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Saturno M, Shaari AL, Yun J, Wein LE, Shaari D, Kappauf C, Laitman BM, Chai RL. Outcomes of Supracricoid Partial Laryngectomy Performed in the United States: A Systematic Review. Laryngoscope 2024; 134:3003-3011. [PMID: 38251796 DOI: 10.1002/lary.31273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 12/09/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024]
Abstract
OBJECTIVE The primary objective of this study was to evaluate oncologic outcomes of all published cases of supracricoid partial laryngectomy (SCPL) performed in the United States. The secondary objective was to assess the functional outcomes associated with this procedure. REVIEW METHODS A systematic review of PubMed, SCOPUS, and Embase for all English-language studies pertaining to SCPL performed in the United States was conducted until August 2021. Primary outcomes included disease-specific survival (DSS), overall survival, and local recurrence rate. Secondary outcomes included larynx preservation rate, gastrostromy tube dependency, days to gastrostomy tube removal, decannulation rate, and days to decannulation. RESULTS A total of six studies were included in the analysis. A total of 113 patients (58.5%) underwent SCPL surgery as a primary treatment method whereas 80 patients (41.5%) underwent SCPL as salvage surgery. The 5-year DSS rates were 87.8% and 100% for primary and salvage procedures, respectively. Approximately 10.3% of patients undergoing a salvage SCPL procedure experienced a local recurrence whereas only 1.85% of primary SCPL procedures resulted in local recurrence. The rates of decannulation following primary and salvage SCPL were 92.7% and 88.1%, respectively. With regard to swallowing, primary and salvage SCPL procedures demonstrated comparably low postoperative gastrostomy tube dependency rates of 3.66% and 4.76%, respectively. CONCLUSIONS SCPL performed in the United States is an effective surgical technique that produces excellent outcomes in qualifying patients, thus validating its viability as an organ-preserving surgical alternative. Laryngoscope, 134:3003-3011, 2024.
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Affiliation(s)
- Michael Saturno
- Thyroid, Head, and Neck Cancer (THANC) Foundation, New York, New York, U.S.A
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Ariana L Shaari
- Thyroid, Head, and Neck Cancer (THANC) Foundation, New York, New York, U.S.A
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Jun Yun
- Thyroid, Head, and Neck Cancer (THANC) Foundation, New York, New York, U.S.A
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Lauren E Wein
- Thyroid, Head, and Neck Cancer (THANC) Foundation, New York, New York, U.S.A
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Diana Shaari
- Thyroid, Head, and Neck Cancer (THANC) Foundation, New York, New York, U.S.A
| | - Catharine Kappauf
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Benjamin M Laitman
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Raymond L Chai
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
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Duan R, Ding Y, Tian Y, Yang H, Xu J. Clinical validation of the nursing outcome "Swallowing status: pharyngeal phase" in patients with laryngeal cancer. Int J Nurs Knowl 2024. [PMID: 38886906 DOI: 10.1111/2047-3095.12480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 05/30/2024] [Indexed: 06/20/2024]
Abstract
AIMS AND OBJECTIVES This study aimed to clinically validate the nursing outcome "Swallowing status: pharyngeal phase" (1013). METHODS A two-stage study was designed: (1) Chinese translation and cultural adaptation and (2) clinical validation. Internal consistency and interrater reliability tests were performed on 285 patients with laryngeal cancer, and an additional 130 patients were randomly selected from the 285 patients as an independent sample. Criterion-related validity tests were performed using the standardized swallowing assessment (SSA). Nursing outcome sensitivity was detected by scoring two time points. RESULTS The Cronbach's alpha coefficients were 0.951 for the nursing outcome and 0.942-0.965 for each indicator. The interclass correlation coefficient (ICC) values for each indicator ranged from 0.73 to 0.929. The scores of the nursing outcome were negatively correlated with the SSA scores (r = -0.555, p < 0.01). With the exception of two indicators, there was a significant difference (p < 0.05) between the total scores of the scale and its 11 indicator scores for the two time points. The results indicated that the nursing outcome "Swallowing status: pharyngeal phase" (1013) exhibited satisfactory psychometric properties and high sensitivity to change. CONCLUSIONS The nursing outcome "Swallowing status: pharyngeal phase" (1013) demonstrated good reliability, validity, and sensitivity in patients with laryngeal cancer. IMPLICATIONS FOR NURSING PRACTICE The nursing outcome "Swallowing status: pharyngeal phase" (1013) can be used to assess swallowing function in patients with laryngeal cancer and provide guidance for the development of rehabilitation intervention plans and nursing care.
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Affiliation(s)
- Ruirui Duan
- Nursing College of Shanxi Medical University, Taiyuan, China
| | - Yongxia Ding
- Nursing College of Shanxi Medical University, Taiyuan, China
| | - Yanzhi Tian
- Nursing College of Shanxi Medical University, Taiyuan, China
| | - Huixian Yang
- Nursing College of Shanxi Medical University, Taiyuan, China
| | - Jing Xu
- Nursing College of Shanxi Medical University, Taiyuan, China
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Liu T, Feng H, Liang Z, Xu S, Qin G. Analysis of swallowing and voice-related quality of life in patients after supracricoid partial laryngectomy. Eur Arch Otorhinolaryngol 2024; 281:1857-1864. [PMID: 38183455 PMCID: PMC10942935 DOI: 10.1007/s00405-023-08416-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 12/12/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVE This study evaluated the swallowing and voice function of laryngeal cancer patients after Supracricoid Partial Laryngectomy(SCPL), and its influence on quality of life to provide a reference for the selection of surgical methods for laryngeal cancer patients. METHODS Twenty-one patients who received SCPL between April 2015 and November 2021 were included. Each patient's swallowing function and quality of life were assessed through fiberoptic endoscopic examination of swallowing (FEES) and the M.D. Anderson Dysphagia Inventory (MDADI). Fundamental, jitter, shimmer, maximum phonation time (MPT), and voice handicap index-10 (VHI-10) were performed to assess voice function and voice-related quality of life. RESULTS The results of the FEES of the 21 patients were as follows: the rates of pharyngeal residue after swallowing solid, semiliquid, and liquid food were 0%, 28.57%, and 38.09%, respectively; the rates of laryngeal infiltration after swallowing solid, semiliquid, and liquid food were 0%, 28.57%, and 4.76%, respectively; and aspiration did not occur in any of the patients. In the evaluation of swallowing quality of life, the mean total MDADI score was 92.6 ± 6.32. The voice function evaluation showed that the mean F0, jitter, shimmer, and MPT values were 156.01 ± 120.87 (HZ), 11.57 ± 6.21 (%), 35.37 ± 14.16 (%) and 7.85 ± 6.08 (s), respectively. The mean total VHI-10 score was 7.14 ± 4.84. CONCLUSION SCPL provides patients with satisfactory swallowing and voice function. The patients in this study were satisfied with their quality of life in terms of swallowing and voice. SCPL can be used as a surgical method to preserve laryngeal function in patients with laryngeal cancer.
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Affiliation(s)
- Tianzhen Liu
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China
| | - Huajun Feng
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China
| | - Zhuoping Liang
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China
| | - Shengen Xu
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China
| | - Gang Qin
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China.
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da Costa Miranda Barbosa R, de Freitas AS, Cerqueira RBA, Mancopes R, Dias FL, Steele CM. Dysphagia in Open Partial Horizontal Laryngectomy Type IIa: Quantitative Analysis of Videofluoroscopy using the ASPEKT Method. Dysphagia 2024:10.1007/s00455-024-10677-3. [PMID: 38431893 DOI: 10.1007/s00455-024-10677-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/30/2024] [Indexed: 03/05/2024]
Abstract
Open Partial Horizontal Laryngectomy (OPHL) Type IIa surgery is a conservative surgical technique used in the treatment of laryngeal carcinomas. In this pilot study, we aimed to characterize swallowing function and physiology in a series of patients after OPHL Type IIa surgery through comparison to healthy reference values for quantitative measures for videofluoroscopy. We performed retrospective quantitative analysis of videofluoroscopy recordings of thin liquid swallows for a preliminary sample of 10 male patients. Each videofluoroscopy clip was rated in triplicate by trained blinded raters according to the ASPEKT Method (Analysis of Swallowing Physiology: Events, Kinematics and Timing). This preliminary sample of patients with previous OPHL surgery showed functional airway protection, with only 2 patients showing incomplete laryngeal vestibule closure (LVC) and associated airway invasion. However, the majority of patients (90%) showed prolonged latencies to LVC and upper esophageal sphincter (UES) opening. Prolonged durations of LVC and UES opening were also noted, but these were in the direction of compensation rather than impairment. Reduced pharyngeal area at rest was seen in 70% of the sample, and all patients showed poor pharyngeal constriction. Post-swallow residue was a prominent finding in ≥ 75% of these patients. In particular, reduced or absent constriction of the hypopharynx in the region of the pyriform sinuses was noted as a characteristic of swallowing in this sample. The data from these patients suggest that despite functional airway protection, severe swallowing dysfunction involving poor pharyngeal constriction and bolus clearance may be likely after OPHL surgery.
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Affiliation(s)
| | | | | | | | | | - Catriona M Steele
- KITE Research Institute-UHN, Toronto, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Canada Research Chair (Tier 1) in Swallowing and Food Oral Processing, Canada Research Chairs Secretariat, Ottawa, Canada
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Alsavaf MB, Tardif J, Salem EH, Matrka L, Carrau RL. A Novel Approach for the Treatment of Intractable Aspiration After Supracricoid Laryngectomy. Ann Otol Rhinol Laryngol 2023; 132:1690-1695. [PMID: 37271983 DOI: 10.1177/00034894231176892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVES This manuscript aims to present a novel and successful intervention for intractable aspiration following a supracricoid laryngectomy (SCL) that may avoid the need for total laryngectomy in patients experiencing intractable aspiration after SCL. STUDY DESIGN This report describes a novel approach to treat intractable aspiration and feeding tube-dependency due to an incomplete posterior apposition of the laryngeal surface of the epiglottis to the arytenoids after a SCL in a 67-year-old man. METHODS The right and left aryepiglottic folds and the median glossoepiglottic fold were denuded using a CO2 laser. Then, an arytenoepiglottopexy was completed by placing 4-0 Vicryl between the lateral aspect of the epiglottis and arytenoids; thus, approximating these structures. RESULTS Two weeks after surgery, fiberoptic endoscopic evaluation of swallowing demonstrated improved closure of the larynx upon swallowing with great upgrading in the Penetration-Aspiration scale (PAS). PAS improved from a 6 to 2, corresponding to, transient penetration for moderately thick liquids and puree solids. He also demonstrated improved secretion management and airway protection. Following a 4-week course of intensive dysphagia therapy, a modified barium swallow revealed a significant improvement in airway protection, with a PAS score of 1 (no airway invasion). CONCLUSIONS Chronic aspiration is a life-threatening condition that can severely reduce patients' quality of life. Despite the use of current therapeutic approaches, a subset of patients will remain plagued by persistent symptoms. We introduce an innovative, simple, and quick endoscopic technique that offers benefit in controlling aspiration after SCL. LEVEL OF EVIDENCE NA.
