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Biomedical subjects

G T Simpson

Publications and source records attributed to G T Simpson.

At least 19 recordsLinked to original sources
PubMed1990

Laser epiglottectomy: endoscopic technique and indications.

Endoscopic epiglottectomy (epiglottidectomy) may be performed with relative ease and minimal morbidity by using standard microlaryngoscopy techniques and the CO2 laser. Depending on the indications, the removal may be partial or complete. Indications for 51 epiglottectomies included treatment of supraglottic airway obstruction--30 cases; discovery of benign or malignant neoplasm (diagnosis and staging)--20 cases; treatment of malignant neoplasm--7 cases; glottic visualization--4 cases; and treatment of chronic inflammatory conditions--1 case. It is not unusual for a patient to have more than one indication for this procedure. Some epiglottic cancers invade the pre-epiglottic space. This crucial information may not be detectable by MRI or CT scanning techniques. Laser epiglottectomy provides a method to explore and perform a biopsy of the pre-epiglottic space and thereby stage these lesions accurately. There are no significant problems with postoperative alimentation, airway, or voice. Any form of primary or adjuvant therapy can be started without delay.

Airway Obstruction↗
PubMed1985

Lymphoscintigraphy of the neck.

Lymph node imaging has been helpful in managing patients with lymphoma, melanoma, and breast cancer. To evaluate 38 patients with head and neck cancers, 99mTc minicolloid was injected adjacent to the tumor and into a similar area on the uninvolved side. Lymphoscintigraphy of the neck was performed at 3- and 5-hour intervals after injection and bilateral cervical lymphatic drainage was observed. Each patient then underwent a neck dissection. The pathologic node findings were then correlated with the neck scans. Results confirmed that cervical lymphatic drainage is unpredictable in 50% of the patients once the channels are involved with metastatic disease. Lymphoscintigraphy is not a reliable method of detecting early metastatic cervical carcinoma.

Carcinoma, Squamous Cell↗
PubMed1984

Excisional biopsy in the selective management of T1 glottic cancer: a three-year follow-up study.

Transoral excisional biopsy has been used in the evaluation and management of 103 T1 glottic cancers. A 3-year follow-up on these patients indicates that excisional biopsy unequivocally established the diagnosis and stage of the disease and that it is adequate treatment for micro and mini squamous cell cancers of the glottis in which the margins of excision are clear. Excisional biopsy with positive margins and larger T1 tumors establishes the absolute need for radiotherapy. Excisional biopsy is ideal for the diagnosis and management of verrucous carcinoma and spindle cell carcinoma. Recurrent/residual squamous cell carcinoma after radiotherapy should be explored by excisional biopsy which may be curative or will establish the need for partial or total laryngectomy. The appropriate use of excisional biopsy in the selective management of early T1 glottic cancers requires attention to detail by the surgeon and the pathologist and sound clinical judgment.

Biopsy↗
PubMed1983

Natural history and management of keratosis, atypia, carcinoma-in situ, and microinvasive cancer of the larynx.

Keratosis, atypia, carcinoma in situ, and microinvasive cancer occurring as white or red patches on the vocal cords are part of the diathesis of cancer of the aerodigestive tract and represented a sequential continuum. Excisional biopsy is the preferred treatment for identification and potential cure of the lesion. If the margins of excision are inadequate, further treatment options are either reexcision or radiotherapy. Radiotherapy should be used only when the need for voice conservation prevails. Cessation of smoking does not remove the potential for progression of the disease, therefore, all patients must be followed indefinitely. Excisional biopsy of keratosis, carcinoma in situ, and microinvasive cancer of the larynx offers an excellent prognosis for voice preservation and survival.

Adult↗
PubMed1983

Palliation of airway obstruction from tracheobronchial malignancy: use of the CO2 laser bronchoscope.

A CO2 laser rigid bronchoscope system has been used to palliate symptoms of a malignancy obstructing the tracheobronchial airway. Fifty-nine endoscopic laser operations (34 patients) were done between 1975 and 1981. Severe dyspnea and obstructive atelectasis were the most common indications for treatment. Contraindications for treatment included extrinsic tracheobronchial compression, widespread distant metastases, rapidly progressing tumors, and highly vascular neoplasms. There were nine primary tracheal malignancies, five metastases from distant sites, and 20 primary lung cancers with tracheobronchial obstructions. Most patients were previously treated with one or more standard modalities (radiation therapy, surgery, and chemotherapy). Removal of airway obstruction was occasionally indicated prior to radiation therapy to facilitate treatment. There were seven instances of complications in this group of patients and one mortality. Most patients (23 of 34) have died from their malignancy. The best palliation was achieved in proximal (tracheal and main stem bronchial), slower growing tumors.

Aged↗
PubMed1983

History of the carbon dioxide laser in otolaryngologic surgery.

The review of recent history shows that since the initial discovery of the principle of the laser, rapid dissemination and application of this modality in the field of medicine have occurred. The use of laser energy has become an established technique in microsurgery and endoscopic surgery, particularly in the field of otolaryngology and head and neck surgery. Laser instruments and surgical techniques and experience are becoming increasingly widely appreciated. All these developments are a tribute to the imagination and determination of a few individuals who were instrumental in recognizing the potential of laser energy for surgical application and in developing and using this new modality in clinical surgery. The major developments in laser surgery include early laboratory studies of laser surgical applications and their effects, the invention and development of instruments allowing application of laser energy in a variety of surgical settings, particularly the upper aerodigestive tract, and clinical studies confirming the efficacy of laser surgery. Other significant developments include the successful application of laser surgery in the eradication or control of selected cancers in the upper aerodigestive tract, including the tracheobronchial tree. Although a firm foundation for laser surgery is well established, its future offers a wide vista of new opportunities.

Animals↗
PubMed1983

Lasers in bronchology.

Endoscopic application of carbon dioxide and YAG laser technology is an important surgical adjuvant for the treatment of tracheobronchial airway obstruction. In cases of malignant disease of the tracheobronchial tree, laser surgery should be considered when definitive treatment (surgery, radiotherapy, and chemotherapy) has failed or is not applicable. The importance of careful selection of patients cannot be overemphasized. In selected cases of benign tracheobronchial lesions and stenosis, endoscopic laser surgery may be used with minimal morbidity. Rapid advances and refinements in laser technology and instrumentation present "new frontiers" for the bronchologist. Endoscopic laser surgery has established its place along with standard therapeutic modalities.

Bronchial Diseases↗
PubMed1982

Rhinologic surgery with the carbon dioxide laser.

Microscopic nasal surgery with the CO2 laser is easily performed. It offers the advantages of excellent hemostasis (even with coagulopathies), excellent healing, minimal discomfort and minimal complications. A wide variety of lesions may be excised, obliterated, or corrected in any age group. We report our experiences with 26 cases of rhinologic surgery with the CO2 laser. These cases represent a variety of pathologic lelsions including telangiectasias, papillomas, nasal polyps, synechiae and granulomas, rhinophymas, sebaceous adenomas, and an adenocarcinoma. This is the first comprehensive report of the use of this technique in nasal surgery.

Adult↗