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Biomedical subjects

E J van der Schans

Publications and source records attributed to E J van der Schans.

9 recordsLinked to original sources
PubMed1987

Treatment of congenital cricoid stenosis.

Congenital cricoid stenosis is a rare malformation generally diagnosed at autopsy. Out of a total of fourteen cases reported by others, only five were treated successfully. Over a 10-year period, seven patients presented with congenital cricoid stenosis at the Sophia Children's Hospital in Rotterdam. On the basis of these numbers we surmise that this anomaly is less rare than is commonly thought. All seven patients were treated successfully. A new method of treatment is described, consisting of a combination of microsurgical laryngofissure and prolonged intubation with a new, low-friction, atoxic, soft, silicone rubber nasotracheal tube. The specially designed intubation material is also recommended for the treatment of iatrogenically damaged airways. The results indicate that this method constitutes a major advance not only in the treatment of cricoid stenosis but also in the treatment of damaged airways.

Child, Preschool↗
PubMed1987

Surgical treatment of congenital laryngotracheo-oesophageal cleft.

Laryngotracheo-oesophageal cleft has been considered a rare congenital anomaly, diagnosed when there is respiratory distress on feeding, associated with multiple congenital disorders. A tracheo-oesophageal fistula should be excluded. Diagnosis, even in skillful endoscopic hands, is difficult. Different approaches to surgical repair have been advocated in literature. Most authors prefer the lateral approach. Only 7 patients have reportedly been treated via the anterior approach. The anterior approach offers the advantage of excellent and also easy exposure of the anomaly. The theoretical disadvantage of postoperative laryngeal instability is not substantiated by experimental work (Calcaterra, Ann Otol 83:810-813, 1974), nor by our own clinical experience in six juvenile patients who underwent laryngofissure for other reasons. A further advantage of the anterior approach is that the laryngeal nerves are not jeopardized as in the lateral approach. We have treated 4 patients. Two patients have been treated successfully via a lateral pharyngotomy approach; each of them has a left recurrent nerve palsy. The other two patients were treated via a laryngofissure, one of them successfully; in the other patient the cleft has been closed with success, but the larynx is still stenosed by excessive mucous membrane folds. Cicatricial subglottic stenosis, which may occur postoperatively, and the frequently coinciding tracheomalacia, have been successfully treated with prolonged nasotracheal intubation with siliconized silicone rubber tubes. Four patients were treated successfully. Three other patients have come to our attention. As is often the case, this disorder seems to occur more frequently than was previously thought.

Esophagus↗
PubMed1985

Adenoid cystic carcinoma of the upper digestive and respiratory tracts. A retrospective study of 59 cases.

Fifty-nine cases of adenoid cystic carcinoma (ACC) in the head and neck were reviewed and the treatment and follow-up results from 1950 to 1983 are reported. Nearly all patients were treated with combined therapy, i.e. surgery and radiotherapy, and the actuarial survival rate was 68% after 5 years, 45% after 10 years, and 30% after 15 years. Modern radiotherapy seems a very valuable means of treatment, not only as a palliative measure.

Adult↗
PubMed1984

High frequency ventilation in laser surgery of the larynx.

For endolaryngeal laser surgery an anaesthetic technique is required which provides the surgeon good access to the larynx. High frequency ventilation of the lungs using a FG 14 insufflation catheter covered by aluminium foil has proved to give a nearly optimal condition for the surgeon, while the fully paralyzed patient is very well ventilated. This has been used in more than 1000 patients, 200 of them have been treated by the laser beam in the airway. A method of total intravenous anaesthesia is described using short acting drugs. This way early awakening after surgery in the airways prevents aspiration of blood or debris into the lungs.

Catheterization↗
PubMed1984

Endoscopic laser surgery for hypopharyngeal diverticula--a preliminary report.

Endoscopic laser surgery for hypopharyngeal diverticula was performed in 28 patients. Complete relief of symptoms was achieved in 22, whilst the remaining patients improved considerably. The rate of complications was low. This new application of laser surgery proved to be a safe and reliable method of treatment for dysphagia caused by a hypopharyngeal diverticulum.

Aged↗