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P Olde Kalter

Publications and source records attributed to P Olde Kalter.

7 recordsLinked to original sources

Open septorhinoplasty. Experiences in 200 patients.

There are two approaches for septorhinoplasty, the endonasal approach and the external approach. The external approach is much criticized for the risk of columellar skin flap necrosis and visible scar formation. This series of patients has shown that the risk can be minimized using a mid-columellar broken incision with a meticulous closure technique. The exposure of the surgical anatomy is much better than with the endonasal approach, leading to better insight in nasal deformities and more detailed reconstruction. There seems to be no reasonable objection which can be raised against the columellar incision to reject the open approach.

Adult↗

Multiple primary tumors in patients with laryngeal squamous cell hyperplasia.

We analyzed retrospectively the case histories of 204 patients with squamous cell hyperplasia of the larynx for the occurrence of multiple primary tumors. All patients were grouped according to Kleinsasser's 1963 classification of laryngeal pathology. Patients with simple hyperplasia (class I) had a low risk for developing a coincidental primary tumor. The rist was 7% in patients with hyperplasia with atypia (class II) and was 15% in patients with carcinoma in situ (class III). This frequency is similar to that of our patients with glottic cancer (13%). Although no coincidental tumors were found in our female patients, the small number of females in our series made the differences in frequency between males and females not significant. This is still of interest to us because our previous study of patients with proven glottic cancers also showed that no second tumors occurred in our female patients. This difference was statistically significant. In our present study, all second tumors occurred metachronously. Our findings indicate that all patients with class III laryngeal disease (carcinoma in situ) should undergo the same aggressive search for second primary tumors, as do patients with invasive glottic cancers. This means that panendoscopy or bronchoscopy should be done at the initial work-up and also at periodic intervals during the follow-up period. We have also found that patients lacking immunoglobulin allotype Km(1) have to be followed aggressively, since these patients are at high risk of developing multiple tumors. A possible exception can be made for female patients.

Carcinoma in Situ↗

Quantitative morphometry of squamous cell hyperplasia of the larynx.

The histopathological diagnosis of squamous cell hyperplasia of the larynx is very subjective. Since morphometry is highly reproducible, this method was applied to routine processed slides of 45 such lesions to assess objectively the epithelial characteristics. In each case measurements of nuclei of 50 cells in the basal, intermediate, and superficial cell layers were carried out. The data were analysed statistically. The findings suggest that quantitative morphometry may be helpful for the histopathological classification of squamous cell hyperplasia of the laryngeal mucosa.

Cell Nucleus↗

The prognostic significance of morphometry for squamous cell hyperplasia of the laryngeal epithelium.

Laryngeal biopsies of squamous cell hyperplasia with atypia were graded by means of morphometry, using five non-correlated nuclear parameters preselected with linear discriminant analysis, and were tested for their prognostic significance, in a follow-up study. Fifty-two biopsy specimens were obtained from 18 patients who were merely followed and if necessary underwent a repeated biopsy examination. The lesions of 10 patients progressed to invasive carcinoma. In 8 patients the second or further biopsies were again classified as squamous cell hyperplasia with atypia. For both groups the mean follow-up period was 7.2 years (range: 3 1/2-11). In the progressive group 73% of the biopsies were morphometrically classified as prognostically unfavourable, whereas the clinical outcome on the basis of the last biopsy was correctly predicted for 6 out of the 10 cases (mean probability: 94%), the other 4 cases were 'mis-classified', although for 3 cases with a low probability (mean: 60%). For a valuable morphometrical classification of lesions of individual patients, the results as presented are still insufficient. Morphometrical classification probabilities may be improved when the numbers of untreated patients with squamous cell hyperplasia with atypia do increase.

Adult↗

The clinical relevance of classification of squamous cell hyperplasia of the larynx by morphometry.

By means of morphometry, differentiation between the classes of laryngeal squamous cell hyperplasia can easily be performed, mutually (Kleinsasser's classification) and in comparison with normal epithelium. It is rather difficult, however, to distinguish between class II (hyperplasia and atypia) and class III (carcinoma in situ). In the group of class II lesions, two groups of patients could be differentiated: a prognostically favourable and an unfavourable group. When using a linear discriminant analysis, the two groups mentioned could be distinguished morphometrically. In histopathological examination, lesions classified as hyperplasia and atypia (class II), must also be examined with morphometry, because in this way the group at risk can be traced.

Biopsy↗