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Affiliation(s)
- Mohammad Bilal Alsavaf
- Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, OH, USA
| | - Jacqueline Tardif
- Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, USA
| | - Eman H Salem
- Department of Otolaryngology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Laura Matrka
- Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, OH, USA
| | - Ricardo L Carrau
- Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, OH, USA
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Abstract
Although total laryngectomy continues to be important treatment of supraglottic laryngeal cancer, the management of early-stage disease has evolved from primary radiation/chemoradiation to consideration of partial laryngectomy surgery. Surgeon experience and careful patient selection can lead to excellent oncologic and functional outcomes for these techniques. However, advanced stage tumors and salvage situations are challenging and the ability to eradicate disease and preserve function should be carefully considered. Contraindications to supraglottic laryngectomy depend on surgical approach, as do complications. With adequate patient selection, high rates of cure and function can be achieved with both open and transoral supraglottic laryngectomy procedures.
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Affiliation(s)
- Rusha Patel
- Oklahoma University, 800 Stanton L Young Boulevard, Suite 1400, Oklahoma City, OK 73104, USA.
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Locatello LG, Jiang S, Chen L, Caini S, Maggiore G, Dong P, Gallo O. Oncological and functional impact of adjuvant treatments after open partial laryngeal surgery: a systematic review of the literature and a meta-analysis. Eur Arch Otorhinolaryngol 2023; 280:2911-2926. [PMID: 36806990 PMCID: PMC10175366 DOI: 10.1007/s00405-023-07871-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 02/06/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND The oncological and functional role of postoperative radiotherapy (PORT) after open partial laryngeal surgery (OPLS) remains debatable. METHODS A systematic review and a meta-analysis of the literature were conducted according to the PRISMA guidelines. Outcomes of patients receiving OPLS with and without PORT for laryngeal cancer were summarized. RESULTS In the 10 studies that were included in the meta-analysis, no significant difference emerged in terms of pooled overall survival between OPLS patients who did and who did not receive PORT (- 0.3%, 95% CI - 5.4 to 4.9%, p = 0.922). Only one study showed a significantly higher incidence of complications in the PORT cohort. CONCLUSIONS PORT may apparently be performed after OPLS in face of adverse postoperative features without an increased risk of toxicities affecting the neolarynx. Because of the limitations in the available literature, the oncological and functional effects of PORT in this setting needs to be prospectively assessed to strengthen the evidence of this treatment strategy for laryngeal cancer.
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Affiliation(s)
- Luca Giovanni Locatello
- Department of Otorhinolaryngology, Careggi University Hospital, Florence, Italy.,Department of Otorhinolaryngology, University Hospital "Santa Maria Della Misericordia", Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.,Department of Otolaryngology-Head & Neck Surgery, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Serena Jiang
- Department of Otorhinolaryngology, Careggi University Hospital, Florence, Italy
| | - Lixiao Chen
- Department of Otolaryngology-Head & Neck Surgery, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Saverio Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | | | - Pin Dong
- Department of Otolaryngology-Head & Neck Surgery, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Oreste Gallo
- Department of Otorhinolaryngology, Careggi University Hospital, Florence, Italy. .,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
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Bo L, Jia R, Feng W, Jun L. An unusual foreign body in the laryngeal trachea following supracricoid partial laryngectomy. Br J Hosp Med (Lond) 2022; 83:1. [PMID: 35377205 DOI: 10.12968/hmed.2021.0470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Li Bo
- Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Ren Jia
- Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Wang Feng
- Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Liu Jun
- Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
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Zorzi SF, Lazio MS, Pietrobon G, Chu F, Zurlo V, Bibiano D, De Benedetto L, Cattaneo A, De Berardinis R, Mossinelli C, Alterio D, Rocca MC, Gandini S, Gallo O, Chiocca S, Tagliabue M, Ansarin M. Upfront surgical organ-preservation strategy in advanced-stage laryngeal cancer. Am J Otolaryngol 2022; 43:103272. [PMID: 34757315 DOI: 10.1016/j.amjoto.2021.103272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/14/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE Advanced-stage laryngeal cancer is a challenging disease that needs multimodal treatment. Medical and surgical organ-preservation strategies have been developing in the last decades to spare these functions while granting cancer cure. The current work presents the experience of a tertiary-care center in conservative surgery for advanced-stage laryngeal cancer. MATERIALS AND METHODS We collected clinical data of patients submitted to open partial horizontal laryngectomies (OPHLs) and any possible adjuvant treatment from 2005 to 2018. Outcomes were also compared to the most recent studies reporting on both medical and surgical organ-preservation strategies. RESULTS One hundred ten patients were included in the analysis. Adjuvant therapy was employed in 51% of cases. The local control rate was 96.4%, while overall survival (OS) was 67%, and laryngo-esophageal dysfunction free survival (LEDFS) was 66%. Stage IV and vascular invasion were associated with a statistically-significant worse survival. CONCLUSIONS OPHLs are valid as upfront treatment in fit patients affected by advanced-stage laryngeal cancer. Disease control and function preservation are granted in a significant percentage of cases, even when followed by adjuvant therapy.
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Affiliation(s)
- Stefano Filippo Zorzi
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Maria Silvia Lazio
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giacomo Pietrobon
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy.
| | - Francesco Chu
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Valeria Zurlo
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Debora Bibiano
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Luigi De Benedetto
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Augusto Cattaneo
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Otorhinolaryngology-Head and Neck Surgery, ASST Lariana, Sant'Anna Hospital, Como, Italy
| | - Rita De Berardinis
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Chiara Mossinelli
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Daniela Alterio
- Division of Radiotherapy, IEO, European Institute of Oncology IRCCS, Milan, Italy.
| | - Maria Cossu Rocca
- Department of Medical Oncology, Urogenital and Head and Neck Tumors Medical Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Sara Gandini
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Oreste Gallo
- First Clinic of Otolaryngology Head-Neck Surgery, Department of Surgery and Translational Medicine, University of Florence, AOU-Careggi, Florence, Italy
| | - Susanna Chiocca
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Marta Tagliabue
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Mohssen Ansarin
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
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The effect of tracheostomy on swallowing function in open partial horizontal laryngectomies: preliminary experience. The Journal of Laryngology & Otology 2021; 136:73-78. [PMID: 34727996 DOI: 10.1017/s0022215121003418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Tracheostomy is required to ensure a safe airway in open partial horizontal laryngectomies. The presence of the tracheostomy tube can contribute to post-operative dysphagia. This study aimed to evaluate the effects of a circumferential tracheostomy technique on swallowing. METHODS A retrospective study was conducted of patients who underwent open partial horizontal laryngectomies between April 2018 and June 2019. Patients were divided into two groups based on the tracheostomy technique: group 1 had two stitches from the inferior tracheal ring to the skin; group 2 had circumferential fixation of the trachea to the skin. Demographic information, surgical data, post-operative rehabilitation course and complication details were collected and analysed. RESULTS Twenty-four patients were enrolled. Patients in group 2 had significant improvement in the initial phases of swallowing rehabilitation. CONCLUSION Tracheostomy with anchorage of the trachea to the skin by circumferential stitches could allow early removal of the tracheal tube, with a better swallowing outcome.
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Seino Y, Miyamoto S, Nakayama M, Yamashita T, Miles A, Allen JE. Characteristics that predict penetration - aspiration in elderly patients following supracricoid laryngectomy with cricohyoidoepiglottopexy - a videofluoroscopic study. J Laryngol Otol 2021; 136:1-23. [PMID: 34702394 DOI: 10.1017/s0022215121003236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjectiveThis study aimed to determine the incidence of laryngeal penetration and aspiration in elderly patients who underwent supracricoid laryngectomy with cricohyoidoepiglottopexy for laryngeal cancer.MethodA retrospective analysis of dynamic videofluoroscopic swallowing studies was performed in patients who had received supracricoid laryngectomy with cricohyoidoepiglottopexy as a treatment for laryngeal cancers. Digital analysis of videofluoroscopic swallowing studies included measurements of displacement and timing related to swallowing safety.ResultsVideofluoroscopic swallowing studies from 52 patients were analysed. All participants were male and over 65 years old. Studies were performed five years after surgery. Among 52 videofluoroscopic swallowing studies, analysis showed that elevated pharyngeal constriction ratio (pharyngeal constriction ratio more than 0.0875, odds ratio = 5.2, p = 0.016), reduced pharyngoesophageal sphincter opening time (pharyngoesophageal sphincter open less than 0.6 seconds, odds ratio = 11.6, p = 0.00018) and reduced airway closure time (airway close less than 0.6 seconds, odds ratio = 10.6, p = 0.00057) were significantly associated with aspiration.ConclusionDeteriorated pharyngeal constriction, shortened airway closure and reduced pharyngoesophageal sphincter opening time are key factors for predicting laryngeal penetration or aspiration after supracricoid laryngectomy with cricohyoidoepiglottopexy.
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Affiliation(s)
- Yutomo Seino
- Department of Otorhinolaryngology, Kitasato University School of Medicine
| | - Syunsuke Miyamoto
- Department of Otorhinolaryngology, Kitasato University School of Medicine
| | - Meijin Nakayama
- Department of Otolaryngology-Head and Neck Surgery, Yokohama City University
| | - Taku Yamashita
- Department of Otorhinolaryngology, Kitasato University School of Medicine
| | - Anna Miles
- Otolaryngology, North Shore Hospital, Auckland
| | - Jacqui E Allen
- Professional Teaching Fellow- Speech Science, The University of Auckland
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de Oliveira Faria S, Hurwitz G, Kim J, Liberty J, Orchard K, Liu G, Barbera L, Howell D. Identifying Patient-Reported Outcome Measures (PROMs) for Routine Surveillance of Physical and Emotional Symptoms in Head and Neck Cancer Populations: A Systematic Review. J Clin Med 2021; 10:jcm10184162. [PMID: 34575271 PMCID: PMC8470145 DOI: 10.3390/jcm10184162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/03/2021] [Accepted: 09/08/2021] [Indexed: 11/16/2022] Open
Abstract
The aims of this review were to identify symptoms experienced by head and neck cancer (HNC) patients and their prevalence, as well as to compare symptom coverage identified in HNC specific patient-reported outcome measures (PROMs). Searches of Ovid Medline, Embase, PsychInfo, and CINAHL were conducted to identify studies. The search revealed 4569 unique articles and identified 115 eligible studies. The prevalence of reported symptoms was highly variable among included studies. Variability in sample size, timing of the assessments, and the use of different measures was noted across studies. Content mapping of commonly used PROMs showed variability and poor capture of prevalent symptoms, even though validation studies confirmed satisfactory reliability and validity. This suggests limitations of some of the tools in providing an accurate and comprehensive picture of the patient's symptoms and problems.
