Læknablaðið : fylgirit - 01.06.2005, Blaðsíða 14

ABSTRACTS / XXIX CONGRESS OF THE NORDIC ASSOCIATION OF OTOLARYNGOLOGY
Response to Treatment Effectiveness of dietary and lifestyle GERD LPR
modifications ++ +
Successful treatment with single-dose PPIs* +++ +
Successful treatment with twice-daily PPIs ++++ +++
*PPIs = Proton pump inhibitors
References
Belafsky PC, Postma GN, Koufman KA. Laryngopharyngeal reflux symptoms
improve before changes in physical findings. Laryngoscope 2001; 111: 979-81.
Koufman JA, Aviv JE, Casiano RR, Shaw GY. Position statement of the
American Academy of Otolaryngology-Head and Neck Surgery on laryngopha-
ryngeal reflux. Otolaryngol Head Neck Surg 2002,127: 32-5.
Koufman JA, Belafsky PC, Daniel E, Bach KK, Postma GN. Prevalence
of esophagitis in patients with pH-documented laryngopharyngeal reflux.
Laryngoscope 2002; 112:1606-9.
Koufman JA. Laryngopharyngeal reflux is differentlrom classic gastroesopha-
geal reflux disease. Ear, Nose Throat J 2002; (Supplement 2) 81: 7-9.
O-l HEAD AND NECK TUMORS
Abstract no.: 011
Osteoradionecrosis during 25 years. The Gothenburg
Experience
G. Granström, Department of Otolaryngology, Head & Neck Surgery
and B. Fagerberg-Mohlin, Department of Oral & Maxillofacial Surgery,
Göteborg University, Sweden
Introduction: Osteoradionecrosis (ORN) is a rare complication
after treatment of head and neck cancer. Since 1980, we have used
a structured programme for the handling of ORN, involving stag-
ing of the disease, minor surgery, hyperbaric oxygen therapy and
reconstructive surgery.
Aim: To evaluate the functional outcome of patients treated for
ORN during a 25-year period.
Method: A database was created where data regarding cancer,
radiotherapy, chemotherapy and surgery were investigated. The
locality of ORN, extension with X-ray as well as treatment options
were recorded. Outcome of the treatment was evaluated and
side-effects registered. Statistical comparison using the Wilcoxon-
Rang test for non-parametric observations was performed.
Results: Altogether 155 ORN in 132 patients was treated dur-
ing this 25-year period. The most common site for ORN was the
mandible, and stage 2 and 3 ORN were most prominent. ORN
occurred most often after treatment of tonsil and floor of the
mouth carcinoma. The combined treatment with HBO and recon-
structive surgery could resolve the disease in 80% of patients.
Condusion: A structured follow-up and planned treatment for
ORN can relive the disease in the majority of patients.
Abstract no.: 012
Early tongue cancer: identifying high risque patients
A Westerborn, Dep of ORL-HNS, J Reizenstein, Dep of Oncology, M
Karlsson, Dep of Pathology, G-B Adamsson, Center of Head & Neck
Oncology, all from the Örebro University Hospital, Örebro, Sweden
Cancer of the oral tongue carries a bad prognosis with 30-40%
local and regional recurrencies even with T1-T2 tumours. Many
different therapies have been advocated without improving sur-
vival. Authors have tried to identify different factors influensing
outcome but very few markers stand out having prognostic mean-
ing. The only factors that seem to have pos correlation between
tumour and outcome is TNM classification and histological fac-
tors such as tumour thickness and growth pattern. Unfortunately
there is no general agreement on when the risque for recurrence
increases.
Method: 1988-2001 we treated 137 tonguecancers. 83 patients
were T1-T2 tumours with x N1-N2 patients. X were stage 1 and y
were stage II. During these years we changed therapeutic regime
going from preop radiotherapy to postop radiotherapy. Preop
radiotherapy was performed in -------- patients. These surgical
specimens have not been reevalutaed. Surgery was performed as
primary treatment in 43 patients. We retrospectively studied the
surgical specimen for tumour thickness and growth pattern in 43
patients with Tl(24)and T2 (19) tumours and compared it with
outcome and risque for recurrencies, both local end regional. We
also looked at other clinical risquefactors and tried to evaluate
which treatment regime has had the best results.
Results: Treatment consisted of primary surgery in 43 cases and
preoperative or therapeutic external radiotherapy in 40 cases.
Primary surgery was followed by no further treatment (23),
brachytherapy (3) or external radiotherapy (17). 43 studied speci-
mens. Tumour thicknes was x-y mm with a cutoff of x mm where
the prognosis got worse. Growth pattern was called aggressive in
y cases?
Conclusion: 43 T1-T2 were operated. 11 (26%) were treated for
recurrencies. 2 year survival is 77%. As in previous studies there is
a positive correlation between tumour thickness and recurrenmce
even in T1 cancers. We also found positive.
Abstract no.: 013
Parotid gland metastasis of non-head and neck origin
Mrena R, Department of Otolaryngology - Head and Neck Surgery, Leivo
I, Department of Pathology, Makitie AA, Department of Otolaryngology
- Head and Neck Surgery, Helsinki University Central Hospital, Helsinki,
Finland
Background: Metastatic tumors involving the parotid gland
and arising from non-head and neck origin are rare. Immuno-
histochemistry has improved the differential diagnosis of these
lesions. Current immunohistochemical markers allow the distinc-
tion between a number of potential primary tumors (e.g. prostate,
colon, lung, kidney, breast).
Patients and methods: The clinical and histomorphological fea-
tures of three renal cell carcinoma patients presenting with a
parotid mass are presented. We review the literature of various
non-head and neck malignancies metastasizing to the parotid
gland and discuss their differential diagnosis.
Results: There were three females (mean age 66 years; range 58-
76 years) with renal cell carcinoma (hypernephroma). In two out
of three cases, a parotid mass was the first clinical manifestation.
In one case, a nephrectomy had been performed nine years ear-
lier to remove hypernephroma. Two of the three cases showed a
highly vascular parotid lesion causing difficulty in interpretation
of the fine needle aspirate. Immunohistochemical stainings for
14 Læknablaðið/Fylgirit 51 2005/91