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Biomedical subjects

E Zapater

Publications and source records attributed to E Zapater.

At least 19 recordsLinked to original sources
PubMed2006

Electrosurgical endoscopic cordectomy with microdissection electrodes: a comparative study with CO2 laser.

Microdissection electrodes (MEs) have previously been used to perform endoscopic cordectomies. We designed a prospective study in order to compare the ME with the CO2 laser technique. Over two years, 20 patients with T1 glottic carcinoma were operated on with CO2 laser and 20 with MEs. The device was chosen alternatively for each new patient. Two patients in both treatment groups had slight glottic incompetence. Three patients in each group showed web formation. The only granuloma was observed in a CO2 laser patient. Seven of the ME patients developed slight dysphonia, 10 developed medium grade dysphonia and three developed severe dysphonia. Seven of the CO2 laser patients developed slight dysphonia, seven developed medium grade dysphonia and six developed severe dysphonia. No statistically significant differences were observed on comparing the grade of dysphonia with patient age, T stage, type of cordectomy or surgical device. We consider the ME to be a useful and inexpensive alternative to CO2 laser.

Adult↗
PubMed2003

Upper lateral cartilage transposition in the surgical management of nasal valve incompetence.

INTRODUCTION: The treatment of nasal valve dysfunction is very controversial and many otorhinolaryngologists do not always take surgery into consideration. The purpose of this paper is to present the author's surgical technique and the description of 13 patients on which it may work. MATERIAL AND METHOD: Thirteen cases presenting with nasal obstruction secondary to nasal valve dysfunction are reviewed. All of the patients presented with internal valvulary incompetence and in three of them an alar collapse was associated. Diagnosis was achieved by means of the clinical findings and physical examination. An open rhinoplasty approach was employed. The surgical technique consisted in a transposition of the upper lateral cartilage over the alar cartilage. In the three patients with alar collapse a fixation graft from the septal cartilage was also employed. RESULTS: Nasal obstruction and valvular incompetence seemed improved in all of the cases. CONCLUSION: Upper lateral cartilage transposition seems to be an adequate method to solve the nasal valve incompetence.

Adult↗
PubMed2002

[Intelligent system to perform a diagnostic protocol for lymphatic invasion in laryngeal cancer].

Laryngeal carcinoma is the most frequent malignant tumour in head and neck. Node invasion is known to be one of the most important prognostic factors. The aim of this study has been to design an intelligent system to perform a diagnostic algorithm of metastasic neck nodes. 122 clinical reports of patients diagnosed of laryngeal carcinoma in our department have been reviewed. The compiled data have been: tumor site, T stage, N stage (clinical, after CT scan and post-surgery). The method used to design the intelligent system has been the ID3, which is able to generate a minimal decision tree. Palpation has been the variable that has given more information about node invasion. CT has proved to be more efficient in supraglottic tumours. ID3 method has shown to be useful in performing diagnostic algorithms, specially when the number of cases and diagnostic tests are high.

Adult↗
PubMed2002

[Delayed deltoid-pectoral flap].

Delayed flaps include surgical techniques performed in order to diminish the blood supply of a flap before placing it at the definitive location. The purpose is to improve the irrigation of the distal region of the flap. Three cases of head and neck reconstructions with delayed deltopectoral flaps are reported. Literature about anatomic and physiologic phenomenon occurred during the delay period is reviewed, as well as the different surgical techniques described to delay a flap. We think that the deltopectoral flap remains an adequate technique, being indicated when the reconstruction is impossible with local flaps. That is the case of defects or irradiated regions. In our opinion, if the deltoid region of the flap is necessary to the reconstruction it is recommended to delay the flap, to increase the probability of complete survival at the distal region. In our cases the delay period has been one week, obtaining a complete survival of the flap in all of them.

Aged↗
PubMed2001

[Radial free flap with drainage through the cephalic vein dissected up to the deltoid region: a resource in the absence of receptor veins].

Repeated treatments on the neck in head and neck oncological patients make more and more difficult to elaborate microvascularized flaps because sometimes it is necessary to sacrifice receptor veins. In this paper it is showed one way of solving this problem, by dissection of the cephalic vein towards the deltoid region, keeping the venous pedicle intact. In this fashion venous anastomosis is avoided, getting efficient blood drainage. Simplicity and efficiency of this technique make possible thinking about it even with existing receptors veins. The main inconvenience is the surgical scare on the anterior region of the arm.