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Affiliation(s)
- Sheilla de Oliveira Faria
- Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo 01246-903, Brazil
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada;
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada
- Correspondence: ; Tel.: +55-11-3061-8278
| | - Gillian Hurwitz
- Cancer Care Ontario, Toronto, ON M5G 2L7, Canada; (G.H.); (J.K.); (J.L.); (K.O.)
| | - Jaemin Kim
- Cancer Care Ontario, Toronto, ON M5G 2L7, Canada; (G.H.); (J.K.); (J.L.); (K.O.)
| | - Jacqueline Liberty
- Cancer Care Ontario, Toronto, ON M5G 2L7, Canada; (G.H.); (J.K.); (J.L.); (K.O.)
| | - Kimberly Orchard
- Cancer Care Ontario, Toronto, ON M5G 2L7, Canada; (G.H.); (J.K.); (J.L.); (K.O.)
| | - Geoffrey Liu
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada;
- Dalla Lana School of Public Health, Toronto, ON M5T 3M7, Canada
- Temerty Faculty of Medicine, Toronto, ON M5S 1A8, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Lisa Barbera
- Tom Baker Cancer Centre, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Doris Howell
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada;
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada
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13
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Fantini M, Crosetti E, Affaniti R, Sprio AE, Bertotto I, Succo G. Preoperative prognostic factors for functional and clinical outcomes after open partial horizontal laryngectomies. Head Neck 2021; 43:3459-3467. [PMID: 34405480 DOI: 10.1002/hed.26845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 06/19/2021] [Accepted: 08/05/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND In minority of cases, the clinical recovery of the neolarynx after open partial horizontal laryngectomies (OPHLs) can be challenging, possibly affecting the final functional outcome. METHODS One hundred and twenty-three patients who underwent OPHLs were selected. A series of clinical preoperative independent variables were considered. All patients were monitored for the following dependent outcome variables: sequelae; need for percutaneous endoscopic gastrostomy positioning; days before tracheal cannula removal and nasogastric tube removal; and length of hospital stay. Univariate and multivariate logistic regression analyses were performed to identify significant associations between preoperative clinical variables and outcomes variables. RESULTS Multivariate analysis confirmed age, cT classification, body mass index, and smoking habits as significant prognostic factors for worse functional and clinical recovery outcomes. CONCLUSIONS Knowing what variables are significantly associated with worse clinical and functional outcomes can guide clinicians in defining the best surgical choice not only from an oncological perspective, but also for a better postoperative recovery.
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Affiliation(s)
- Marco Fantini
- Head and Neck Oncology Unit, Candiolo Cancer Institute, FPO IRCCS, Candiolo (TO), Italy
| | - Erika Crosetti
- Head and Neck Oncology Unit, Candiolo Cancer Institute, FPO IRCCS, Candiolo (TO), Italy
| | - Riccardo Affaniti
- Head and Neck Oncology Unit, Candiolo Cancer Institute, FPO IRCCS, Candiolo (TO), Italy
| | - Andrea Elio Sprio
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.,Department of Research, ASOMI College of Sciences, Marsa, Malta
| | - Ilaria Bertotto
- Radiology Unit, Candiolo Cancer Institute, FPO IRCCS, Candiolo, Italy
| | - Giovanni Succo
- Head and Neck Oncology Unit, Candiolo Cancer Institute, FPO IRCCS, Candiolo (TO), Italy.,Oncology Department, University of Turin, Orbassano (TO), Italy
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14
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Nakai MY, Menezes MB, de Carvalho JVBG, Dias LPM, de Barros Silva LA, Tenório LR, Gonçalves AJ. Quality of life after Supracricoid Partial Laryngectomy. J Otolaryngol Head Neck Surg 2021; 50:20. [PMID: 33766134 PMCID: PMC7995799 DOI: 10.1186/s40463-021-00499-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 02/22/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Supracricoid partial laryngectomy has good oncologic results in the treatment of advanced laryngeal cancer with the advantage of preserving larynx phonatory function when compared with total laryngectomy. However the rehabilitation could be a challenge, especially regarding swallowing function. Is supracricoid partial laryngectomy associated with better quality of life than total laryngectomy? METHODS Survey study that included 33 patients (16 total laryngectomy and 17 supracricoid partial laryngectomy) with advanced larynx cancer surgically treated and fully rehabilitated. The quality of life were evaluated with EORTC QLQ C30 and H&N 35 instrument. RESULTS Patients who underwent supracricoid partial laryngectomy obtained better scores in global health status-quality of life and general activities and had lower levels of sensory and speech-related symptoms. CONCLUSION SPL was associated with better quality of life when compared with TL.
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Affiliation(s)
- Marianne Yumi Nakai
- Santa Casa de São Paulo School of Medical Sciences and Irmandade da Santa Casa de Misericórdia de São Paulo, Rua Cesário Motta Jr 112, São Paulo, SP, Brazil.
| | - Marcelo Benedito Menezes
- Santa Casa de São Paulo School of Medical Sciences and Irmandade da Santa Casa de Misericórdia de São Paulo, Rua Cesário Motta Jr 112, São Paulo, SP, Brazil
| | | | | | | | - Lucas Ribeiro Tenório
- Santa Casa de São Paulo School of Medical Sciences and Irmandade da Santa Casa de Misericórdia de São Paulo, Rua Cesário Motta Jr 112, São Paulo, SP, Brazil
| | - Antonio José Gonçalves
- Santa Casa de São Paulo School of Medical Sciences and Irmandade da Santa Casa de Misericórdia de São Paulo, Rua Cesário Motta Jr 112, São Paulo, SP, Brazil
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15
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Tokat T, Adibelli ZH, Koc AM, Muderris T, Atsal G, Ozkok G. Impact of magnetic resonance on the decision of conservative surgery in advanced larynx cancer. Am J Otolaryngol 2021; 42:102855. [PMID: 33445039 DOI: 10.1016/j.amjoto.2020.102855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 11/16/2020] [Accepted: 12/22/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To evaluate the utility of magnetic resonance images (MRI) in the selection of treatment procedures for intermediate-advanced laryngeal cancers. MATERIAL AND METHOD This study included patients with histologically proven laryngeal squamous cell carcinoma defined as cT3 and T4a at our tertiary academic care hospital. All scans were evaluated by two radiologists experienced in head and neck cross-sectional studies. Signal patterns in MRI sections of laryngeal compartment subsites were delineated as T1w, T2w hyperintensity, and T2w intermediate signals, and were compared with the postoperative pathological results. Sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) were calculated. RESULTS The study included 51 patients with a mean age of 62.55 ± 9.14 (range, 45-80) years. Tumor was glottic in 12 (23.5%) patients, supraglottic in 19 (31.4%) patients, glottic-supraglottic in 11 (21.6%) patients, transglottic in 9 (27%) patients. The posterior paraglottic space had the strongest specificity of MRI according to tumor infiltration in the histologic analysis (specificity 96.9% and sensitivity 78.6%). The specificity of MRI was poor for tumor infiltration in thyroid cartilage (specificity 70.0%). Spearman's test demonstrated that there was a statistically significant correlation between the MRI-based prediction scores of all subunites and the findings of histopathologic analyses (mean±SD: 4.96±4.46-5.53±4.38, respectively, R2: 0.711, p<0.001). CONCLUSION The high specificity values of the predictions, which were MRI-based in all subsites, indicated that MRI could provide an important contribution for defining tumor infiltration and the presurgical assessment of patients with tumors of the larynx.
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16
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Porras Alonso E, Vilaseca González I, García Teno M, Barberá Durbán R, Viscasillas Pallàs G, Sancho Mestre M, Rebollo Otal J, Menoyo Bueno A, Díaz de Cerio Canduela P. Early glottic tumours with anterior commissure involvement. Literature review and consensus document. Head and Neck and Skull Base Commission, SEORL-CCC. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2020; 71 Suppl 1:1-20. [PMID: 32532450 DOI: 10.1016/j.otorri.2020.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 02/04/2020] [Indexed: 01/08/2023]
Abstract
The choice of the most appropriate treatment in early-stage glottic cancer with anterior commissure involvement remains controversial. Its therapeutic management is complex because it is a significant prognostic indicator of local control with 37% recurrence, due to the difficulty in establishing tumour extension with understaging of up to 40%, and due to the comparison of results in series on tumours that behave variably as they progress, such as T1a, T1b and T2a with commissure involvement. Furthermore, the complexity of the surgical approach using transoral CO2 laser microsurgery requires surgical skill, appropriate equipment and experience. Aspects to be reviewed in this document are: an updated anatomical definition of the anterior commissure, tumour progression based on histopathological studies, usefulness of videostroboscopy and NBI in diagnostic accuracy, validity of imaging tests, oncological results published in series reviews, systematic reviews and meta-analyses, tumour margin treatment and voice evaluation.Finally, by way of a summary, the document includes a series of recommendations for the treatment of these tumours.
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17
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Early Glottic Tumours With Anterior Commissure Involvement. Literature Review and Consensus Document. Head and Neck and Skull Base Commission, SEORL-CCC. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2020. [DOI: 10.1016/j.otoeng.2020.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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18
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Zica GM, Freitas ASD, Silva ACAE, Dias FL, Santos IC, Freitas EQ, Koch HA. Swallowing, voice and quality of life of patients submitted to extended supratracheal laryngectomy. EINSTEIN-SAO PAULO 2020; 18:eAO5390. [PMID: 32428067 PMCID: PMC7233281 DOI: 10.31744/einstein_journal/2020ao5390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 12/12/2019] [Indexed: 12/13/2022] Open
Abstract
Objective To describe functional and quality of life results after extended supratracheal laryngectomy. Methods In the period from September 2009 to January 2018, 11 male subjects were submitted to extended supratracheal laryngectomy. Swallowing abilities were assessed through videofluoroscopy and the clinical scale Functional Communication Measures of Swallowing. The voices were classified by means of the perceptual-auditory analysis Consensus Auditory-Perceptual Evaluation of Voice. All subjects completed a self-assessment questionnaire for voice and swallowing. Results Aspiration was found in four patients and all presented stasis in different structures. All subjects in this study were exclusively orally fed and hydrated. In the evaluation of quality of life in swallowing, patients had mean >80 in all areas (83.47 mean of scores). The general degree and the presence of roughness were the highest means present in Consensus Auditory-Perceptual Evaluation of Voice (37.81 and 49.36, respectively). The mean of 33.36 (±22.56) had little impact on quality of life under the perspective of vocal aspects. Conclusion After supratracheal laryngectomy, swallowing was sufficiently restored and the quality of life was satisfactory. The voice presents severely impaired quality and preserved oral communication, with low impact on the activities of daily living. All individuals who maintained two cricoarytenoid units presented better functional results in swallowing and voice.
