Srp Ark Celok Lek
-
Sulcus vocalis is an epithelial invagination along the free edge of the membranous vocal fold. It interferes with the glottic closure and vibration pattern. Sulcus vocalis provokes voice fatigue, hoarseness and breathiness, and it usually appears in association with hyperkinetic phonatory pattern. Hyperkinesis develops secondarily, due to the compensatory effort to overcome the deficiency in glottic closure. The treatment of sulcus vocalis is very difficult. Phonosurgery is used, and is followed by postoperative voice therapy. ⋯ The surgical procedure which is safe and accepted by the majority of surgeons has not yet been at our disposal. The treatment of sulcus vocalis should start with voice therapy, which lasts as long as the patient shows a progress. Only then the surgical procedure can be discussed. We obtained the best results with the combination of excision and voice therapy. However, the surgeon and the patient must be aware that the treatment is demanding and long-lasting.
-
The benefit of adjuvant therapy in colorectal cancer (CRC) has been provided in clinical studies that have demonstrated reduction of up to 30% in a 5-year overall mortality in patients (pts.) with TNM stage III (Dukes' stage C) carcinoma. Patients with metastatic CRC are usually in a relatively good condition despite their advanced disease. Therefore, some clinicians wished to withheld the toxicity of chemotherapy until the disease became symptomatic. ⋯ We have treated and followed-up these stable disease patients as patients without clinical benefit. We have no answer if they could reach better time to progression and/or survival if they had been treated for more than 4 courses. Careful studies in the evaluation of the quality of life in connection with treatment effects for all stable disease subpopulations of patients are warranted. (ABSTRACT TRUNCATED)