1
|
Dai J, Qi G, Cao Y, Xu M, Wang S, Song H, Cai J, Li S, Wei J, Huai D. Effect of CO2 laser combined with low-temperature plasma radiofrequency ablation on the early glottic laryngeal carcinoma. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2023. [DOI: 10.1016/j.jrras.2022.100501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
|
2
|
Yin Y, Cai Q, Zheng Y, Huang X, Peng J, Liang F, Yang J, Chen W, Su Y, Guan Z. CO 2 transoral laser microsurgery for early glottic carcinoma with anterior commissure involvement. Auris Nasus Larynx 2022; 50:415-422. [PMID: 36163067 DOI: 10.1016/j.anl.2022.09.006] [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: 05/17/2022] [Revised: 08/22/2022] [Accepted: 09/07/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Anterior commissure (AC) involvement is an unfavorable factor for transoral laser microsurgery (TLM) treatment of early glottic carcinoma (EGC). This study aimed to evaluate the therapeutic efficacy of TLM treatment for EGC with AC involvement. METHODS From 2008 to 2017, 177 patients with T1-T2 EGC with AC involvement were retrospectively included and divided into the TLM group (n=115) receiving CO2 laser TLM and the control group undergoing open surgery (n=62). The survival outcomes, postoperative complications, laryngeal preservation rate, recurrence and the phonological results were compared between groups. RESULT The TLM group had significantly reduced hospital stay, hospitalization costs, and intraoperative blood loss as compared with the control group. The tracheotomy rate was significantly higher in the control group (96.8% vs. 0%). The 5-year overall survival (OS) was 89.6% and 85.5% in the TLM group and control group, respectively. Log-rank test showed no difference in survival rate between the two groups. There was no significant difference in laryngeal preservation rate and overall recurrence rate between groups. In postoperative vocal function evaluation, there were significant differences in the overall grade (G), the roughness (R), the breathiness (B), Voice Handicap Index-10 (VHI-10), Jitter, Shimmer, noise/harmonic ratio (NHR), maximum phonation time (MPT), phonation threshold pressure (PTP) between the two groups. CONCLUSION For EGC with AC involvement, TLM has similar survival outcomes with the open surgery, but has better postoperative voice outcomes. Meanwhile, TLM can effectively reduce intraoperative blood loss, hospitalization time, hospitalization costs and postoperative complications.
Collapse
Affiliation(s)
- Yetao Yin
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University, Guangzhou, China; Department of Otolaryngology, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qian Cai
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University, Guangzhou, China
| | - Yiqing Zheng
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University, Guangzhou, China
| | - Xiaoming Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University, Guangzhou, China
| | - Jieren Peng
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University, Guangzhou, China
| | - Faya Liang
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University, Guangzhou, China
| | - Jinshan Yang
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University, Guangzhou, China
| | - Wenjun Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University, Guangzhou, China
| | - Yuejia Su
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University, Guangzhou, China
| | - Zhong Guan
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University, Guangzhou, China.
| |
Collapse
|
3
|
Tian H, Gao S, Yu J, Zhou X, Chen X, Zuo L, Cai X, Song B, Yu K. Application of digital modeling and three-dimensional printing of titanium mesh for reconstruction of thyroid cartilage in partial laryngectomy. Acta Otolaryngol 2022; 142:363-368. [PMID: 35393915 DOI: 10.1080/00016489.2022.2055138] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Digital modeling and three-dimensional (3D) printing techniques have been used to assist the resection of the laryngeal lesions and repair the remnant larynx in glottic cancer patients with anterior commissure involvement. AIMS/OBJECTIVES To evaluate the feasibility of digital modeling and 3D printing of titanium mesh for thyroid cartilage reconstruction in partial laryngectomy, and compare the advantages and disadvantages with crico-hyoido-epiglottopexy (CHEP). MATERIAL AND METHODS Forty-four glottic cancer patients with anterior commissure involvement were randomly assigned into group A and group B. The digital modeling and 3 D printing were used for patients in group A, and patients in group B underwent the modified CHEP. RESULTS In group A, 10 patients underwent tracheotomy and tracheal tube was removed after 2 weeks. All the patients were discharged within 10 d after surgery, and the majority of them had a satisfactory level of pronunciation. In group B, the majority of the patients were discharged 2 - 3 weeks after surgery with a moderate level of pronunciation. CONCLUSIONS AND SIGNIFICANCE The proposed surgical method, employing digital modeling and 3D printing to facilitate resection of laryngeal lesions and reconstruction of residual larynx, exhibited to be beneficial for accurate reconstruction of thyroid cartilage and soft tissues.