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19
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Bozec A, Culié D, Poissonnet G, Dassonville O. Current Role of Total Laryngectomy in the Era of Organ Preservation. Cancers (Basel) 2020; 12:cancers12030584. [PMID: 32138168 PMCID: PMC7139381 DOI: 10.3390/cancers12030584] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 01/02/2023] Open
Abstract
In this article, we aimed to discuss the role of total laryngectomy (TL) in the management of patients with larynx cancer (LC) in the era of organ preservation. Before the 1990s, TL followed by radiotherapy (RT) was the standard treatment for patients with locally advanced LC. Over the last 30 years, various types of larynx preservation (LP) programs associating induction or concurrent chemotherapy (CT) with RT have been developed, with the aim of treating locally advanced LC patients while preserving the larynx and its functions. Overall, more than two-thirds of patients included in a LP program will not require total laryngectomy (TL) and will preserve a functional larynx. However, despite these advances, the larynx is the only tumor site in the upper aero-digestive tract for which prognosis has not improved during recent decades. Indeed, none of these LP protocols have shown any survival advantage compared to primary radical surgery, and it appears that certain LC patients do not benefit from an LP program. This is the case for patients with T4a LC (extra-laryngeal tumor extension through the thyroid cartilage) or with poor pretreatment laryngeal function and for whom primary TL is still the preferred therapeutic option. Moreover, TL is the standard salvage therapy for patients with recurrent tumor after an LP protocol.
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Affiliation(s)
- Alexandre Bozec
- Correspondence: ; Tel.: +0033-4-92-03-17-66; Fax: +0033-4-92-03-17-64
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20
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Crosetti E, Bertolin A, Molteni G, Bertotto I, Balmativola D, Carraro M, Sprio AE, Berta GN, Presutti L, Rizzotto G, Succo G. Patterns of recurrence after open partial horizontal laryngectomy types II and III: univariate and logistic regression analysis of risk factors. ACTA ACUST UNITED AC 2020; 39:235-243. [PMID: 31501615 PMCID: PMC6734199 DOI: 10.14639/0392-100x-2409] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 01/11/2019] [Indexed: 11/23/2022]
Abstract
In choosing the best surgical treatment (total or partial laryngectomy) for patients affected by laryngeal squamous cell carcinoma (SCC), it is still necessary to identify a link between prognostic factors and oncological outcomes. A retrospective analysis of clinical outcomes of 819 patients affected by laryngeal cancer who underwent OPHL type II and III between 1995 to 2014 was carried out. Focusing on recurrence and its site (local, regional or distant), our cohort has been divided in two groups: patients showing recurrence (n = 108) vs those without recurrence (n = 711). Thirteen clinical-pathological parameters have been studied by univariate and multivariate analysis to identify possible correlations between recurrence and oncological outcomes (overall survival (OS), disease free survival (DFS), disease specific survival (DSS), laryngectomy free survival (LSF), laryngectomy free freedom (FFL). In multivariate analysis, we found 4 negative prognostic factors for recurrence: site of tumour (> supraglottic), cartilage invasion (> if present), perineural invasion (> if present) and type of OPHL (> in OPHL type III). The knowledge and detection of negative prognostic factors for the risk of recurrence (pN classification, cartilage involvement, perineural invasion, and thus the type of surgical treatment adopted) could increase the already well-established potentiality of OPHLs in treating cases with a safe indication after careful discussion in the tumour board.
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Affiliation(s)
- E Crosetti
- Head and Neck Oncology Service, Candiolo Cancer Institute - FPO IRCCS, Candiolo (TO), Italy
| | - A Bertolin
- Otolaryngology Service, Vittorio Veneto Hospital, Vittorio Veneto (TV) Italy
| | - G Molteni
- Department of Otolaryngology-Head and Neck Surgery, University Hospital of Verona, Italy
| | - I Bertotto
- Radiology Service, Candiolo Cancer Institute - FPO IRCCS, Candiolo (TO), Italy
| | - D Balmativola
- Pathology Service, Candiolo Cancer Institute - FPO IRCCS, Candiolo (TO), Italy
| | - M Carraro
- Head and Neck Oncology Service, Candiolo Cancer Institute - FPO IRCCS, Candiolo (TO), Italy
| | - A E Sprio
- Department of Clinical and Biological Sciences, University of Turin, Italy
| | - G N Berta
- Department of Clinical and Biological Sciences, University of Turin, Italy
| | - L Presutti
- Otolaryngology Service, Head and Neck Dept., Policlinico Hospital, University of Modena, Italy
| | - G Rizzotto
- Otolaryngology Service, Vittorio Veneto Hospital, Vittorio Veneto (TV) Italy
| | - G Succo
- Head and Neck Oncology Service, Candiolo Cancer Institute - FPO IRCCS, Candiolo (TO), Italy.,Oncology Dept. University of Turin, Italy
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21
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Shah RR, Weinstein GS, Mirza NA. Voice Restoration after Radiation and Supracricoid Partial Laryngectomy by Injection Augmentation of the Arytenoid. J Voice 2019; 35:483-486. [PMID: 31791668 DOI: 10.1016/j.jvoice.2019.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 11/04/2019] [Accepted: 11/06/2019] [Indexed: 10/25/2022]
Abstract
Supracricoid partial laryngectomy (SCPL) is an organ-preserving surgical technique intended to achieve oncologic control of laryngeal cancer while maintaining laryngeal functions. Most patients who undergo SCPL achieve a serviceable voice. However, several factors can affect the function of the neoglottis after SCPL. We report the case of a 53-year-old male referred for near aphonia after undergoing SCPL for recurrent laryngeal carcinoma initially treated with radiation. Calcium hydroxylapatite injection augmentation of the right arytenoid was performed to assist neoglottic closure. Flexible laryngoscopy demonstrated greatly improved neoglottic closure postoperatively, and the patient's voice was successfully restored. This case demonstrates a novel technique for voice restoration in patients who have undergone partial laryngectomy.
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Affiliation(s)
- Ravi R Shah
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Gregory S Weinstein
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Natasha A Mirza
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
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22
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Vella O, Blanchard D, de Raucourt D, Rame JP, Babin E. Function evaluation of laryngeal reconstruction using infrahyoid muscle after partial laryngectomy in 37patients. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 137:7-11. [PMID: 31540850 DOI: 10.1016/j.anorl.2019.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Treatment of small laryngeal cancerous lesions (T1 and T2) is based on partial endoscopic or open surgery and radiotherapy. In addition to the oncological imperative, these techniques must optimally preserve the functions of breathing, swallowing and phonation. OBJECTIVE To analyze the above functions in patients treated with supracricoid laryngectomy and reconstruction using infrahyoid muscle. MATERIALS AND METHODS Breathing, swallowing and phonation were analyzed in 37patients treated in two institutes between 2005 and 2015. All patients undergoing the above type of reconstruction with a minimum 1year's follow-up were included. Respiratory study noted any tracheotomy and measured peak inspiratory flow. Preservation of cricoarytenoid units and nasogastric intubation time, and DHI-30 self-administered questionnaire results were collected to analyze swallowing function. Phonation was assessed on the VHI-30 self-administered questionnaire. RESULTS The rate of primary surgery without tracheotomy was 64.9% (13patients), with rapid resumption of oral feeding (mean intubation time, 13days). Mean VHI score was 28.3 and mean DHI 30score 2.7. Mean peak inspiratory flow was 203.3mL/min. CONCLUSION Supracricoid laryngectomy with reconstruction using subhyoid muscle is an alternative technique for the treatment of small laryngeal cancerous lesions, providing uncomplicated functional outcome.
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Affiliation(s)
- O Vella
- Service d'ORL et de chirurgie cervico-faciale, CHU de Caen, Avenue de la Côte de Nacre, 14033 Caen, France.
| | - D Blanchard
- Service d'ORL et de chirurgie cervico-faciale, CLCC François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France
| | - D de Raucourt
- Service d'ORL et de chirurgie cervico-faciale, CLCC François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France
| | - J P Rame
- Service d'ORL et de chirurgie cervico-faciale, CLCC François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France
| | - E Babin
- Service d'ORL et de chirurgie cervico-faciale, CHU de Caen, Avenue de la Côte de Nacre, 14033 Caen, France
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23
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Pizzorni N, Crosetti E, Santambrogio E, de Cillis G, Bertolin A, Rizzotto G, Fantini M, Succo G, Schindler A. The Penetration-Aspiration Scale: Adaptation to Open Partial Laryngectomy and Reliability Analysis. Dysphagia 2019; 35:261-271. [PMID: 31161405 DOI: 10.1007/s00455-019-10025-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 05/06/2019] [Accepted: 05/25/2019] [Indexed: 11/25/2022]
Abstract
A standard for assessing swallowing function after open partial horizontal laryngectomy (OPHL) is still not established. The variability in the measures used to investigate swallowing functional outcomes after OPHL limits the communication among clinicians and the possibility to compare and combine results from different studies. The study aims to adapt the PAS to the altered anatomy after OPHLs using fiberoptic endoscopic evaluation of swallowing (FEES) and to test its reliability. To adapt the PAS, two landmarks were identified: the entry of the laryngeal vestibule and the neoglottis. Ninety patients who underwent an OPHL were recruited (27 type I, 31 type II and 32 type III). FEES was performed and video-recorded. Two speech and language therapists (SLTs) independently rated each FEES using the PAS adapted for OPHL (OPHL-PAS). FEES recordings were rated for a second time by both SLTs at least 15 days from the first video analysis. Inter- and intra-rater agreement was assessed using unweighted Cohen's kappa. Overall, inter-rater agreement of the OPHL-PAS was k = 0.863, while intra-rater agreement was k = 0.854. Concerning different OPHL types, inter- and intra-rater agreement were k = 0.924 and k = 0.914 for type I, k = 0.865 and k = 0.790 for type II, and k = 0.808 and k = 0.858 for type III, respectively. The OPHL-PAS is a reliable scale to assess the invasion of lower airway during swallowing in patients with OPHL using FEES. The study represents the first attempt to define standard tools to assess swallowing functional outcome in this population.
