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Li Y, Ruan S, Hong Y, Zhuang F, Zheng C, Lu M, Chen X. Reconstruction of laryngeal function by thyroid cartilage fenestration and draw-out resection followed by internal fixation with titanium microplates for early glottic carcinoma: a novel and efficient surgical approach. Am J Transl Res 2024; 16:2589-2598. [PMID: 39006276 PMCID: PMC11236634 DOI: 10.62347/atpe6857] [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: 03/28/2024] [Accepted: 05/25/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVE To explore the clinical effectiveness of reconstructing laryngeal function using thyroid cartilage fenestration and "draw-out" resection, supplemented by internal fixation with titanium microplates in early glottic carcinoma. METHODS Data from 99 patients with glottic carcinoma treated in the Second Affiliated Hospital of Fujian Medical University between January 2014 and September 2021 were retrospectively analyzed. Forty-eight patients who underwent thyroid cartilage fenestration and resection followed by internal fixation with titanium microplates for laryngeal function reconstruction were assigned to the thyroid cartilage fenestration group (TCF group), while the other 51 patients who underwent sternohyoid muscle and fascia repair for laryngeal function reconstruction were assigned to the sternohyoid muscle repair group (SMR group). Patients were followed up for 1-8 years. Data on postoperative phonatory function, respiratory function, swallowing function, and survival status were collected. RESULTS Compared to the SMR group, patients in the TCF group showed better postoperative recovery in phonatory function and verbal communication (all P<0.05). In the TCF group, patients demonstrated stable respiration and the extubation rate was 100.00%, which was significantly higher than 82.35% in the SMR group (P<0.05). Patients in both groups showed good postoperative recovery of swallowing function (P>0.05). CONCLUSION One-stage reconstruction of laryngeal function by thyroid cartilage fenestration and "draw-out" resection with adjuvant internal titanium microplate fixation in early glottic carcinoma demonstrates good postoperative recovery and good preservation of the laryngeal function.
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Affiliation(s)
- Yahong Li
- Department of Otorhinolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Fujian Medical University Quanzhou 362000, Fujian, China
| | - Shenjiong Ruan
- Department of Otorhinolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Fujian Medical University Quanzhou 362000, Fujian, China
| | - Yuming Hong
- Department of Otorhinolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Fujian Medical University Quanzhou 362000, Fujian, China
| | - Feiyi Zhuang
- Department of Otorhinolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Fujian Medical University Quanzhou 362000, Fujian, China
| | - Chaohui Zheng
- Department of Otorhinolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Fujian Medical University Quanzhou 362000, Fujian, China
| | - Ming Lu
- Department of Otorhinolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Fujian Medical University Quanzhou 362000, Fujian, China
| | - Xiaofang Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Fujian Medical University Quanzhou 362000, Fujian, China
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Functional outcomes of early laryngeal cancer - endoscopic laser surgery versus external beam radiotherapy: a systematic review. The Journal of Laryngology & Otology 2021; 136:898-908. [PMID: 34641985 DOI: 10.1017/s0022215121002887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Raquel ACS, Buzaneli EP, Lima Silveira HS, Simões-Zenari M, Kulcsar MAV, Kowalski LP, Nemr K. Quality of life among total laryngectomized patients undergoing speech rehabilitation: correlation between several instruments. Clinics (Sao Paulo) 2020; 75:e2035. [PMID: 33206762 PMCID: PMC7603229 DOI: 10.6061/clinics/2020/e2035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 09/08/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The aim of this study was to correlate several instruments currently used for the assessment of the quality of life of patients who underwent total laryngectomy and speech rehabilitation. METHODS A cross-sectional, observational study was conducted with 38 patients after total laryngectomy and speech therapy aiming to develop oesophageal speech. The patients were divided into the following two groups (19 participants each): speakers and non-speakers. The quality of life instruments used were as follows: visual analogue scale (VAS); Voice Handicap Index (VHI); Voice-Related Quality of Life (V-RQOL); Functional Assessment of Cancer Therapy - Head & Neck (FACT-H&N); European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30); European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck (EORTC QLQ-H&N35); and University of Washington Quality of Life (UW-QOL). RESULTS The V-RQOL global health domain exhibited a strong correlation with the VHI. The EORTC QLQ-C30 exhibited a moderate to strong correlation with the EORTC QLQ-H&N35 functional domain in both groups. The EORTC QLQ-C30 functional domain exhibited a strong to moderate correlation with all other instruments in both groups. The UW-QOL exhibited a moderate to strong correlation with the VHI and EORTC QLQ-C30 in both groups. CONCLUSION The EORTC QLQ-C30, EORTC QLQ-H&N35 and UW-QOL were the instruments that most correlated with the remaining instruments, indicating that any of the three can be used to assess the quality of life of the target population regardless of oesophageal voice development.