Collapse
Affiliation(s)
- Hao Tian
- Hunan Cancer Hospital/Cancer Hospital of Xiangya Medical College, Central South University, Changsha, China
- School of Materials Science and Engineering, Central South University, Changsha, China
| | - Shuichao Gao
- Affiliated Cancer Hospital of Xiangya Medical College, Central South University, Changsha, China
| | - Jianjun Yu
- Affiliated Cancer Hospital of Xiangya Medical College, Central South University, Changsha, China
| | - Xiao Zhou
- Affiliated Cancer Hospital of Xiangya Medical College, Central South University, Changsha, China
| | - Xing Chen
- Affiliated Cancer Hospital of Xiangya Medical College, Central South University, Changsha, China
| | - Liang Zuo
- Affiliated Cancer Hospital of Xiangya Medical College, Central South University, Changsha, China
| | - Xu Cai
- Affiliated Cancer Hospital of Xiangya Medical College, Central South University, Changsha, China
| | - Bo Song
- Affiliated Cancer Hospital of Xiangya Medical College, Central South University, Changsha, China
| | - Kun Yu
- School of Materials Science and Engineering, Central South University, Changsha, China
| |
Collapse
|
4
|
T1a Glottic Cancer: Advances in Vocal Outcome Assessment after Transoral CO 2-Laser Microsurgery Using the VEM. J Clin Med 2021; 10:jcm10061250. [PMID: 33802971 PMCID: PMC8002749 DOI: 10.3390/jcm10061250] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/10/2021] [Accepted: 03/15/2021] [Indexed: 12/18/2022] Open
Abstract
Patients with unilateral vocal fold cancer (T1a) have a favorable prognosis. In addition to the oncological results of CO2 transoral laser microsurgery (TOLMS), voice function is among the outcome measures. Previous early glottic cancer studies have reported voice function in patients grouped into combined T stages (Tis, T1, T2) and merged cordectomy types (lesser- vs. larger-extent cordectomies). Some authors have questioned the value of objective vocal parameters. Therefore, the purpose of this exploratory prospective study was to investigate TOLMS-associated oncological and vocal outcomes in 60 T1a patients, applying the ELS protocols for cordectomy classification and voice assessment. Pre- and postoperative voice function analysis included: Vocal Extent Measure (VEM), Dysphonia Severity Index (DSI), auditory-perceptual assessment (GRB), and 9-item Voice Handicap Index (VHI-9i). Altogether, 51 subjects (43 male, eight female, mean age 65 years) completed the study. The 5-year recurrence-free, overall, and disease-specific survival rates (Kaplan–Meier method) were 71.4%, 94.4%, and 100.0%. Voice function was preserved; the objective parameter VEM (64 ± 33 vs. 83 ± 31; mean ± SD) and subjective vocal measures (G: 1.9 ± 0.7 vs. 1.3 ± 0.7; VHI-9i: 18 ± 8 vs. 9 ± 9) even improved significantly (p < 0.001). The VEM best reflected self-perceived voice impairment. It represents a sensitive measure of voice function for quantification of vocal performance.
Collapse
|
5
|
Hendriksma M, van Loon Y, Klop WMC, Hakkesteegt MM, Heijnen BJ, El Hasnaoui I, de Jong M, Langeveld TPM, van Benthem PPG, Baatenburg de Jong RJ, Sjögren EV. Quality of life and voice outcome of patients treated with transoral CO 2 laser microsurgery for early glottic carcinoma (T1-T2): a 2-year follow-up study. Eur Arch Otorhinolaryngol 2019; 276:805-814. [PMID: 30810819 PMCID: PMC6411677 DOI: 10.1007/s00405-019-05348-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 02/13/2019] [Indexed: 02/06/2023]
Abstract
Purpose Longitudinal studies in laryngeal cancer can provide clinicians information about short-term and long-term functional outcomes, like quality of life (QoL) and voice outcome. This information is important when counseling patients or choosing a primary treatment modality. The present study assessed long-term (2 years) QoL and voice outcome in patients with extended T1 and limited T2 glottic carcinoma treated with transoral CO2 laser microsurgery (TLM) (unilateral type III or bilateral type II resections). Methods Three questionnaires were administered: the Voice Handicap Index (VHI), the European Organization for Research and Treatment of Cancer (EORTC) QoL questionnaire (QLQ)-C30, the EORTC QLQ-HN35. A perceptual voice evaluation at six different time points was conducted: preoperatively, and postoperatively at 6 weeks, 3 months, 6 months, 1 year, and 2 years. Fluctuations over time were investigated. Results Sixty-one patients were included in the analysis. Patients reported high-level functioning and low symptom scores 2 years postoperatively. Gender significantly affected the VHI scores at 2 years (mean VHI scores: female 8.7 vs. male, 23.9; p = 0.023). The major improvement in VHI scores was observed within the first 6 months. The tumor stage (T1a, T1b, and T2) significantly impacted the grade (mean scores at 2 years: 1.0, 1.9, and 1.7; p = 0.001). These scores stabilized at 6 months. Conclusions Patients show good long-term QoL with low symptom scores, a low voice handicap, and mild to moderate dysphonia, 2 years postoperatively. Scores stabilize at 6 months and provide a clear indication of status at 1 and 2 years.