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Affiliation(s)
- Nicole Pizzorni
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy.
| | - Erika Crosetti
- Head and Neck Oncology Service, Candiolo Cancer Institute-FPO IRCCS, Candiolo, Italy
| | - Elena Santambrogio
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Giada de Cillis
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Andy Bertolin
- Department of Otorhinolaryngology, Ospedale Civile of Vittorio Veneto, Belluno, Italy
| | - Giuseppe Rizzotto
- Department of Otorhinolaryngology, Ospedale Civile of Vittorio Veneto, Belluno, Italy
| | - Marco Fantini
- Head and Neck Oncology Service, Candiolo Cancer Institute-FPO IRCCS, Candiolo, Italy
| | - Giovanni Succo
- Head and Neck Oncology Service, Candiolo Cancer Institute-FPO IRCCS, Candiolo, Italy
| | - Antonio Schindler
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
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24
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Succo G, Crosetti E. Limitations and Opportunities in Open Laryngeal Organ Preservation Surgery: Current Role of OPHLs. Front Oncol 2019; 9:408. [PMID: 31192120 PMCID: PMC6540733 DOI: 10.3389/fonc.2019.00408] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 04/30/2019] [Indexed: 11/29/2022] Open
Abstract
The current trend for treatment of intermediate-early advanced laryngeal cancer is essentially oriented toward preservation of organ and laryngeal function, and with a good potential for treating the disease. This goal can be achieved by adopting open laryngeal organ preservation surgery (OLOPS), at present mainly represented by open partial horizontal laryngectomies (OPHLs). An approach using rigorous selection criteria based on both the general condition of the patient and the local and regional extent of the disease gives excellent oncological and functional results in untreated patients. Similar outcomes, albeit slightly worse, are also obtainable in radio-recurrent and laser-recurrent patients. Troublesome postoperative management and the inconsistency of functional recovery are the main limitations for extensive application of this therapeutic strategy. The future direction is represented by simplification of the indications identifying iso-prognostic sub-categories within the T-stage, wider consensus on rehabilitation protocols, hybrid approaches to the larynx, and open minimally invasive access.
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Affiliation(s)
- Giovanni Succo
- Oncology Department, University of Turin, Turin, Italy.,Head Neck Oncology Unit, Candiolo Cancer Institute, FPO IRCCS, Turin, Italy
| | - Erika Crosetti
- Head Neck Oncology Unit, Candiolo Cancer Institute, FPO IRCCS, Turin, Italy
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25
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Pizzorni N, Schindler A, Castellari M, Fantini M, Crosetti E, Succo G. Swallowing Safety and Efficiency after Open Partial Horizontal Laryngectomy: A Videofluoroscopic Study. Cancers (Basel) 2019; 11:cancers11040549. [PMID: 30999620 PMCID: PMC6520791 DOI: 10.3390/cancers11040549] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/10/2019] [Accepted: 04/15/2019] [Indexed: 12/11/2022] Open
Abstract
Dysphagia is common after an open partial horizontal laryngectomy (OPHL). The mechanisms causing lower airways’ invasion and pharyngeal residue are unclear. The study aims to examine physio-pathological mechanisms affecting swallowing safety and efficiency after OPHL. Fifteen patients who underwent an OPHL type IIa with arytenoid resection were recruited. Videofluoroscopic examination of swallowing was performed. Ten spatial, temporal, and scalar parameters were analyzed. Swallowing safety and efficiency were assessed through the Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) scale. Swallowing was considered unsafe or inefficient for a DIGEST safety or efficiency grade ≥2, respectively. Videofluoroscopic measurements were compared between safe vs. unsafe swallowers, and efficient vs. inefficient swallowers. Seven patients (46.7%) showed unsafe swallowing and 6 patients (40%) inefficient swallowing. Unsafe swallowers had worse laryngeal closure (p = 0.021). Inefficient swallowers presented a longer pharyngeal transit time (p = 0.008), a reduced pharyngoesophageal segment opening lateral (p = 0.008), and a worse tongue base retraction (p = 0.018 with solids and p = 0.049 with semisolids). In conclusion, swallowing safety was affected by incomplete laryngeal closure, while swallowing efficiency was affected by increased pharyngeal transit time, reduced upper esophageal sphincter opening, and incomplete tongue base retraction. The identified physio-pathological mechanisms could represent targets for rehabilitative and surgical approaches in patients with dysphagia after OPHL.
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Affiliation(s)
- Nicole Pizzorni
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Via GB Grassi 74, 20154 Milano, Italy.
| | - Antonio Schindler
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Via GB Grassi 74, 20154 Milano, Italy.
| | - Micol Castellari
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Via GB Grassi 74, 20154 Milano, Italy.
| | - Marco Fantini
- Head and Neck Oncology Service, Candiolo Cancer Institute-FPO IRCCS, Strada Provinciale 142 km 95, 10060 Candiolo (TO), Italy.
| | - Erika Crosetti
- Head and Neck Oncology Service, Candiolo Cancer Institute-FPO IRCCS, Strada Provinciale 142 km 95, 10060 Candiolo (TO), Italy.
| | - Giovanni Succo
- Head and Neck Oncology Service, Candiolo Cancer Institute-FPO IRCCS, Strada Provinciale 142 km 95, 10060 Candiolo (TO), Italy.
- Department of Oncology, University of Turin, 10043 Orbassano (TO), Italy.
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Di Santo D, Bondi S, Giordano L, Galli A, Tulli M, Ramella B, Bussi M. Long-term Swallowing Function, Pulmonary Complications, and Quality of Life after Supracricoid Laryngectomy. Otolaryngol Head Neck Surg 2019; 161:307-314. [DOI: 10.1177/0194599819835189] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objectives Long-term effects of supracricoid laryngectomies are nowadays under discussion. The purpose of this study was to detect the prevalence of chronic aspiration and incidence of pulmonary complications, to investigate possible influencing factors, and to analyze dysphagia-related quality of life in a cohort of patients who recovered swallowing function after undergoing supracricoid laryngectomies. Study Design Retrospective observational study. Setting San Raffaele Hospital, Vita-Salute University, Milan, Italy. Methods A cohort of 39 patients who recovered swallowing function free of disease after a minimum 3-year follow-up period was retrospectively investigated between October and December 2017—clinically with the Pearson’s Scale and M. D. Anderson Dysphagia Inventory and instrumentally with fiberoptic endoscopic evaluation of swallowing. Results Chronic aspiration was demonstrated in a significant portion of patients (clinically in 33.3% and instrumentally in 35.9%). Aspiration was influenced by advanced age at surgery ( P = .020). Type of surgical procedure, resection of 1 arytenoid cartilage, postoperative rehabilitation with a speech-language therapist, radiotherapy, age at consultation, and length of follow-up did not influence the prevalence of aspiration. Pulmonary complications affected 5 patients; incidence of pulmonary complications was related to aspiration and was favored by poor laryngeal sensation/cough reflex. Aspiration significantly affected quality of life. Conclusions Chronic aspiration is frequent and affects patients’ quality of life. However, incidence of pulmonary complications is low; therefore, oral feeding should not be contraindicated for aspirating patients. Preservation of laryngeal sensation and cough reflex is mandatory to prevent pulmonary complications.
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Affiliation(s)
- Davide Di Santo
- Department of Otorhinolaryngology–Head and Neck Surgery, San Raffaele Hospital, Vita-Salute University, Milan, Italy
| | - Stefano Bondi
- Department of Otorhinolaryngology–Head and Neck Surgery, San Raffaele Hospital, Vita-Salute University, Milan, Italy
| | - Leone Giordano
- Department of Otorhinolaryngology–Head and Neck Surgery, San Raffaele Hospital, Vita-Salute University, Milan, Italy
| | - Andrea Galli
- Department of Otorhinolaryngology–Head and Neck Surgery, San Raffaele Hospital, Vita-Salute University, Milan, Italy
| | - Michele Tulli
- Department of Otorhinolaryngology–Head and Neck Surgery, San Raffaele Hospital, Vita-Salute University, Milan, Italy
| | - Barbara Ramella
- Department of Otorhinolaryngology–Head and Neck Surgery, San Raffaele Hospital, Vita-Salute University, Milan, Italy
| | - Mario Bussi
- Department of Otorhinolaryngology–Head and Neck Surgery, San Raffaele Hospital, Vita-Salute University, Milan, Italy
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Nakayama M, Holsinger FC, Orosco RK. Hybrid supracricoid partial laryngectomy with cricohyoidoepiglottopexy via transoral robotic surgery. Laryngoscope 2018; 129:2065-2070. [DOI: 10.1002/lary.27628] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Meijin Nakayama
- Department of Otolaryngology–Head and Neck SurgeryYokohama City University Yokohama Japan
| | - F. Christopher Holsinger
- Division of Head and Neck Surgery, Department of OtolaryngologyStanford University Palo Alto California U.S.A
| | - Ryan K. Orosco
- Division of Head and Neck SurgeryUniversity of California San Diego San Diego California U.S.A
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Role of supracricoid partial laryngectomy with cricohyoidoepiglottopexy in glottic carcinoma with anterior commissure involvement. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:249-253. [DOI: 10.1016/j.anorl.2018.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Succo G, Crosetti E, Bertolin A, Piazza C, Molteni G, Cirillo S, Petracchini M, Tascone M, Sprio AE, Berta GN, Peretti G, Presutti L, Rizzotto G. Treatment for T3 to T4a laryngeal cancer by open partial horizontal laryngectomies: Prognostic impact of different pathologic tumor subcategories. Head Neck 2018; 40:1897-1908. [DOI: 10.1002/hed.25176] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 11/27/2017] [Accepted: 02/15/2018] [Indexed: 11/07/2022] Open
Affiliation(s)
- Giovanni Succo
- Head and Neck Oncology Service, Oncology Department; University of Turin, Candiolo Cancer Institute - FPO; IRCCS Candiolo (To) Italy
| | - Erika Crosetti
- Head and Neck Oncology Service, Oncology Department; University of Turin, Candiolo Cancer Institute - FPO; IRCCS Candiolo (To) Italy
| | - Andy Bertolin
- Otolaryngology Service, Vittorio Veneto Hospital; Vittorio Veneto; Treviso Italy
