American family physician
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American family physician · Jul 1991
ReviewLaryngeal cancer: diagnosis, treatment and speech rehabilitation.
Cancer of the larynx occurs most often in men between 50 and 70 years of age. Cigarette smoking and alcohol are responsible for more than 75 percent of cases. Hoarseness is the most common presenting complaint. ⋯ The five-year cure rate, with preservation of voice and glottic function, is as high as 90 percent if the lesions of the vocal cords are found in an early stage. Total laryngectomy is required for more extensive disease. Speech rehabilitation has been revolutionized by tracheoesophageal speech techniques.
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Herpes zoster results from reactivation of latent varicella-zoster virus. It is most common in elderly patients and immunosuppressed patients, especially those with human immunodeficiency virus (HIV) infection. Zoster is often the earliest indicator of HIV infection. ⋯ High-dose acyclovir (800 mg orally five times daily) has recently been approved for treatment of herpes zoster and, if started early, decreases the duration and severity of symptoms. In the prevention of postherpetic neuralgia, acyclovir does not appear to be effective, and the efficacy of steroids is questionable. The best therapy currently available for postherpetic neuralgia is amitriptyline, topical capsaicin and transcutaneous electrical stimulation.