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Oncological Outcomes of Primary vs. Salvage OPHL Type II: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031837. [PMID: 35162858 PMCID: PMC8835477 DOI: 10.3390/ijerph19031837] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 12/16/2022]
Abstract
Background: Open partial horizontal laryngectomy type II (OPHL type II) has two main aims: oncological radicality and laryngeal preservation. The aim of this review is to define and emphasize the oncological efficacy of OPHL type II, both as primary and salvage surgery, by analyzing the latest literature. Methods: The research was carried out on Pubmed, Scopus and Web of Science databases, by using strict keywords. Oncological outcomes were evaluated by the following parameters: overall survival, disease-specific survival, disease-free survival, local control, laryngeal preservation, local recurrence. Results: The review included 19 articles divided into three groups: (1) primary OPHL type II, (2) salvage OPHL type II, (3) adjuvant radiotherapy after primary OPHL type II. The articles showed excellent results as far as oncological radicality and organ preservation. Conclusions: This review demonstrated that OPHL type II is useful to obtain oncological radicality both as primary surgery and salvage surgery. Nevertheless, the only criterion that determined the positive outcome and efficacy of this technique is the strict selection of patient and tumor.
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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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Xia X, Zhu YY, Diao WW, Zhu XL, Shi XH, Li WY, Gao ZQ, Li GJ, Chen XM. Matched-pair analysis of survival in the patients with T3 laryngeal squamous cell carcinoma treated with supracricoid partial laryngectomy or total laryngectomy. Onco Targets Ther 2018; 11:7947-7953. [PMID: 30519036 PMCID: PMC6235336 DOI: 10.2147/ott.s175358] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The survival outcomes between supracricoid partial laryngectomy (SCPL) and total laryngectomy (TL) were compared in the groups of matched-pair patients with T3 laryngeal squamous cell carcinoma (LSCC). Methods Patients with T3 LSCC were matched based on prognostic factors. The Kaplan–Meier curve and the Cox proportional hazards model were used for analysis on survival. Results A total of 212 patients with T3 LSCC were included after matching (106 underwent SCPL and 106 underwent TL). Multivariable analysis showed no differences in overall survival (hazard risk [HR]=1.15; 95% CI: 0.79–1.67; P=0.47), disease-specific survival (HR=1.11; 95% CI: 0.69–1.80; P=0.66), and recurrence-free survival (HR=1.07; 95% CI: 0.68–1.68; P=0.77) between the SCPL group and TL group. Conclusion SCPL provides reliable therapeutic outcomes and can be used to avoid a TL surgery in some patients with advanced primary laryngeal cancer.
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Affiliation(s)
- Xin Xia
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China,
| | - Ying-Ying Zhu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China,
| | - Wen-Wen Diao
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China,
| | - Xiao-Li Zhu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China,
| | - Xiao-Hua Shi
- Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Wu-Yi Li
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China,
| | - Zhi-Qiang Gao
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China,
| | - Guo-Jun Li
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China,
| | - Xing-Ming Chen
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China,
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Buzaneli ECP, Zenari MS, Kulcsar MAV, Dedivitis RA, Cernea CR, Nemr K. Supracricoid Laryngectomy: The Function of the Remaining Arytenoid in Voice and Swallowing. Int Arch Otorhinolaryngol 2018; 22:303-312. [PMID: 29983773 PMCID: PMC6033597 DOI: 10.1055/s-0038-1625980] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 12/17/2017] [Indexed: 12/01/2022] Open
Abstract
Introduction
Supracricoid laryngectomy still has selected indications; there are few studies in the literature, and the case series are limited, a fact that stimulates the development of new studies to further elucidate the structural and functional aspects of the procedure.
Objective
To assess voice and deglutition parameters according to the number of preserved arytenoids.
Methods
Eleven patients who underwent subtotal laryngectomy with cricohyoidoepiglottopexy were evaluated by laryngeal nasofibroscopy, videofluoroscopy, and auditory-perceptual, acoustic, and voice pleasantness analyses, after resuming oral feeding.