| | - Cesare Piazza
- Department of Otorhinolaryngology - Head and Neck Surgery; University of Brescia; Brescia Italy
| | - Gabriele Molteni
- Otolaryngology Service, Head and Neck Department, Policlinico Hospital; University of Modena; Italy
| | - Stefano Cirillo
- Radiology Service; Mauriziano Umberto I Hospital; Turin Italy
| | | | - Martina Tascone
- Head and Neck Oncology Service, Oncology Department; University of Turin, Candiolo Cancer Institute - FPO; IRCCS Candiolo (To) Italy
| | - Andrea Elio Sprio
- Department of Clinical and Biological Sciences; University of Turin; Italy
| | | | - Giorgio Peretti
- Department of Otorhinolaryngology - Head and Neck Surgery; University of Genoa; Genoa Italy
| | - Livio Presutti
- Otolaryngology Service, Head and Neck Department, Policlinico Hospital; University of Modena; Italy
| | - Giuseppe Rizzotto
- Otolaryngology Service, Vittorio Veneto Hospital; Vittorio Veneto; Treviso Italy
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Güneş S, Orhan KS, Başaran B, Çelik M, Kıyak E. Comparison of long-term functional results between standard supracricoid laryngectomy and modified technique with sternohyoid muscle. Braz J Otorhinolaryngol 2018; 85:344-350. [PMID: 29631896 PMCID: PMC9442898 DOI: 10.1016/j.bjorl.2018.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 01/29/2018] [Accepted: 02/20/2018] [Indexed: 12/03/2022] Open
Abstract
Introduction Laryngeal cancer is the most common cancer of the upper respiratory tract. The main methods of treatment included surgery (partial laryngectomy and total laryngectomy) and radiation therapy. Laryngeal dysfunction is seen after both treatment modalities. Objective The aim of the study is to compare postoperative functional results of the standard supracricoid partial laryngectomy technique and a modified supracricoid partial laryngectomy technique using the sternohyoid muscle. Methods In total, 29 male patients (average years 58.20 ± 9.00 years; range 41–79 years) with laryngeal squamous cell carcinoma who underwent supra cricoid partial laryngectomy were included. The patients were divided into two groups in terms of the surgical techniques. In Group A, all patients underwent standard supracricoid partial laryngectomy technique between January 2007 and November 2011. In Group B, all patients underwent modified supracricoid partial laryngectomy between August 2010 and November 2011. Fiberoptic endoscopic evaluation of swallowing test, short version of the voice handicap index scores, and the MD Anderson dysphagia inventory, the time of oral feeding and the decanulation of the patients after surgery of each groups were compared. Results The mean maximum phonation time was 8.68 ± 4.21 s in Group A and 15.24 ± 6.16 s in Group B (p > 0.05). The S/Z (s/s) ratio was 1.23 ± 0.35 in Group A and 1.08 ± 0.26 in Group B (p > 0.05); the voice handicap index averages were 9.86 ± 4.77 in Group A and 12.42 ± 12.54 in Group B (p > 0.05); the fiberoptic endoscopic evaluation of swallowing test averages were calculated as 12.73 ± 3.08 in Group A and 13.64 ± 1.49 in Group B (p > 0.05). In the MD Anderson dysphagia inventory, evaluation of swallowing, the emotional, physical, and functional scores were 29.21 ± 4.11, 32.21 ± 6.85, and 20.14 ± 2.17 in the Group B, and 29.20 ± 2.54, 32.4 ± 4.79, and 19 ± 1.92 in Group A, respectively. Conclusion Although there is no statistical difference in functional outcome comparisons, if rules are adhered to in preoperative patient selection, modified supracricoid partial laryngectomy can be applied safely and meaningful gains can be achieved in functional outcomes.
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Affiliation(s)
- Selçuk Güneş
- Istanbul University, Faculty of Medicine, Department of Otolaryngology Head and Neck Surgery, Istanbul, Turkey; Bakırköy Dr Sadi Konuk Research and Teaching Hospital, Department of Otolaryngology Head and Neck Surgery, Istanbul, Turkey.
| | - Kadir Serkan Orhan
- Istanbul University, Faculty of Medicine, Department of Otolaryngology Head and Neck Surgery, Istanbul, Turkey
| | - Bora Başaran
- Istanbul University, Faculty of Medicine, Department of Otolaryngology Head and Neck Surgery, Istanbul, Turkey
| | - Mehmet Çelik
- Istanbul University, Faculty of Medicine, Department of Otolaryngology Head and Neck Surgery, Istanbul, Turkey
| | - Erkan Kıyak
- Istanbul University, Faculty of Medicine, Department of Otolaryngology Head and Neck Surgery, Istanbul, Turkey
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Relationship between swallowing-related quality of life and fiberoptic endoscopic evaluation of swallowing in patients who underwent open partial horizontal laryngectomy. Eur Arch Otorhinolaryngol 2018; 275:973-985. [DOI: 10.1007/s00405-018-4888-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 01/24/2018] [Indexed: 10/18/2022]
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Supratracheal partial laryngectomy: indications, oncologic and functional results. Curr Opin Otolaryngol Head Neck Surg 2018; 25:127-132. [PMID: 28169863 DOI: 10.1097/moo.0000000000000344] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW To describe current evidence about supratracheal laryngectomies, focusing on indications, contraindications, oncologic results, functional outcomes and side-effects of this 'extreme' function-sparing surgical approach to laryngeal cancer. RECENT FINDINGS In the latest years, some studies have analyzed oncologic and functional results of open partial supratracheal laryngectomy, a surgical approach whose modern technique was recently described. In selected patients, supratracheal partial laryngectomies show promising long-term oncologic and functional outcomes, similar to those of supracricoid partial laryngectomies. SUMMARY The application of supratracheal laryngectomy in the context of a surgical modular approach can be considered a valid and effective therapeutic choice for selected patients with glottic or transglottic laryngeal cancer with subglottic extension, not only in terms of oncologic results, but also in regard of functional outcomes.
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Crosetti E, Caracciolo A, Molteni G, Sprio AE, Berta GN, Presutti L, Succo G. Unravelling the risk factors that underlie laryngeal surgery in elderly. ACTA OTORHINOLARYNGOLOGICA ITALICA 2017; 36:185-93. [PMID: 27214829 PMCID: PMC4977005 DOI: 10.14639/0392-100x-817] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 01/10/2016] [Indexed: 01/13/2023]
Abstract
Older patients are not considered good candidates to undergo more challenging therapeutic treatments, e.g. highly invasive surgery and complex chemotherapy. However, their exclusion from standard therapeutic options is not justifiable. Herein, we reviewed 212 patients aged ≥ 70, affected with laryngeal squamous cell carcinoma, and treated with transoral laser microsurgery or open neck (partial / total) laryngectomy with radical intent. The main aim was to compare patient outcomes to identify predictive factors that can be used by surgeons to choose the most appropriate treatment option. In our cohort, patients affected with more advanced tumour and hence treated by invasive open neck surgeries (above all TL) are more prone to develop complications and undergo fatal outcome than those with early disease treated by laser microsurgery, independently of age at surgery. In conclusion, elderly patients affected by laryngeal cancer can be treated similarly to younger patients, keeping in mind that more invasive surgeries are associated with a higher risk of developing complications. The advantages of mini-invasive surgery make it a possible first choice treatment in very old and frail patients suffering from laryngeal cancer, especially considering the recent success in treatment of some advanced stage tumours. Furthermore, comorbidities, by themselves, should not be used as exclusion criteria for subjecting an elderly patient to a different treatment that is from standard therapy.
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Affiliation(s)
- E Crosetti
- Head and Neck Service, Candiolo Cancer Institute, FPO IRCCS, Candiolo (TO), Italy
| | - A Caracciolo
- Otorhinolaryngology Service, San Luigi Gonzaga Hospital, University of Turin, Italy
| | - G Molteni
- Otorhinolaryngology Service, Policlinico di Modena Hospital, University of Modena, Department of Head and Neck Surgery, Modena, Italy
| | - A E Sprio
- Department of Clinical and Biological Sciences, University of Turin, Italy
| | - G N Berta
- Department of Clinical and Biological Sciences, University of Turin, Italy
| | - L Presutti
- Otorhinolaryngology Service, Policlinico di Modena Hospital, University of Modena, Department of Head and Neck Surgery, Modena, Italy
| | - G Succo
- Otorhinolaryngology Service, San Luigi Gonzaga Hospital, University of Turin, Italy
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Giordano L, Di Santo D, Crosetti E, Bertolin A, Rizzotto G, Succo G, Bussi M. Open partial horizontal laryngectomies: is it time to adopt a modular form of consent for the intervention? ACTA OTORHINOLARYNGOLOGICA ITALICA 2017; 36:403-407. [PMID: 27958601 PMCID: PMC5225796 DOI: 10.14639/0392-100x-769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 06/11/2016] [Indexed: 11/23/2022]
Abstract
Nowadays, open partial horizontal laryngectomies (OPHLs) are well-established procedures for treatment of laryngeal cancer. Their uniqueness is the possibility to modulate the intervention intraoperatively, according to eventual tumour extension. An OPHL procedure is not easy to understand: there are several types of procedures and the possibility to modulate the intervention can produce confusion and lack of adherence to the treatment from the patient. Even if the surgery is tailored to a patient's specific lesion, a unified consent form that discloses any possible extensions, including a total laryngectomy, is still needed. We reviewed the English literature on informed consent, and propose comprehensive Information and Consent Forms for OPHLs. The Information Form is intended to answer any possible questions about the procedure, while remaining easy to read and understand for the patient. It includes sections on laryngeal anatomy and physiology, surgical aims and indications, alternatives to surgery, complications, and physiology of the operated larynx. The Consent Form is written in a "modular" way: the surgeon defines the precise extension of the lesion, chooses the best OPHL procedure and highlights all possible expected extensions specific for the patient. Our intention, providing these forms both in Italian and in English, is to optimise communication between the patient and surgeon, improving surgical procedure arrangements and preventing any possible misunderstandings and medico-legal litigation.
