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Ronaldo Bova

Publications and source records attributed to Ronaldo Bova.

4 recordsLinked to original sources

Total pharyngolaryngectomy for squamous cell carcinoma of the hypopharynx: a review.

OBJECTIVES: To evaluate our experience with total pharyngolaryngectomy in the treatment of hypopharyngeal squamous cell carcinoma. STUDY DESIGN: Retrospective analysis of consecutively treated patients in an academic otolaryngology, head and neck department. METHODS: One hundred eighty patients who had total pharyngolaryngectomy performed for hypopharyngeal carcinoma were included in this study. Patients with a history of previous head and neck cancer were excluded. Clinicopathologic parameters were recorded and survival calculated using the Kaplan-Meier method. RESULTS: One hundred sixty-two (90%) of the patients were male, and the patients had a mean age of 62 years. The majority (91%) of patients had advanced overall clinical stage disease (stage 3,4). Thirty-one (17.8%) and 43 (24%) patients developed locoregional and metastatic disease recurrence, respectively. The 2- and 5-year disease-specific survival rates were 72% and 52%, respectively. Advanced nodal stage, perineural invasion, lymphovascular invasion, and positive margins were predictors of poor survival on univariate analysis, and lymphovascular invasion was an independent prognostic factor on multivariate analysis. CONCLUSION: Surgery and postoperative radiotherapy remains the treatment against which other modalities should be compared for advanced stage hypopharyngeal squamous cell carcinoma.

Antineoplastic Combined Chemotherapy Protocols↗

Total glossectomy: is it justified?

BACKGROUND: The treatment of advanced malignancies of the tongue with total glossectomy is controversial. METHODS: The present study retrospectively reviews 20 patients that had total glossectomy with or without laryngectomy performed at the Princess Alexandra Hospital (Woolloongabba, QLD, Australia) over the past 10 years. The clinicopathologic parameters, perioperative morbidity and mortality were assessed. RESULTS: The 5 years disease free and disease specific survival rates were 34% and 38%, respectively. Ninety per cent of patients acquired independent oral feeding prior to discharge, while 57% of patients that had laryngeal preservation performed achieved satisfactory vocal rehabilitation. CONCLUSION: Total glossectomy is an oncologically sound surgical procedure that should only be performed in carefully selected patients with advanced malignancies affecting the tongue.

Adenocarcinoma↗

Parotidectomy: review of treatment and outcomes.

BACKGROUND: Parotidectomy is a common surgical procedure performed for a wide array of benign and malignant tumours. The aim of the present study was to review a single-institution experience with parotidectomy over a 10 year period. METHODS: We retrospectively reviewed 170 patients who had parotidectomy performed. The preoperative investigations, clinicopathological parameters, perioperative morbidity and mortality were assessed. RESULTS: One hundred and six (62%) of the patients were men. The mean age was 54 years (range 21-80). Indications for parotidectomy included benign tumour (44%), malignant tumour (42%), inflammatory parotid disease (7%) and miscellaneous (5%). The most common benign tumour was pleomorphic adenoma (25%). The most common malignant tumour was metastatic cutaneous squamous cell carcinoma (SCC) (19%). Fine needle aspiration cytology was performed in 83% patients with a sensitivity and specificity for benign tumours of 76% and 97%, respectively. The sensitivity and specificity for malignant tumours was 90% and 99%, respectively. One (0.6%) patient died in the postoperative period. Postoperative complications included wound infection (2.3%), wound haematoma (3.5%) and seroma (6.6%). Six patients (3.5%) developed temporary complete facial paresis, while 33 patients (20%) developed temporary partial facial palsy in the immediate postoperative period. The 2-year disease-free and disease-specific survival for those patients with metastatic cutaneous SCC were 75% and 76%, respectively. CONCLUSIONS: The most common indications for parotidectomy were pleomorphic adenoma and metastatic cutaneous SCC. Our perioperative morbidity and survival for patients with malignant parotid disease compare favourably with other institutional series.

Adult↗

Retropharyngeal abscess in children.

BACKGROUND: Retropharyngeal abscess (RPA) is an uncommon, potentially fatal condition found more frequently in children than adults. Prompt diagnosis and surgical management of this condition is imperative to prevent complications including airway obstruction and mediastinitis. Few studies have been dedicated to paediatric retropharyngeal abscess. METHODS: A retrospective analysis of 21 cases of retropharyngeal abscess at the Sydney Children's Hospital over a 12-year period was performed. RESULTS: There were 12 boys and nine girls involved in the analysis. Their ages ranged from 3 months to 12 years. Common -presenting symptoms and signs included fever, dysphagia, neck swelling and torticollis. Respiratory compromise was present in 29% of the children at presentation. Foreign body ingestion accounted for 10% of cases. Seventeen cases were managed with surgical drainage. Surgical approaches adopted included transoral (70%), external cervical approach (20%) and a combined approach in 10%. There was no mortality. Mediastinitis occurred in two patients, one of whom also had recurrent laryngeal nerve palsy. No other serious complications occurred. CONCLUSION: Retropharyngeal abscess should be considered in all children presenting with neck pain and dysphagia. Prompt diagnosis and institution of appropriate medical and surgical therapy is imperative to prevent complications such as airway obstruction. The management of this condition should occur in a paediatric institution with appropriate medical, surgical and intensive care -facilities.

Child↗