Results
Functional abnormalities were detected in two out of the three patients who underwent arytenoidectomy, and in six patients from the remainder of the sample. Almost half of the sample presented silent laryngeal penetration and/or vallecular/hypopharyngeal stasis on the videofluoroscopy. The mean voice analysis scores indicated moderate vocal deviation, roughness and breathiness; severe strain and loudness deviation; shorter maximum phonation time; the presence of noise; and high third and fourth formant values. The voices were rated as unpleasant. There was no difference in the number and functionality of the remaining arytenoids as prognostic factors for deglutition; however, in the qualitative analysis, favorable voice and deglutition outcomes were more common among patients who did not undergo arytenoidectomy and had normal functional conditions.
Conclusion
The number and functionality of the preserved arytenoids were not found to be prognostic factors for favorable deglutition efficiency outcomes. However, the qualitative analysis showed that the preservation of both arytenoids and the absence of functional abnormalities were associated with more satisfactory voice and deglutition patterns.
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Affiliation(s)
- Elaine Cristina Pires Buzaneli
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Marcia Simões Zenari
- Department of Reabilitation, Instituto do Câncer, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Marco Aurélio Vamondes Kulcsar
- Department of Head and Neck Surgery, Instituto do Câncer, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Rogerio A Dedivitis
- Department of Head and Neck Surgery, Instituto do Câncer, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Cláudio Roberto Cernea
- Department of Head and Neck Surgery, Instituto do Câncer, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Kátia Nemr
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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Silveira HSL, Simões-Zenari M, Kulcsar MA, Cernea CR, Nemr K. Combined Vocal Exercises for Rehabilitation After Supracricoid Laryngectomy: Evaluation of Different Execution Times. J Voice 2017; 32:723-728. [PMID: 29111339 DOI: 10.1016/j.jvoice.2017.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 09/08/2017] [Accepted: 09/12/2017] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The supracricoid partial laryngectomy allows the preservation of laryngeal functions with good local cancer control. OBJECTIVE To assess laryngeal configuration and voice analysis data following the performance of a combination of two vocal exercises: the prolonged /b/vocal exercise combined with the vowel /e/ using chest and arm pushing with different durations among individuals who have undergone supracricoid laryngectomy. METHODS Eleven patients undergoing partial laryngectomy supracricoid with cricohyoidoepiglottopexy (CHEP) were evaluated using voice recording. Four judges performed separately a perceptive-vocal analysis of hearing voices, with random samples. For the analysis of intrajudge reliability, repetitions of 70% of the voices were done. Intraclass correlation coefficient was used to analyze the reliability of the judges. For an analysis of each judge to the comparison between zero time (time point 0), after the first series of exercises (time point 1), after the second series (time point 2), after the third series (time point 3), after the fourth series (time point 4), and after the fifth and final series (time point 5), the Friedman test was used with a significance level of 5%. The data relative to the configuration of the larynx were subjected to a descriptive analysis. RESULTS In the evaluation, were considered the judge results 1 which have greater reliability. There was an improvement in the general level of vocal, roughness, and breathiness deviations from time point 4 [T4]. CONCLUSION The prolonged /b/vocal exercise, combined with the vowel /e/ using chest- and arm-pushing exercises, was associated with an improvement in the overall grade of vocal deviation, roughness, and breathiness starting at minute 4 among patients who had undergone supracricoid laryngectomy with CHEP reconstruction.
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Affiliation(s)
- Hevely Saray Lima Silveira
- Faculdade de Medicina-Universidade de São Paulo, Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, São Paulo, SP, Brazil
| | - Marcia Simões-Zenari
- Faculdade de Medicina-Universidade de São Paulo, Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, São Paulo, SP, Brazil
| | - Marco Aurélio Kulcsar
- Faculdade de Medicina-Universidade de São Paulo, Departamento de Cirurgia, Disciplina de Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Claudio Roberto Cernea
- Faculdade de Medicina-Universidade de São Paulo, Departamento de Cirurgia, Disciplina de Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Kátia Nemr
- Faculdade de Medicina-Universidade de São Paulo, Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, São Paulo, SP, Brazil.
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