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Affiliation(s)
- L Giordano
- Otolaryngology Service, Head and Neck Department, "San Raffaele" Hospital, "Vita-Salute" University, Milan, Italy
| | - D Di Santo
- Otolaryngology Service, Head and Neck Department, "San Raffaele" Hospital, "Vita-Salute" University, Milan, Italy
| | - E Crosetti
- Head and Neck Oncology Service, IRCCS FPO Candiolo Cancer Institute Turin, Italy
| | - A Bertolin
- Otolaryngology Service, Vittorio Veneto Hospital, Treviso, Italy
| | - G Rizzotto
- Otolaryngology Service, Vittorio Veneto Hospital, Treviso, Italy
| | - G Succo
- Otolaryngology Service, Oncology Department, "San Luigi Gonzaga" Hospital, University of Turin, Italy
| | - M Bussi
- Otolaryngology Service, Head and Neck Department, "San Raffaele" Hospital, "Vita-Salute" University, Milan, Italy
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Hamilton NJI, Birchall MA. Tissue-Engineered Larynx: Future Applications in Laryngeal Cancer. CURRENT OTORHINOLARYNGOLOGY REPORTS 2017; 5:42-48. [PMID: 28367360 PMCID: PMC5357481 DOI: 10.1007/s40136-017-0144-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Purpose of Review This article reviews the latest developments in tissue engineering for the larynx with a specific focus on the treatment of laryngeal cancer. Recent Findings Challenges in tissue engineering a total larynx can be divided into scaffold design, methods of re-mucosalization, and how to restore laryngeal function. The literature described a range of methods to deliver a laryngeal scaffold including examples of synthetic, biomimetic, and biological scaffolds. Methods to regenerate laryngeal mucosa can be divided into examples that use a biological dressing and those that engineer a new mucosal layer de novo. Studies aiming to restore laryngeal function have been reported, but to date, the optimum method for achieving this as part of a total laryngeal transplant is yet to be determined. Summary There is great potential for tissue engineering to improve the treatments available for laryngeal cancer within the next 10 years. A number of challenges exist however and advances in restoring function must keep pace with developments in scaffold design.
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Ahn SH, Hong HJ, Kwon SY, Kwon KH, Roh JL, Ryu J, Park JH, Baek SK, Lee GH, Lee SY, Lee JC, Chung MK, Joo YH, Ji YB, Hah JH, Kwon M, Park YM, Song CM, Shin SC, Ryu CH, Lee DY, Lee YC, Chang JW, Jeong HM, Cho JK, Cha W, Chun BJ, Choi IJ, Choi HG, Lee KD. Guidelines for the Surgical Management of Laryngeal Cancer: Korean Society of Thyroid-Head and Neck Surgery. Clin Exp Otorhinolaryngol 2017; 10:1-43. [PMID: 28043099 PMCID: PMC5327593 DOI: 10.21053/ceo.2016.01389] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 10/24/2016] [Indexed: 01/08/2023] Open
Abstract
Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to develop clinical practice guidelines for the surgical treatment of laryngeal cancer. This Task Force conducted a systematic search of the EMBASE, MEDLINE, Cochrane Library, and KoreaMed databases to identify relevant articles, using search terms selected according to the key questions. Evidence-based recommendations were then created on the basis of these articles. An external expert review and Delphi questionnaire were applied to reach consensus regarding the recommendations. The resulting guidelines focus on the surgical treatment of laryngeal cancer with the assumption that surgery is the selected treatment modality after a multidisciplinary discussion in any context. These guidelines do not, therefore, address non-surgical treatment such as radiation therapy or chemotherapy. The committee developed 62 evidence-based recommendations in 32 categories intended to assist clinicians during management of patients with laryngeal cancer and patients with laryngeal cancer, and counselors and health policy-makers.
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Affiliation(s)
- Korean Society of Thyroid-Head and Neck Surgery Guideline Task Force
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Catholic Kwandong University College of Medicine, Incheon, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Hallym University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, University of Ulsan College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, National Cancer Center, Goyang, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Chosun University College of Medicine, Gwangju, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Korea Cancer Center Hospital, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Daejin Medical Center, Bundang Jesaeng Hospital, Seongnam, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Wonkwang University School of Medicine, Iksan, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Inje University College of Medicine, Busan, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Seonam University College of Medicine, Goyang, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Kosin University College of Medicine, Busan, Korea
| | - Soon-Hyun Ahn
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun Jun Hong
- Department of Otorhinolaryngology Head and Neck Surgery, Catholic Kwandong University College of Medicine, Incheon, Korea
| | - Soon Young Kwon
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Kee Hwan Kwon
- Department of Otorhinolaryngology Head and Neck Surgery, Hallym University College of Medicine, Seoul, Korea
| | - Jong-Lyel Roh
- Department of Otorhinolaryngology Head and Neck Surgery, University of Ulsan College of Medicine, Seoul, Korea
| | - Junsun Ryu
- Department of Otorhinolaryngology Head and Neck Surgery, National Cancer Center, Goyang, Korea
| | - Jun Hee Park
- Department of Otorhinolaryngology Head and Neck Surgery, Chosun University College of Medicine, Gwangju, Korea
| | - Seung-Kuk Baek
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Guk Haeng Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Korea Cancer Center Hospital, Seoul, Korea
| | - Sei Young Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jin Choon Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
| | - Man Ki Chung
- Department of Otorhinolaryngology Head and Neck Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Hoon Joo
- Department of Otorhinolaryngology Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong Bae Ji
- Department of Otorhinolaryngology Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Jeong Hun Hah
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Minsu Kwon
- Department of Otorhinolaryngology Head and Neck Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Young Min Park
- Department of Otorhinolaryngology Head and Neck Surgery, Daejin Medical Center, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Chang Myeon Song
- Department of Otorhinolaryngology Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Sung-Chan Shin
- Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
| | - Chang Hwan Ryu
- Department of Otorhinolaryngology Head and Neck Surgery, National Cancer Center, Goyang, Korea
| | - Doh Young Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Young Chan Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jae Won Chang
- Department of Otorhinolaryngology Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
| | - Ha Min Jeong
- Department of Otorhinolaryngology Head and Neck Surgery, Wonkwang University School of Medicine, Iksan, Korea
| | - Jae-Keun Cho
- Department of Otorhinolaryngology Head and Neck Surgery, Inje University College of Medicine, Busan, Korea
| | - Wonjae Cha
- Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
| | - Byung Joon Chun
- Department of Otorhinolaryngology Head and Neck Surgery, Seonam University College of Medicine, Goyang, Korea
| | - Ik Joon Choi
- Department of Otorhinolaryngology Head and Neck Surgery, Korea Cancer Center Hospital, Seoul, Korea
| | - Hyo Geun Choi
- Department of Otorhinolaryngology Head and Neck Surgery, Hallym University College of Medicine, Seoul, Korea
| | - Kang Dae Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Kosin University College of Medicine, Busan, Korea
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Wiegand S. Evidence and evidence gaps of laryngeal cancer surgery. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2016; 15:Doc03. [PMID: 28025603 PMCID: PMC5169076 DOI: 10.3205/cto000130] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Surgical treatment of laryngeal cancer has been established for decades. In addition to total laryngectomy, which was first performed in 1873, a large number or organ preservation surgical techniques, like open partial laryngectomy, transoral laser microsurgery, and transoral robotic surgery have been developed. Studies on laryngeal cancer surgery are mainly retrospective case series and cohort studies. The evolution of chemoradiation protocols and their analysis in prospective randomized trials have led to an increasing acceptance of non-surgical treatment procedures. In addition to an improvement of prognosis, in recent years the preservation of function and maintenance of life quality after primary therapy of laryngeal cancer has increasingly become the focus of therapy planning. Significant late toxicity after chemoradiation has been identified as an important issue. This leads to a reassessment of surgical concepts and initiation of studies on laryngeal cancer surgery which was additionally stimulated by the advent of transoral robotic surgery in the US. Improving the evidence base of laryngeal cancer surgery by successful establishment of surgical trials should be the future goal.
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Affiliation(s)
- Susanne Wiegand
- Department of Otolaryngology, Head & Neck Surgery, University Hospital of Leipzig, Germany
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Breunig C, Benter P, Seidl RO, Coordes A. Predictable swallowing function after open horizontal supraglottic partial laryngectomy. Auris Nasus Larynx 2016; 43:658-65. [DOI: 10.1016/j.anl.2016.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 12/26/2015] [Accepted: 01/14/2016] [Indexed: 12/20/2022]
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Kılıç C, Tunçel Ü, Kaya M, Cömert E, Özlügedik S. Swallowing and Aspiration: How Much Is Affected by the Number of Arytenoid Cartilages Remaining After Supracricoid Partial Laryngectomy? Clin Exp Otorhinolaryngol 2016; 10:344-348. [PMID: 27440130 PMCID: PMC5678037 DOI: 10.21053/ceo.2015.01837] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 06/07/2016] [Accepted: 06/10/2016] [Indexed: 11/22/2022] Open
Abstract
Objectives The aim of this study was to compare the effect of the presence of one or two arytenoids on early/late period swallowing-aspiration functions. Methods Supracricoid partial laryngectomy (SCPL) with the diagnosis of laryngeal cancer between 2012 and 2014 were retrospectively evaluated. The patients were categorized into two groups as follows: group I, patients who underwent SCPL with one arytenoid cartilage and group II, patients who underwent SCPL with two arytenoid cartilages. The time of decannulation and oral feeding onset, and swallowing-aspiration functions were evaluated and compared in the early nutritional period, first, and third months. Results There was no significant correlation between decannulation time and swallowing-aspiration. The aspiration rates in group I and group II were similar and there was no significant difference in oral feeding onset and aspiration grades in the first and third months between both groups. Conclusion We found similar oncological and functional outcomes in SCPL which protected one or two arytenoid cartilages. Therefore we suggest to be performed one arytenoid cartilage SCPL in selected patients who was advance stage and tumor volume over with larynx cancer.
