Decompression surgery for thyroid-associated orbitopathy--a ten year experience.
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Decompression, Surgical↗
Biomedical subjects
P Bumb
Publications and source records attributed to P Bumb.
Carcinoma of the hypopharynx and the cervical oesophagus: a surgical challenge.
OBJECTIVE: To report our results after reconstruction of the upper digestive tract for locally advanced carcinoma of the hypopharynx and cervical oesophagus. DESIGN: Open study. SETTING: Teaching University hospital, Germany. SUBJECTS: Of the 517 patients who presented with carcinoma of the oesophagus between September 1985 and March 1997, 16 had a locally advanced tumour of the hypopharynx and 25 of the cervical oesophagus. INTERVENTIONS: Free jejunal grafts were used after circular resection in all patients with carcinoma of the hypopharynx, and for the 3 with oesophageal carcinoma in whom we obtained adequate resection margins. In the remainder stomach was used in 21 and colon in 1. MAIN OUTCOME MEASURES: Morbidity and mortality. RESULTS: After jejunal grafting 1 patient died within 30 days and 2 died in hospital. After gastric or colonic reconstruction 2 patients died within 30 days and 4 in hospital. There was 1 anastomotic leak, 1 transplant became necrotic and had to be replaced, in 2 patients the recurrent nerve was damaged, 1 patient developed a wound infection and 1 a cardiac infarction. After gastric or colonic replacement 7 patients had paralysed recurrent laryngeal nerves, there was 6 anastomotic leaks, 1 chylous leak, 1 haemorrhage, and in 1 the transplant necrosed. CONCLUSION: Despite the fact that we compared tumours in different sites, these results suggest that the jejunal graft is safer for upper oesophageal and hypopharyngeal reconstruction.
Adenocarcinoma↗
[Free small intestine transplantation with microvascular anastomosis for complete replacement of the hypopharynx and cervical esophagus].
12 patients were operated on due to a cancer of the hypopharynx (T2-T4, N2-3). After resection, the reconstruction was performed with a free jejunal segment. Intraoperatively the venous anastomosis had to be renewed in 2 cases. One of these patients developed postoperatively a partial necrosis of the transplant. A further patient developed an insufficiency of the proximal anastomosis. One patient died on the 12th postoperative day due to a myocardial infarction. The median survival time was 17 months.
Adult↗
[Reoperations in otosclerosis. Indications, intraoperative findings, and results].
The audiological outcome of 140 stapedectomy revisions done between 1977 and 1987, as well as the pre- and intraoperative findings and the subjective appraisal of the revisions, are presented. The recurrence of the conductive deafness was the most often indication for the surgical revision and the shift of the prosthesis, verified intraoperatively, the most encountered finding. Audiological results showed, as mean value, an important reduction of the transmissive hearing loss whilst the bone conduction remained unaltered. Patients' subjective evaluation of the results were worse than audiometric controls. From the retrospective study of these 140 revisions the AA' experience is that the stapedectomy revision offers no major risk for the inner ear.
Adolescent↗
[Results of tinnitus therapy using lidocaine iontophoresis].
54 patients with severe tinnitus were treated by lidocaine iontophoresis. 25 patients suffered from a bilateral tinnitus. A total of 75 ears were treated. The ratio of male to female patients was 3:1. The average age was 45 years. All patients had got over at least one ineffective treatment. Prior to iontophoresis a complete audiologic, neuro-otologic and x-ray examination of the temporal bones was performed. In all patients the frequency and intensity of tinnitus were determined before and immediately after a treatment. In 44 patients there was no difference in their tinnitus after the treatment. In one patient the tinnitus has become lower by the iontophoresis. The value of this method in tinnitus therapy is discussed.
Adolescent↗
[Temporal encephalocele].
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Child, Preschool↗
[Surgery of facial paralysis in fractures of the petrous bone].
Follow-up of 38 patients with facial nerve paralysis in fractures of the petrous bone. Transmastoidal approach was performed in 23 cases. 15 patients underwent either translabyrinthine or transtemporal approach. The clinical and intraoperative findings and procedures are demonstrated. The need for surgical treatment in facial paralysis caused by petrous bone fractures is stressed.
Adolescent↗
[Clinical aspects of bilateral facial paralysis].
Facial diplegia is a rare disease. 18 patients suffering from bilateral facial palsy were examined. The clinical findings and therapeutic possibilities of ENT-surgeons are demonstrated. Common and rare causes of the lesions are discussed.
Brain Neoplasms↗
[Tumors of the facial nerve canal].
The X-ray tomograms of 13 patients with tumors in the facial nerve canal are discussed. The leading clinical symptom is the peripheral facial nerve palsy without recovery, often combined with deafness and dizziness. The X-ray film shows opacity, widening of the internal auditory canal and/or of the third part of the facial nerve canal, further erosion of the bony structures and destruction of the pyramid.
Cranial Nerve Neoplasms↗
Rupture of supra-aortic neck arteries due to lesions caused by tracheal tubes.
Haemorrhages from the common carotid or innominate artery caused by tracheal tubes are rare but dramatic complications of head and neck surgery. Patients with metal tracheostomy cannulas or patients in the phase of wound healing after radical tumour resections of the pharynx and larynx run a greater risk. Following extensive tumour resections and radiation of the upper respiratory and digestive tracts in 680 patients, acute bleeding of the larger neck arteries occurred in 18 patients. In four of these cases, fistulae developed in the innominate or common carotid artery. These ruptures were caused by both plastic and metal tracheal tubes.
Adult↗
[Rupture, emergency ligature and elective ligature of the carotid artery].
680 patients underwent surgery with radical neck dissection and tumour resection because of malignant diseases of the upper respiratory and digestive tract. Further therapy was pre- and/or postoperative radiation and in some cases preoperative cytostatic therapy. Carotid "blow out" occurred in 18 patients (2,6%) because of fistula formation, bad wound healing and tumour recurrence. Emergency ligation of the common carotid artery or internal carotid artery caused no neurological casualties in 70% of the patients. 4 patients underwent elective carotid ligation. Here, too, no neurological signs were seen. In these patients sufficient collateral perfusion was proved by angiography with balloonocclusion under simultaneous EEG-registration and measurement of the brain perfusion with 133 xenon.
Carotid Arteries↗