Arm↗
PubMed2000

[Prognostic factors in supraglottic laryngeal cancer: a review of 74 cases].

Laryngeal carcinoma is a frequent neoplasm in Spain, constituting about 5.6% of all malignant tumors. The supraglottic location is more frequent than either glottic or subglottic sites. Prognostic factors were analyzed in a series of 74 supraglottic laryngeal carcinomas. Two statistical methods were used. Firstly, Cox regression, a multivariate analysis that defines a survival function of the patients, was used to detect variables with prognostic influence. Secondly, mortality tables were studied for all of them. This univariate method is used to determine the number of patients for every option of a study variable and their survival. The most important prognostic variables in our series were: tracheostomy before surgery, pathological study of the cervical nodes, time from surgery to radiotherapy, type of biopsy, and alcohol use.

Adult↗
PubMed2000

Contribution of artificial intelligence to the knowledge of prognostic factors in laryngeal carcinoma.

Many studies have investigated prognostic factors in laryngeal carcinoma, with sometimes conflicting results. Apart from the importance of environmental factors, the different statistical methods employed may have influenced such discrepancies. A program based on artificial intelligence techniques is designed to determine the prognostic factors in a series of 122 laryngeal carcinomas. The results obtained are compared with those derived from two classical statistical methods (Cox regression and mortality tables). Tumor location was found to be the most important prognostic factor by all methods. The proposed intelligent system is found to be a sound method capable of detecting exceptional cases.

Aged↗
PubMed1999

[Progression of profound perceptive deafness in children].

We have studied 340 cases of deep neurisensorial deafness in children and their evolution along a 7.2 years term. Conventional audiometry has been used as commonest method for assessing the auditive function. In a considerable number of cases (15.9%) hearing loss was progressive and some relation referring to sex, the bearing of hearing aids and the etiology is statistically contemplated.

Audiometry, Pure-Tone↗
PubMed1998

Pull-through oropharyngectomy in advanced stage malignant tumours.

Surgery is the first therapeutic option in extensive oropharyngeal carcinomas. An operation to treat these tumours is described, based on the hemiglossopelvectomy without mandibulectomy technique. Tumours located in the oropharynx are resected downwards by a modified pull-through approach, performing the resection of the oropharyngeal tumour in monoblock with the ipsilateral neck dissection, avoiding any action upon the mandible. The operation has been performed in 14 consecutive patients. By avoiding either mandibulotomy or mandibulectomy, morbidity and post-operative recovery are improved.

Humans↗
PubMed1996

Cholesterol granuloma of the middle ear: report of 5 cases.

Cholesterol granulomas of the middle ear (CGME) constitute a focal inflammatory response with foreign body giant cells mobilized against the presence of cholesterol crystals. The air spaces within the temporal bone are commonly affected, especially in association with chronic disease of the middle ear involving diminished ventilation. The aim of this paper is to review 5 cases of CGME. The authors intend to establish the etiology of CGME and its likely relationship with other common middle ear diseases.

Adolescent↗
PubMed1996

Invasive fungal sinusitis in immunosuppressed patients. Report of three cases.

Report of three cases. Newly appeared immunosuppression related conditions have led to an increase in morbidity of systemic opportunistic mycoses. Rhinosinusal infection has also increased in frequency. Three invasive nasosinusal mycoses are presented: two cases of mucormycosis and a simultaneous infection by mucormycosis and candida albicans. In all cases, and despite treatment, progression of the disease could not be stopped and the patients died. The main characteristics of invasive nasosinusal mycoses are reviewed, to obtain early diagnosis. Early therapy improves the prognosis, and thus clinical suspicion justifies treatment before establishing a microbiological diagnosis.

AIDS-Related Opportunistic Infections↗
PubMed1996

Non-Hodgkin's lymphoma of the head and neck in association with HIV infection.

People infected with HIV have a greater risk of developing malignancies. The most frequent one is the Kaposi's sarcoma (KS). The second is the Non-Hodgkin's lymphoma (NHL). We report six cases of NHL in association with HIV infection (NHL-HIV) of the head and neck. Three of them had extranodal location (2 oral lymphomas and one case affecting the maxillary sinus). The other 3 cases were located in the cervical nodes. The oral malignancies were treated with radiotherapy (RT). Chemotherapy was applied to the other 4. Only one of our patients has survived more than two years. In one case the NHL was the first manifestation of the infection with HIV. Diagnosis of extranodal NHL requires search for AIDS.