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Affiliation(s)
- Caner Kılıç
- Department of Otorhinolaryngology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Ümit Tunçel
- Department of Otorhinolaryngology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Metin Kaya
- Batman Government Hospital, Batman, Turkey
| | - Ela Cömert
- Department of Otorhinolaryngology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Samet Özlügedik
- Department of Otorhinolaryngology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
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The senile functional evolution of the larynx after supracricoid reconstructive surgery. Eur Arch Otorhinolaryngol 2016; 273:4359-4368. [DOI: 10.1007/s00405-016-4177-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 06/24/2016] [Indexed: 10/21/2022]
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Peretti G, Piazza C, Penco S, Santori G, Del Bon F, Garofolo S, Paderno A, Guastini L, Nicolai P. Transoral laser microsurgery as primary treatment for selected T3 glottic and supraglottic cancers. Head Neck 2016; 38:1107-12. [DOI: 10.1002/hed.24424] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2015] [Indexed: 11/12/2022] Open
Affiliation(s)
- Giorgio Peretti
- Department of Otorhinolaryngology - Head and Neck Surgery; University of Genoa; Genoa Italy
| | - Cesare Piazza
- Department of Otorhinolaryngology - Head and Neck Surgery; University of Brescia; Brescia Italy
| | - Sara Penco
- Department of Otorhinolaryngology - Head and Neck Surgery; University of Genoa; Genoa Italy
| | - Gregorio Santori
- Department of Surgical Sciences and Integrated Diagnostics; University of Genoa; Genoa Italy
| | - Francesca Del Bon
- Department of Otorhinolaryngology - Head and Neck Surgery; University of Brescia; Brescia Italy
| | - Sabrina Garofolo
- Department of Otorhinolaryngology - Head and Neck Surgery; University of Genoa; Genoa Italy
| | - Alberto Paderno
- Department of Otorhinolaryngology - Head and Neck Surgery; University of Brescia; Brescia Italy
| | - Luca Guastini
- Department of Otorhinolaryngology - Head and Neck Surgery; University of Genoa; Genoa Italy
| | - Piero Nicolai
- Department of Otorhinolaryngology - Head and Neck Surgery; University of Brescia; Brescia Italy
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Schindler A, Pizzorni N, Fantini M, Crosetti E, Bertolin A, Rizzotto G, Succo G. Long-term functional results after open partial horizontal laryngectomy type IIa and type IIIa: A comparison study. Head Neck 2015; 38 Suppl 1:E1427-35. [PMID: 26560504 DOI: 10.1002/hed.24254] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2015] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The purpose of this study was to compare long-term swallowing, voice results, and quality of life (QOL) after open partial horizontal laryngectomy (OPHL) type IIa and type IIIa. METHODS Twenty-three patients after OPHL type IIa and 18 patients after OPHL type IIIa were involved. Swallowing skills and neoglottis' motility and vibrations were videoendoscopically assessed. Aerodynamic measures, spectrogram analysis, aspiration pneumonia, body weight variations, and voice perceptual assessment were performed. Generic voice-related and swallowing-related QOL were assessed. Data were statistically compared using Mann-Whitney U test or Fisher exact tests, as appropriate. RESULTS Significant differences were found only for the residue with solids and for the intelligibility (I) parameter of the overall quality impression and intelligibility, additive and unnecessary noise, speech fluency, and presence of voiced segments scale with patients of the OPHL type IIIa group showing worse performances than the OPHL type IIa group. CONCLUSION Patients who underwent OPHL type IIa and type IIIa show comparable long-term functional outcomes. OPHL type IIIa represents a valid surgical alternative to OPHL type IIa. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1427-E1435, 2016.
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Affiliation(s)
- Antonio Schindler
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Nicole Pizzorni
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Marco Fantini
- Department of Otorhinolaryngology, Ospedale San Luigi Gonzaga, University of Turin, Italy
| | - Erika Crosetti
- Department of Otorhinolaryngology, Ospedale Martini, Turin, Italy
| | - Andy Bertolin
- Department of Otorhinolaryngology, Ospedale Civile of Vittorio Veneto, Belluno, Italy
| | - Giuseppe Rizzotto
- Department of Otorhinolaryngology, Ospedale Civile of Vittorio Veneto, Belluno, Italy
| | - Giovanni Succo
- Department of Otorhinolaryngology, Ospedale San Luigi Gonzaga, University of Turin, Italy
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Schindler A, Pizzorni N, Mozzanica F, Fantini M, Ginocchio D, Bertolin A, Crosetti E, Succo G. Functional outcomes after supracricoid laryngectomy: what do we not know and what do we need to know? Eur Arch Otorhinolaryngol 2015; 273:3459-3475. [DOI: 10.1007/s00405-015-3822-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 10/29/2015] [Indexed: 10/22/2022]
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Succo G, Crosetti E, Bertolin A, Lucioni M, Arrigoni G, Panetta V, Sprio AE, Berta GN, Rizzotto G. Benefits and drawbacks of open partial horizontal laryngectomies, Part B: Intermediate and selected advanced stage laryngeal carcinoma. Head Neck 2015; 38 Suppl 1:E649-57. [DOI: 10.1002/hed.24064] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 01/26/2015] [Accepted: 04/10/2015] [Indexed: 11/11/2022] Open
Affiliation(s)
- Giovanni Succo
- Otorhinolaryngology Service; Department of Oncology; San Luigi Gonzaga Hospital, University of Turin; Turin Italy
| | - Erika Crosetti
- Otorhinolaryngology Service; Martini Hospital; Turin Italy
| | - Andy Bertolin
- Otorhinolaryngology Service; Vittorio Veneto Hospital, Vittorio Veneto; Treviso Italy
| | - Marco Lucioni
- Otorhinolaryngology Service; Vittorio Veneto Hospital, Vittorio Veneto; Treviso Italy
| | - Giulia Arrigoni
- Otorhinolaryngology Service; Department of Oncology; San Luigi Gonzaga Hospital, University of Turin; Turin Italy
| | - Valentina Panetta
- L'altrastatistica srl; Consultancy and Training, Biostatistics Office; Rome Italy
| | - Andrea E. Sprio
- Department of Clinical and Biological Sciences; University of Turin; Turin Italy
| | - Giovanni N. Berta
- Department of Clinical and Biological Sciences; University of Turin; Turin Italy
| | - Giuseppe Rizzotto
- Otorhinolaryngology Service; Vittorio Veneto Hospital, Vittorio Veneto; Treviso Italy
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Lips M, Speyer R, Zumach A, Kross KW, Kremer B. Supracricoid laryngectomy and dysphagia: A systematic literature review. Laryngoscope 2015; 125:2143-56. [DOI: 10.1002/lary.25341] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Marieke Lips
- Department of Otorhinolaryngology and Head and Neck Surgery; Maastricht University Medical Center; Maastricht The Netherlands
| | - Renée Speyer
- Department of Otorhinolaryngology and Head and Neck Surgery; Leiden University Medical Center; Leiden The Netherlands
- School of Public Health; Tropical Medicine and Rehabilitation Sciences; James Cook University; Townsville Queensland Australia
| | - Anne Zumach
- Department of Otorhinolaryngology and Head and Neck Surgery; Maastricht University Medical Center; Maastricht The Netherlands
| | - Kenneth W. Kross
- Department of Otorhinolaryngology and Head and Neck Surgery; Maastricht University Medical Center; Maastricht The Netherlands
| | - Bernd Kremer
- Department of Otorhinolaryngology and Head and Neck Surgery; Maastricht University Medical Center; Maastricht The Netherlands
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Abstract
PURPOSE OF REVIEW Treatment of laryngeal carcinoma continues to evolve, and whereas there was a transition from total laryngectomy to chemoradiation in response to the Veterans Affairs study and Radiation Therapy Oncology Group (RTOG) 91-11, recent data suggest the role of partial laryngectomy must be revisited. RECENT FINDINGS Recent data have shown that laryngeal preservation does not equate with laryngeal function. Data are accumulating in support of operative management of advanced laryngeal carcinoma away from chemoradiation for select patients. In particular, supracricoid laryngectomy may be a viable option for intermediate and selected advanced laryngeal carcinoma while maintaining laryngeal function. SUMMARY The evolution of treatment for advanced laryngeal carcinoma is focusing treatment on maintaining locoregional control while also maintaining a functional larynx.
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Wang Y, Li X, Pan Z. Analyses of functional and oncologic outcomes following supracricoid partial laryngectomy. Eur Arch Otorhinolaryngol 2014; 272:3463-8. [DOI: 10.1007/s00405-014-3363-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 10/21/2014] [Indexed: 10/24/2022]
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Rizzotto G, Crosetti E, Lucioni M, Bertolin A, Monticone V, Sprio AE, Berta GN, Succo G. Oncologic outcomes of supratracheal laryngectomy: Critical analysis. Head Neck 2014; 37:1417-24. [DOI: 10.1002/hed.23773] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 03/26/2014] [Accepted: 05/13/2014] [Indexed: 11/06/2022] Open
Affiliation(s)
- Giuseppe Rizzotto
- Otorhinolaryngology Department; Vittorio Veneto Hospital; Vittorio Veneto Treviso Italy
| | - Erika Crosetti
- Otorhinolaryngology Department; Martini Hospital; Turin Italy
| | - Marco Lucioni
- Otorhinolaryngology Department; Vittorio Veneto Hospital; Vittorio Veneto Treviso Italy
| | - Andy Bertolin
- Otorhinolaryngology Department; Vittorio Veneto Hospital; Vittorio Veneto Treviso Italy
| | | | - Andrea Elio Sprio
- Department of Clinical and Biological Sciences; University of Turin; Turin Italy
| | | | - Giovanni Succo
- Otorhinolaryngology Department; San Luigi Gonzaga Hospital; Turin Italy
- Department of Oncology; University of Turin; Turin Italy
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Schindler A, Fantini M, Pizzorni N, Crosetti E, Mozzanica F, Bertolin A, Ottaviani F, Rizzotto G, Succo G. Swallowing, voice, and quality of life after supratracheal laryngectomy: preliminary long-term results. Head Neck 2014; 37:557-66. [PMID: 24677483 DOI: 10.1002/hed.23636] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Revised: 11/14/2013] [Accepted: 02/17/2014] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The purpose of this study was to report preliminary long-term outcomes after supratracheal laryngectomy (STL). METHODS Twenty-two male patients who underwent STL were involved in this study. Swallowing skills, neoglottis motility, and vibrations were videoendoscopically assessed. Aerodynamic measures, spectrogram analysis, aspiration pneumonia, body weight variations, and voice perceptual assessment were performed. Generic, voice-related, and swallowing-related quality of life (QOL) were assessed. RESULTS Aspiration was found in 10, 2, and 5 patients, respectively, for liquids, semisolids, and solids. Neoglottis motility was generally preserved, whereas vibration was impaired. Aerodynamic measures showed a poor performance. Perceptual assessment revealed highly dysphonic voices. In only 8 patients, a harmonic structure was visible in the spectrograms. Aspiration pneumonia occurred in 2 patients. Preoperative weight was maintained in 16 patients. Generic, voice-related, and swallowing-related QOL revealed satisfied patients. CONCLUSION After STL, swallowing was sufficiently restored and QOL was satisfactory, whereas the voice was severely impaired even if oral communication was well preserved.
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Affiliation(s)
- Antonio Schindler
- Department of Biomedical and Clinical Sciences "L. Sacco,", University of Milan, Milan, Italy
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Abstract
Squamous cell carcinoma of the larynx continues to be the commonest head and neck cancer in many Western countries. The larynx plays a key role for many essential functions, including breathing, voice production, airway protection, and swallowing. The goals of laryngeal cancer treatment are thus to provide best possible oncologic control, while optimizing functional outcomes. In recent decades, the treatment paradigm for advanced laryngeal cancer has shifted from one of primary surgery (total laryngectomy) as gold standard, toward non-surgical organ-preserving treatment using radiotherapy or chemoradiotherapy. However, concerns have emerged regarding functional outcomes after chemoradiotherapy, as well as possible decreased overall survival in patients with laryngeal cancer. The purpose of the present review is to review surgical and non-surgical options for treatment of advanced laryngeal cancer, as well as the evidence supporting each of these.
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