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Affiliation(s)
- Ana Carolina Soares Raquel
- Programa de pos-graduacao em Ciencias da reabilitacao, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Elaine Pires Buzaneli
- Programa de pos-graduacao em Ciencias da reabilitacao, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Hevely Saray Lima Silveira
- Programa de pos-graduacao em Ciencias da reabilitacao, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Marcia Simões-Zenari
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
| | | | - Luiz Paulo Kowalski
- Departamento de Cirurgia - Cirurgia de Cabeça e Pescoço, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Kátia Nemr
- Programa de pos-graduacao em Ciencias da reabilitacao, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, BR
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, BR
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Abstract
This retrospective study explored the quality of life (QoL) in Chinese patients with laryngeal cancer (LC) after radiotherapy.Fifty-nine eligible patients with Tis-T4 LC were included in this retrospective study. All patients received radiotherapy. Outcomes were measured by the core measure Questionnaire-C30 (QLQ-C30), and the disease-specific Head & Neck cancer module (QLQ-H&N35). All outcomes were assessed before and 3 months after the radiotherapy.Three months after the radiotherapy, all items of QLQ-C30 and QLQ-H&N35 scales changed significantly (P < .05), except the social functioning (P = .09), role activities (P = .81), and global (P = .12) in QLQ-C30 scale and social contacts (P = 1.00), teeth problems (P = .21), trismus (P = 1.00), and feeling ill (P = .07) in QLQ-H&N35 scale, compared with these items before the radiotherapy.The results of this study showed that most items of QoL changed significantly after 3 months of radiotherapy in Chinese patients with LC.
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Affiliation(s)
- Ji-Wei Mu
- Department of Otolaryngology, First Affiliated Hospital of Jiamusi University
| | - Mei-Jia Zhang
- Department of Otolaryngology, First Affiliated Hospital of Jiamusi University
| | - Bi-Qi Luan
- Department of otolaryngology, Second Affiliated Hospital of Jiamusi University, Jiamusi
| | - Jian Wu
- Department of otolaryngology, Second Affiliated Hospital of Jiamusi University, Jiamusi
| | - Ping Sun
- Department of Anatomy, Mudanjiang Medical University, Mudanjiang, China
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Davidson SM, Ko HC, Harari PM, Wieland AM, Chen S, Baschnagel AM, Kimple RJ, Witek ME. Impact of HPV Status on the Prognostic Potential of the AJCC Staging System for Larynx Cancer. Otolaryngol Head Neck Surg 2018; 159:456-465. [PMID: 29611770 DOI: 10.1177/0194599818766035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objective We evaluated the ability of the American Joint Committee on Cancer (AJCC) seventh edition staging system to prognosticate the overall survival of patients with human papillomavirus (HPV)-positive laryngeal squamous cell carcinoma. Study Design Retrospective analysis. Setting National Cancer Database. Subjects and Methods Patients diagnosed with laryngeal squamous cell carcinoma who were treated with curative intent were identified in the National Cancer Database. Multivariate analysis was utilized to determine factors correlated with overall survival in the HPV-negative and HPV-positive cohorts. Unadjusted and propensity score-weighted Kaplan-Meier estimation was used to determine overall survival of HPV-negative and HPV-positive patients across AJCC stage groupings. Results We identified 3238 patients with laryngeal squamous cell carcinoma, of which 2812 were HPV negative and 426 were HPV positive. Overall survival adjusted for age, sex, and comorbidity status confirmed significant differences among all consecutive stage groupings (I vs II, P < .001; II vs III, P < .05; III vs IVA, P < .001; IVA vs IVB, P < .05) in the HPV-negative cohort, whereas only stages IVAs and IVB ( P < .01) exhibited a significant difference in overall survival for HPV-positive patients. Conclusion The current AJCC staging system does not accurately distinguish risk of mortality for patients with HPV-positive disease. These data support the consideration of HPV status in estimating prognosis as well as clinical trial design and clinical decision making for patients with laryngeal squamous cell carcinoma.
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Affiliation(s)
- Stacey M Davidson
- 1 Division of Radiation Oncology, Department of Oncology, Western University, London, Canada
| | - Huasing C Ko
- 2 Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA
| | - Paul M Harari
- 2 Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA
| | - Aaron M Wieland
- 3 Division of Otolaryngology and Head and Neck Surgery, Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA
| | - Shuai Chen
- 4 Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA
| | - Andrew M Baschnagel
- 2 Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA
| | - Randall J Kimple
- 2 Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA
| | - Matthew E Witek
- 2 Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA
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Oliveira IBD, Marialva DRSD. Laringectomias supracricóides: revisão de literatura em protocolos de qualidade de vida. REVISTA CEFAC 2016. [DOI: 10.1590/1982-0216201618315115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO: A Laringectomia Parcial Supracricóide (LPSC) é indicada para tratamento de tumores com estadiamento1 e 2 e certos casos de tumores avançados. É considerada pela literatura como apresentando resultados satisfatórios em ambas situações, preservação da laringe e funcionalidade. Este estudo tem como objetivo rever de forma sistemática a literatura voltada para qualidade de vida em voz de pacientes submetidos a LPSC, identificando-se os protocolos de qualidade de vida em câncer de cabeça e pescoço. Para a revisão de literatura sistemática exploratória foram considerados os seguintes bancos de dados: MEDLINE, SciELO, LILACS; PubMed. Utilizados descritores em português, inglês e espanhol. A seleção dos artigos seguiu critérios de inclusão, para aplicação de teste de Relevância. Esta revisão de literatura revelou que os protocolos específicos para pacientes oncológicos de cabeça e pescoço mais utilizados são o EORTC-C30/H&N35, UW-QOL e HNQOL. A LPSC embora seja considerada uma cirurgia que vise à preservação das funções de deglutição e fonação é apontada como tendo possibilidade de permanência de queixas em tais funções. A literatura afirma que os pacientes se declaram satisfeitos com a própria voz, tendo pouca dificuldade para se comunicar de forma inteligível. Estudos relacionam pacientes com dificuldades respiratórias após LPSC, inclusive com apneia obstrutiva do sono. Conclui-se que há necessidade de mais pesquisas que visem pontuar as dificuldades resultantes da LPSC e que utilizem protocolos específicos em cabeça e pescoço, para melhor mostrar o impacto da LPSC na qualidade de vida.
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