Adult↗
PubMedDate not supplied

[Reconstruction of the floor of the nasal cavity, hemipalate, bucal cheek and lower lip].

We describe the surgical technique used to reconstruct a defect created by resection of a tumor of the palate, malar mucosa, lower lip and adjacent gingival mucosa. We used a microvascular radial forearm flap. A strip across the flap is de-epithelialized and the flap is folded in half at that point. The sides are used for the oral and nasal linings, respectively. The thinness of this flap, its vascularization and the length of its pedicle make this design possible. Four months after the surgery the patient was free of disease and had achieved adequate phonation and swallowing.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

[Experience in the treatment of 98 carcinomas of the nasopharynx. Long-term follow-up and analysis of prognostic factors].

This was a retrospective study of 98 patients (pts.) with histologically confirmed nasopharyngeal carcinoma. The clinico-demographic characteristics were: median age of 53 years (11-83); 74 males and 24 females (ratio 3:1); histology subtype OMS 2-3 in 89 pts. (90.8%); cranial nerve deficits in 11 pts. (11.2%); 50 (51%) were stage T3T4; 68 pts. (69.4%) N2N3 and 77 pts. (78.6%) stage IV. The therapeutic modalities were: radical radiotherapy (RT) alone in 42 pts., chemotherapy (CT) alone in 4 pts., RT + adjuvant CT in 10 pts. and neoadjuvant CT + RT in 42 pts. RT was delivered in wide fields, doses between 50-75 Gy with conventional fractionation. CT consisted in cisplatinum-based schedules (PF in 34 pts., BEC in 9 and others in 13 pts.). Analyzed by treatment, more males and stages N2N3 and IV were accrued in neoCT + RT arm (p < or = 0.05). For the entire population, the overall complete response was achieved in 65 pts. (66.3%); in 27/35 pts. (77.1%) of the RT group and 30/51 pts. (58.8%) of CT + RT group (p 0.07) of pts. with III-IV stages. With a median follow-up of 74.5 months, 32 pts. (32.65%) are alive and free of disease. The projected OS for all pts. was 40 months (m), 51.4% at 3 years (y) and 45.5% at 5 y with a disease free survival of 37 m (0-236). No differences between treatment arms were found (p 0.4). In univariant analysis for OS in stage III-IV pts., age > 50 y, histology OMS1, cranial nerve deficits, stage T3T4 and N2N3, were considered adverse prognostic factors (p < or = 0.05). In multivariant analysis, only age > 50 y and stages T3-T4, N2-N3 were significant (p < or = 0.05). In conclusion, we demonstrated good long term survival without any differences among treatment modalities in pts. with advanced nasopharyngeal carcinomas. New therapeutic approaches are warranted in order to improve the outcome of this patients.

Adolescent↗
PubMedDate not supplied

Malignant fibrous histiocytoma of the head and neck. Case report.

Malignant fibrous histiocytoma (MFH) is a rare tumor included in the group of soft tissue sarcomas. Approximately 1-3% of these tumors affect the head and neck, with about 100 cases reported to date. A case affecting the retromolar trigone and involving the postero-lateral portion of the left hemi-tongue is reported. Etiological and pathological aspects are discussed. Diagnosis, treatment and prognosis of this neoplasm are reviewed.

Aged↗
PubMedDate not supplied

[Pleomorphic adenoma of the minor salivary gland].

Minor salivary gland tumors represent about 10-15% of salivary gland tumors. The most frequently seen histological type are pleomorphic adenomas, which are usually located at the hard palate. Clinical and pathological features of 7 cases are reviewed.

Adenoma, Pleomorphic↗
PubMedDate not supplied

[The effect of visual feedback exercises on balance in normal subjects].

The effects of visual feedback exercises on balance was studied in normal individuals, to evaluate the efficacy of visual feedback of postural oscillation in improving stability. A DINAS-CAN dynamometric platform designed by the Valencian Institute of Biomechanics (IBv) was used. Before to commencing training sessions, we determined the following parameters in each individual: (a) static stability, via posturography; and (b) individual ability to displace and voluntarily maintain the center of gravity within the limits of stability. All static measures were poorer after training, but the differences were not significant (p > 0.01). In contrast, the exercises performed via visual feedback of postural control improved significantly (p < 0.01). Training by visual feedback facilitates integration of visual, somatosensory, and vestibular information. In normal individuals, stability improves under excentric conditions, but no improvement is seen in the central resting position.

Adult↗