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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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Jia Y, Jiang D, Wu X, He X, Tang J, Sun Z. Analysis of Clinical Treatment of Laryngeal Stenosis After Radiotherapy and Supracricoid Partial Laryngectomy with Cricohyoidoepiglottopexy of Mid-stage and Advanced Laryngeal Cancer. EAR, NOSE & THROAT JOURNAL 2023:1455613221149644. [PMID: 36772810 DOI: 10.1177/01455613221149644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
OBJECTIVE To investigate the possible causes and treatment methods of laryngeal stenosis after radiotherapy following supracricoid partial laryngectomy with cricohyoidoepiglottopexy (SCPL-CHEP). METHODS The data of seven patients with laryngeal stenosis after radiotherapy following SCPL-CHEP were analysed retrospectively. All patients were diagnosed with mid-stage or advanced laryngeal carcinoma before surgery, and the pathological type was squamous cell carcinoma. All patients met the requirements for SCPL-CHEP surgery. When laryngeal stenosis was found during the post-surgical follow-up period, patients were immediately given the appropriate treatment according to their conditions. RESULTS All seven patients had laryngeal stenosis. One patient underwent granulation resection using a laryngoscope, four patients underwent granulation removal + low-temperature plasma ablation using a laryngoscope, and two patients underwent laryngeal dehiscence surgery + laryngotracheal T-tube placement. All patients recovered well after surgery, with patent airways. CONCLUSION Laryngeal stenosis in patients with mid- and late-stage laryngeal carcinoma is one of the rare complications of SCPL-CHEP. Second-stage laryngeal dilatation can be selected according to the patient's laryngeal stenosis. Most patients with laryngeal stenosis can be extubated completely.
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Affiliation(s)
- Yanxuan Jia
- Department of Otolaryngology Head & Neck Surgery, The First Affiliated Hospital of Kunming Medical University, Yunnan Kunming, China
| | - Donghui Jiang
- Department of Otolaryngology Head & Neck Surgery, The First Affiliated Hospital of Kunming Medical University, Yunnan Kunming, China
| | - Xiaoguang Wu
- Department of Otolaryngology Head & Neck Surgery, The First Affiliated Hospital of Kunming Medical University, Yunnan Kunming, China
| | - Xiaoguang He
- Department of Otolaryngology Head & Neck Surgery, The First Affiliated Hospital of Kunming Medical University, Yunnan Kunming, China
| | - Ju Tang
- Department of Otolaryngology Head & Neck Surgery, The First Affiliated Hospital of Kunming Medical University, Yunnan Kunming, China
| | - Zewu Sun
- Department of Otolaryngology,The People' Hospital of Mengzi, Yunnan Mengzi, China
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Gerstner AOH, Laffers W. [Integrity of swallowing apparatus-past, present, and future]. HNO 2021; 69:185-191. [PMID: 33438078 DOI: 10.1007/s00106-020-00990-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Swallowing is one of the most complex movement patterns. The integrity of the epithelial lining is essential. OBJECTIVE Which surgical techniques were developed at the beginnings of modern surgery and what methods are now available to maintain/reconstitute the integrity of the swallowing apparatus? MATERIALS AND METHODS This study comprises a selective literature search in early operation manuals and online archives, with incorporation of the authors' own experience. RESULTS Up until the 1950s, only very limited techniques were available to reconstruct the epithelial lining. Microvascular reanastomosed grafts were the game changer for reconstructive surgery, enabling reconstitution of the swallowing apparatus in primary surgery but also in challenging secondary interventions after insufficient or complicated primary therapy. CONCLUSION The need for anatomical and functional rehabilitation by reconstructive surgery is as pertinent as ever. Particularly in the oncological context, improved early detection and novel local treatment modalities could minimize treatment-associated damage to swallowing.
