaluating the objective results of postoperative sleep studies has been the variations in reporting data. In addition, no standard of postoperative care, including analgesia, and immediate postoperative monitoring has been described. Our experience with 42 UPPP patients (34 studied with preoperative and postoperative polysomnography) indicates a 76% response (56% successes, and an additional 20% with limited success) with use of the more stringent criteria described recently. We discuss our management of these cases, including postoperative oxygen saturation monitoring and avoidance of narcotic analgesia as necessary factors for success with this operation.

Female↗
PubMed1987

Primary small cell carcinoma of the larynx: analysis of treatment.

Primary small cell carcinoma of the larynx continues to pose problems in its treatment. Four patients with this neoplasm were seen in a seven-year period at our institution and 49 patients were reviewed from the world literature. The only variables which significantly affected survival were the presence of metastases at initial examination and treatment modality. Those patients treated with chemotherapy and radiation therapy had an increased length of survival and increased chance of survival as compared to patients subjected to other treatment modalities. Because of the small number of patients reported in the world literature and lack of controlled studies, the treatment of small cell carcinoma of the larynx remains controversial; this retrospective analysis suggests that combination chemotherapy plus radiation offers the best chance for cure.

Aged↗
PubMed1980

Small cell anaplastic carcinoma of the larynx: review of the literature and report of a case.

The case study of a patient with small cell anaplastic carcinoma (oat cell) of the larynx is detailed and the literature is reviewed. Small cell anaplastic carcinoma of the larynx has been demonstrated to be histologically identical to small cell anaplastic carcinoma of bronchogenic origin. The aggressive biologic behavior of this tumor justifies managing small cell anaplastic carcinoma as a systemic disease. Because of early widespread dissemination of tumor, surgery or radiotherapy alone or in combination have not been successful in controlling the disease. The combination of radiotherapy with chemotherapy has been shown to be the most effective approach to the treatment of small cell anaplastic carcinoma of the lung. We believe that a similar regimen should be considered the treatment of choice for small cell anaplastic carcinoma of the larynx.

Aged↗
PubMed1978

Cervicofacial actinomycosis.

Actinomycotic infections are unusual, but the actual incidence is likely to be significantly higher than records indicate. The disease may complicate trauma of many types to the respiratory and digestive tracts, including operative procedures. This possibility should encourage more frequent use of anaerobic cultures in inflammatory diseases, particularly posttraumatic, and should prompt consideration of actinomycosis in the differential diagnosis of infections, especially in the cervicofacial area. We report four cases that demonstrate the variable course of this infection. Treatment is highly successful with appropriate use of antibiotics and surgery. A plea is made to use the least expensive, effective antibiotic in view of the prolonged course of therapy that is necessary to eradicate this infection.

Abscess↗
PubMed1975

The inverted Schneiderian papilloma: a clinical and pathological study.

Inverted papillomas which arise from the lining membranes of the nose and paranasal sinuses are relatively unfamiliar lesions which have been reported in the literature under a variety of titles. The uncertainly surrounding their etiology, their relationship to nasal polyps and their malignant potential have resulted in an ill-defined clinical approach to their management. The designation Inverted Schneiderian Papilloma is suggested as an appropriate title that best conveys the qualities of inversion, location and distinctiveness of character. The characteristic microscopic feature is the increase in thickness of the covering epithelium with extensive invasion of this hyperplastic epithelium into the underlying stroma. In the absence of a better explanation of the origin, the tumor should be considered a true epithelial neoplasm. The clinical features in 24 previously unreported cases are presented. The most common presenting complaints are nasal obstruction and epistaxis. The common site of origin is the lateral nasal wall in the region of the middle meatus and ethmoid cells. In no instance was an isolated lesion of the maxillary, frontal or sphenoid sinus present. The most characteristic attributes of the tumor were its tendency to recur, its destructive capacity and its propensity to be associated with malignancy. The common radiographic abnormality on routine sinus films was unilateral opacification of the sinuses and nasal airway. Tomography is helpful in defining the extent of the lesion and in selecting an appropriate surgical approach. A philosophy of management has evolved based on the experiences gained from these 24 patients, combined with a review of the experience of others and a study of the regional anatomy. Surgical excision is the treatment of choice. A bold surgical approach has been used for tumors involving the lateral nasal wall and paranasal sinuses. A lateral rhinotomy incision is employed and when necessary, this exposure is increased by extending the incision of split the upper lip and reflect the cheek flap as is customarily done with the Weber-Ferfusson incision. Fifteen patients have been followed for more than two years and the results have been excellent with the exception of one patient who later developed an invasive squamous carcinoma. An associated malignancy was found in 12.5 percent of the cases.

Adult↗