Advanced cancer treatment reaches hospital
New radiosurgery equipment is inaugurated that will offer a more precise and less invasive method for patients with different types of malignant tumors. Residents of the downtown area and south and all New Yorkers in general, will approach a further developed treatment for malignant growth, and brilliant, because of a radiosurgery unit that was recently renovated in a hospital in that county.
The renovation of the equipment, which cost $ 1.1 million, will improve the treatment of a few kinds of malignancy in the Hospital Cancer Center, since it might be more accurate to intervene tumors, while limiting the damage caused to the surrounding healthy tissue. Furthermore, the machine offers two new treatment alternatives: stereotactic radiosurgery and stereotactic body radiotherapy.
As explained by the hospital authorities in a statement, the unit's renovation, which was a combination of software and hardware improvements, adds state-of-the-art guided radiotherapy functionality that allows physicians to identify the real-time position of a tumor, particularly useful when treating tumors in moving parts of the body, such as the lungs.
Image scans are repeated and processed using a computer program to identify changes in the size and location of the tumor, which allows radiation oncologists to have the necessary information to reposition the patient or adjust the radiation rays for direct more precisely the specific radiation dose that is applied to the tumor according to its shape and size. This aides, in the meantime, to safeguard nature of ordinary tissues.
With this linear accelerator significantly improves the ability to treat all parts of the body, including cancers of the brain, lung, liver, prostate, lymph nodes and spine, through the use of radiosurgery. (Despite its name, radiosurgery is not a surgical procedure and does not involve incisions).
High resolution approach laryngoscopy
In the Institute of Laryngology a technique has been developed that aims to identify, in the most precise way possible, the individual anatomical characteristics of the vocal folds. For this purpose, a high definition endoscopy camera with digital image approach has been used (Richard Wolf 85550012 3 CCD HDTV Endocam), coupled to a rigid endoscope of 70 degrees with adjustable optical approach (Richard Wolf 4450.501). The possibility of excellent magnification, together with the high definition of the camera, allows to get pictures that encourage the unmistakable recognizable proof of the anatomical subtleties of the vocal folds and the surrounding structures.
Traditionally the examination of the larynx with rigid endoscopes is limited to the observation of the vocal folds from above, generally seeing only the upper face thereof, which scarcely makes it conceivable to see from that position the states of the free edge, and generally without allowing the evaluation of the great extension of the subglottic portion.
Additionally, in the vast majority of cases the vocal folds can not be observed in detail because the approach achieved is insufficient, and on the screen, other structures occupy space that, for the specific case of the study of dysphonia caused by structural defects, have no relevance. It does not mean that, in any way, that obvien other fundamental steps of the examination, such as the general observation of the hypopharynx, the appearance and functioning of the arytenoids, the back larynx, etc., in the meantime, when the discernment is over as a rule, the examiner concentrates on the true vocal folds.
From the point of view not only anatomical, but functional, the vocal fold should be considered as a three-dimensional structure. There is currently a lot of emphasis on the analysis of the vibratory pattern, but in many clinical conditions an abnormal vibratory pattern is identified, sometimes without finding the structural cause of it. In the diagnostic process it is fundamental to define the individual anatomy, in this way have the ability to understand the impact that the structure of each fold has on the vibratory behavior.
The developed method is based on the fact of being able to examine the complete structure of each fold in a comprehensive manner. This implies an examination that is more uncomfortable for the patient than a laryngoscopy traditional, because the descent of the endoscope to the glottis is essential, in addition to the inevitable rotation of the same laterally to allow the observation of the entire structure.
In order to achieve the objective it is necessary to adequately inform the patient about the type of procedure, the discomfort you may experience, as well as the importance of carefully following the instructions of the examiner with the In order to reduce discomfort and the risk of possible injuries.
The use of local anesthetics (2% lidocaine) is not routine, and is reserved only for cases in which the endoscope causes discomfort, which the patient does not feel able to tolerate. The careful handling of the endoscope is essential, the space in which you are going to work is very small. This type of diagnostic procedure has allowed the clarification of structural conditions that in Many occasions go unnoticed or have been confused with another type of pathology, a situation that is illustrated with some examples below:
Case 1. A 9-year-old male patient with a history of hoarseness consisting of hoarseness from a very young age. In multiple evaluations both clinical
as endoscopic, the diagnosis of laryngeal nodules was repeatedly made and he was in phoniatric treatment several times over the years without presenting no improvement (figure 3a). Due to the persistence of the dysphonia and the fact that in another institution surgical treatment of the "nodules" was suggested due to lack In response to voice therapy, the examination was performed with the high resolution approach system, through which it was possible to clearly identify the structural conditions of the folds vocal, being obvious that the diagnosis was wrong (figure 3b, 3c) because the patient had a bilateral sulcus and deformity of the left free edge.
Case 2. A 57-year-old pediatrician who consults for dysphonia with a breathed voice and fonasthenia, symptoms that begin after midday and affect their work activities The sequence of images in Figure 4 shows clearly that the structural problem is a bilateral, much deeper sulcus and rigid in the right vocal fold.