Collapse
Affiliation(s)
- Martine Hendriksma
- Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands.
| | - Yda van Loon
- Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - W Martin C Klop
- Department of Head and Neck Surgery, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Marieke M Hakkesteegt
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Bas J Heijnen
- Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Ibtissam El Hasnaoui
- Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Martin de Jong
- Department of Radiotherapy, Leiden University Medical Center, Leiden, The Netherlands
| | - Ton P M Langeveld
- Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter Paul G van Benthem
- Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Robert J Baatenburg de Jong
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Elisabeth V Sjögren
- Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
6
|
van Loon Y, Hendriksma M, Heijnen BJ, van de Kamp VAH, Hakkesteegt MM, Böhringer S, Langeveld TPM, de Jong MA, Klop WMC, Baatenburg de Jong RJ, Sjögren EV. Voice outcome after unilateral ELS type III or bilateral type II resections for T1-T2 glottic carcinoma: Results after 1 year. Head Neck 2019; 41:1638-1647. [PMID: 30652373 PMCID: PMC6590407 DOI: 10.1002/hed.25582] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 08/22/2018] [Accepted: 12/07/2018] [Indexed: 12/14/2022] Open
Abstract
Background Voice outcome was assessed in patients with extended T1 and limited T2 glottic carcinoma, treated with a unilateral type III or a bilateral type II resection according to the European Laryngological Society (ELS) classification. Methods Objective evaluation (acoustic and aerodynamic parameters), perceptual evaluation (GRBAS), and patients' self‐assessment (voice handicap index [VHI]) were performed before and 1 year after treatment. Results were evaluated according to ELS resection type and the involvement of the anterior commissure. Results The majority of voice parameters in all resection subgroups showed an improvement of the mean score 1 year postoperatively. Grade of dysphonia varied between 1.15 and 1.66 postoperatively and VHI score varied from 23.3 to 24.5. Conclusion Voice outcome after ELS unilateral type III or a bilateral type II resection for extended T1 and limited T2 glottic carcinoma is good with mild to very moderate perceptive dysphonia and low self‐reported voice impairment.
Collapse
Affiliation(s)
- Yda van Loon
- Department of Otorhinolaryngology, Head & Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Martine Hendriksma
- Department of Otorhinolaryngology, Head & Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Bas J Heijnen
- Department of Otorhinolaryngology, Head & Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Vivienne A H van de Kamp
- Department of Otorhinolaryngology, Head & Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Marieke M Hakkesteegt
- Department of Otorhinolaryngology, Head & Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Stefan Böhringer
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Ton P M Langeveld
- Department of Otorhinolaryngology, Head & Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - M A de Jong
- Department of Radiotherapy, Leiden University Medical Center, Leiden, The Netherlands
| | - W Martin C Klop
- Department of Head and Neck Surgery, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Robert J Baatenburg de Jong
- Department of Otorhinolaryngology, Head & Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Elisabeth V Sjögren
- Department of Otorhinolaryngology, Head & Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
7
|
Structured review of papers reporting specific functions in patients with cancer of the head and neck: 2006 - 2013. Br J Oral Maxillofac Surg 2016; 54:e45-51. [PMID: 26923873 DOI: 10.1016/j.bjoms.2016.02.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 02/09/2016] [Indexed: 11/21/2022]
Abstract
Health-related quality of life (HRQoL) focuses on 4 core domains: physical and psychological function, social interaction, disease, and treatment-related symptoms, and is a key outcome in patients with cancer of the head and neck. We reviewed papers published between 2006 and 2013 that used validated questionnaires to report functional outcome in this group. A total of 572 papers were identified and 118 of them concerned function. Specific outcomes included anxiety, chewing, maxillectomy, mucositis, pain, shoulder function, and trismus. The specific functions most often identified were xerostomia, speech or voice, and swallowing or dysphagia. A considerable body of evidence has now accumulated on HRQoL and functional outomes although the precise role of HRQoL during the planning of treatment remains controversial. Over time, the emphasis of the studies included has tended to move away from the reporting of outcomes in general to more hypothesis-driven and group-specific work.
Collapse
|
8
|
Voice Outcomes After Transoral Laser Microsurgery for Early Glottic Cancer—Considering Signal Type and Smoothed Cepstral Peak Prominence. J Voice 2015; 29:370-81. [DOI: 10.1016/j.jvoice.2014.08.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 05/07/2014] [Indexed: 11/21/2022]
|
9
|
CO2 laser cordectomy for glottic squamous cell carcinoma involving the anterior commissure: voice and oncologic outcomes. Eur Arch Otorhinolaryngol 2014; 272:413-8. [DOI: 10.1007/s00405-014-3368-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 10/23/2014] [Indexed: 10/24/2022]
|