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Affiliation(s)
- A O H Gerstner
- Hals‑, Nasen-, Ohrenklinik, Klinikum Braunschweig, Holwedestraße16, 38118, Braunschweig, Deutschland.
| | - W Laffers
- Klinik für Hals-Nasen-Ohrenheilkunde, Evangelisches Krankenhaus, Carl-von-Ossietzky-Universität, Steinweg 13-17, 26122, Oldenburg, Deutschland.
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Oncological and Functional Outcomes of Conservation Surgery for Carcinoma Glottis. Indian J Surg Oncol 2020; 11:438-445. [PMID: 33013124 DOI: 10.1007/s13193-020-01157-9] [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: 03/05/2020] [Accepted: 06/30/2020] [Indexed: 12/24/2022] Open
Abstract
Conservation laryngectomy has gained considerable acceptance as a means of enhancing overall long-term function preservation in the management of glottic cancers. This study aims to evaluate the oncological and functional outcomes of conservation surgery for carcinoma of the glottis. Fifty consecutive conservation laryngectomies from January 2010 to December 2018 were studied. Glottic cancers of stages I to IVa were carefully selected both in the primary and salvage settings after a consensus from the multidisciplinary tumour board (MDT). Oncological outcomes in terms of overall survival and disease-free survival were measured, and the long-term functional outcomes of voice and swallowing were evaluated using the GRBAS vocal scale and SWAL-QOL questionnaire. The median follow-up period was 63.4 months. The overall 5-year survival probability was 98% (standard error 2.2%), while median disease-free survival was 23 months. The median GRBAS scores in the open and transoral laser microsurgery (TOLMS) group were 1.828 and 1.428, respectively. The median SWAL-QOL scores in majority of quality of life domains were in the mild or no disease impact zone (71-100). Conservative laryngeal surgery plays a crucial role in the treatment of glottic cancers in all stages. It is oncologically safe, and the functional outcomes are favourable.
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McSpadden R, Zender C, Eskander A. AHNS series: Do you know your guidelines? Guideline recommendations for recurrent and persistent head and neck cancer after primary treatment. Head Neck 2018; 41:7-15. [PMID: 30536532 DOI: 10.1002/hed.25443] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 08/16/2018] [Indexed: 11/10/2022] Open
Abstract
Locoregional recurrent/persistent head and neck cancer following primary treatment is a significant challenge as it is usually difficult to treat and has worse outcomes compared to the primary setting. Surgical resection of a local or regional recurrence offers the best chance of cure when feasible. Local recurrence outcomes vary by subsite with laryngeal recurrences having the best prognoses and hypopharynx having the worst. Instances of persistent neck masses following primary nonsurgical treatment can be evaluated with positron emission tomography (PET) with CT (PET-CT) when there is no definitive diagnosis of a recurrence/persistence. Reirradiation with or without chemotherapy can be considered for primary treatment when surgery is not an option, for adjuvant treatment following salvage surgery, or for palliation. Immunotherapy represents a newer class of chemotherapeutic agents. Current guidelines recommend enrollment in clinical trials especially when surgery is not an option as outcomes remain universally poor in the recurrent/persistent setting.
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Affiliation(s)
- Ryan McSpadden
- Department of Head & Neck, Plastic and Reconstructive Surgery - Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Chad Zender
- Department of Otolaryngology - Head & Neck Surgery, Division of Head & Neck Oncology, University Hospital Cleveland Medical Center and Case Western Reserve University, Cleveland, Ohio, USA
| | - Antoine Eskander
- Department of Otolaryngology - Head & Neck Surgery, Division of Head & Neck Oncology, University of Toronto, Sunnybrook Health Sciences and the Odette Cancer Centre, Michael Garron Hospital, Toronto, Ontario, Canada
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Kim JH, Kim WS, Koh YW, Kim SH, Byeon HK, Choi EC. Oncologic and functional outcomes of salvage supracricoid partial laryngectomy. Acta Otolaryngol 2018; 138:1117-1122. [PMID: 30702020 DOI: 10.1080/00016489.2018.1506154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Supracricoid partial laryngectomy (SCL) can have a positive impact on patients' quality of life by circumventing dysphagia and voice problems resulting from creation of a permanent stoma after conventional total laryngectomy (TL) surgery. AIMS/OBJECTIVES The aim of this study was to investigate the oncologic and functional outcomes of salvage SCL for recurrent laryngeal carcinoma. MATERIAL AND METHODS Forty-five patients that underwent salvage surgery for recurrent laryngeal carcinoma between January 2004 and May 2015 after initial treatment failure were included in this retrospective study. RESULTS Overall survival and disease free survival were non-significantly higher in the salvage SCL group (n = 14) than in the salvage TL group (n = 31) (87.5 versus 56.5%, 53.4 versus 41.9%). Multivariate analyses showed only positive resection margin to be significantly associated with survival and recurrence (HR 9.974, p = .007, and HR 9.196, p = .002, respectively). In the salvage SCL group, 92.8% achieved successful decannulation and all patients returned to an oral diet. All patients in the salvage TL group sustained a permanent stoma and conversation was possible only through esophageal voice or a voice prosthesis. 74.2% of patients in the group were able to tolerate an oral diet. CONCLUSIONS AND SIGNIFICANCE Salvage SCL showed comparable oncologic outcomes and favorable functional outcomes relative to the classic salvage TL. This study could provide a sufficient basis of SCL as salvage treatment for recurrent laryngeal carcinoma in selected patients.
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Affiliation(s)
- Ji Hoon Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Yonsei University Wonju College of Medicine, Ilsanro, Wonju, Korea
| | - Won Shik Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University, Gwanak-gu, Seoul, Korea
| | - Yoon Woo Koh
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Se-Heon Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Hyung Kwon Byeon
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, South Korea
| | - Eun Chang Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
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Zhang MJ, Mu JW, Qu XS, Feng C, Zhao W. Effect of neuromuscular electrical stimulation for fatigue management in patients with advanced laryngeal cancer receiving chemoradiotherapy. Medicine (Baltimore) 2018; 97:e11370. [PMID: 29995774 PMCID: PMC6076145 DOI: 10.1097/md.0000000000011370] [Citation(s) in RCA: 2] [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] [Indexed: 11/26/2022] Open
Abstract
This study retrospectively investigated the effect of neuromuscular electrical stimulation (NMES) for fatigue management in patients with advanced laryngeal cancer (ALC) receiving chemoradiotherapy.A total of 60 eligible patients with ALC receiving chemoradiotherapy were included. These patients were assigned equally to a treatment group and a control group. Patients in the treatment group received NMES therapy and were treated for a total of 8 weeks, while the patients in the control group did not receive NMES therapy. The primary outcome was fatigue, measured by the multidimensional fatigue inventory (MFI). The secondary outcomes included anxiety and depression, measured by the Hospital Anxiety and Depression Scale (HADS), and sleep quality, measured by the Pittsburgh Sleep Quality Index (PSQI). All outcomes were evaluated before and after 8-week NMES treatmentAfter 8-week NMES treatment, the patients in the treatment group did not exert better effect than patients in the control group in fatigue relief, measured by the MFI score, anxiety and depression decrease, assessed by HADS, and sleep quality improvement, evaluated by PSQI.The results of this study demonstrate that NMES may not benefit for fatigue relief in patients with ALC receiving chemoradiotherapy. Future studies should still focus on this topic and warrant these results.
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Affiliation(s)
- Mei-jia Zhang
- Department of Otolaryngology, First Affiliated Hospital of Jiamusi University
| | - Ji-wei Mu
- Department of Otolaryngology, First Affiliated Hospital of Jiamusi University
| | - Xiu-sheng Qu
- Department of Radiotherapy, Second Affiliated Hospital of Jiamusi University, Jiamusi
| | - Chong Feng
- Department of Ultrasound, Hongqi Affiliated Hospital of Mudanjiang Medical University
| | - Wei Zhao
- Department of Anatomy, Mudanjiang Medical University, Mudanjiang, China
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