1
|
Evers JM, Minton LA, Webb C, Taylor RM, York NL. Care of the Patient With an Artificial Airway. Dimens Crit Care Nurs 2024; 43:202-211. [PMID: 38787776 DOI: 10.1097/dcc.0000000000000648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Artificial airways are essential in various clinical settings to maintain a patient's airway and provide necessary support for ventilation and oxygenation. These devices are commonly temporary and come in several types, each serving specific purposes. Understanding the indications, types, and proper care of artificial airways is crucial for health care professionals to ensure patients receive optimal care and prevent complications. OBJECTIVE This article aims to review the indications for using artificial airways and discuss the most commonly used types, including supraglottic airway devices, endotracheal tubes, tracheostomy tubes, and laryngectomy tubes. It also provides insights into the procedures involved in intubation and percutaneous tracheostomy and offers guidance on patient management, emphasizing assessment, oral care, suctioning, and humidification for patients with these airway devices. CONCLUSION This article underscores the significance of understanding artificial airways, not just as a set of skills but as a commitment to patient welfare. Health care professionals who master the knowledge and care of these devices can significantly contribute to their patients' well-being and quality of life.
Collapse
|
2
|
Kouka M, Beckmann L, Bitter T, Kaftan H, Böger D, Büntzel J, Müller A, Hoffmann K, Podzimek J, Pietschmann K, Ernst T, Guntinas-Lichius O. Oncological and functional outcome after laryngectomy for laryngeal and hypopharyngeal cancer: a population-based analysis in Germany from 2001 to 2020. Sci Rep 2024; 14:7761. [PMID: 38565603 PMCID: PMC10987613 DOI: 10.1038/s41598-024-58423-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 03/28/2024] [Indexed: 04/04/2024] Open
Abstract
Prognostic factors for overall survival (OS), percutaneous endoscopic gastrostomy (PEG) dependency, and long-term speech rehabilitation via voice prosthesis (VP) after laryngectomy for laryngeal or hypopharyngeal cancer were investigated in a retrospective population-based study in Thuringia, Germany. A total of 617 patients (68.7% larynx; hypopharynx; 31.3%; 93.7% men; median age 62 years; 66.0% stage IV) from 2001 to 2020 were included. Kaplan-Meier and Cox multivariable regression analyses were performed. 23.7% of patients received a PEG. 74.7% received a VP. Median OS was 131 months. Independent factors for lower OS were stage IV (compared to stage II; hazard ratio [HR] = 3.455; confidence interval [CI] 1.395-8.556) and laryngectomy for a recurrent disease (HR = 1.550; CI 1.078-2.228). Median time to PEG removal was 7 months. Prior partial surgery before laryngectomy showed a tendency for independent association for later PEG removal (HR = 1.959; CI 0.921-4.167). Postoperative aspiration needing treatment was an independent risk factor (HR = 2.679; CI 1.001-7.167) for later definitive VP removal. Laryngectomy continuously plays an important role in a curative daily routine treatment setting of advanced laryngeal or hypopharyngeal cancer in Germany. Long-term dependency on nutrition via PEG is an important issue, whereas use of VP is a stable long-term measure for voice rehabilitation.
Collapse
Affiliation(s)
- Mussab Kouka
- Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Louise Beckmann
- Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Thomas Bitter
- Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Holger Kaftan
- Department of Otorhinolaryngology, Helios-Klinikum Erfurt, Erfurt, Germany
| | - Daniel Böger
- Department of Otorhinolaryngology, SRH Zentralklinikum Suhl, Suhl, Germany
| | - Jens Büntzel
- Department of Otorhinolaryngology, Suedharzklinikum Nordhausen, Nordhausen, Germany
| | - Andreas Müller
- Department of Otorhinolaryngology, SRH Wald-Klinikum Gera, Gera, Germany
| | - Kerstin Hoffmann
- Department of Otorhinolaryngology, Sophien-Hufeland-Klinikum, Weimar, Germany
| | - Jiri Podzimek
- Department of Otorhinolaryngology, Klinikum Bad Salzungen, Bad Salzungen, Germany
| | - Klaus Pietschmann
- Department of Radiation Oncology, Jena University Hospital, Jena, Germany
| | - Thomas Ernst
- University Tumor Center, Jena University Hospital, Jena, Germany
| | - Orlando Guntinas-Lichius
- Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
| |
Collapse
|
3
|
Sykes JJ, Edwards K, Danan D. Increasing health care providers' knowledge of tracheostomy and laryngectomy. Head Neck 2024; 46:609-614. [PMID: 38146779 DOI: 10.1002/hed.27616] [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: 07/12/2023] [Revised: 10/29/2023] [Accepted: 12/11/2023] [Indexed: 12/27/2023] Open
Abstract
BACKGROUND The differences between tracheostomy and total laryngectomy are frequently misunderstood by healthcare professionals. Insufficient knowledge can potentially result in life-threatening consequences in the event of an emergent airway situation. METHODS A seven-question assessment of providers' anatomical knowledge and airway management was completed prior to and following a standardized one-hour didactic lecture. RESULTS Forty-six participants completed the pre- and post-assessment. There were 20 (43.5%) ENT ICU/IMC Staff (EBU), 20 (43.5%) Florida Surgical Center Staff (FSC), and 6 (13%) Anesthesia providers (Anes). Pre-lecture score average was 44.7% across all providers, significantly improving to 83.8% post-lecture (p < 0.001). Nursing staff from the Otolaryngology ICU, and OR staff, had significant improvement in knowledge base (p < 0.001). Anesthesia providers showed improvement, but the difference was not statistically significant (p = 0.052). CONCLUSIONS Didactic lectures are a simple and low-cost option with significant potential in improving provider knowledge on these critical topics and improve patient care by non-otolaryngology providers.
Collapse
Affiliation(s)
- John J Sykes
- College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Kaitlyn Edwards
- Department of Otolaryngology, University of Florida, Gainesville, Florida, USA
| | - Deepa Danan
- Department of Otolaryngology, University of Florida, Gainesville, Florida, USA
| |
Collapse
|
4
|
Poutoglidis A, Forozidou E, Fyrmpas G, Mantsopoulos K, Paraskevas GK, Lazaridis N, Savvakis S, Karamitsou P. A Novel and Simple Technique to Reduce the Rate of Pharyngocutaneous Fistula Formation Following a Total Laryngectomy - our Initial Results. Indian J Otolaryngol Head Neck Surg 2024; 76:997-1001. [PMID: 38440597 PMCID: PMC10908975 DOI: 10.1007/s12070-023-04343-7] [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: 09/05/2023] [Accepted: 11/02/2023] [Indexed: 03/06/2024] Open
Abstract
Objective: Pharyngocutaneous fistula (PCF) is a common and often devastating complication of total laryngectomy. Patients undergoing a total laryngectomy need enhancement of the neopharynx to reduce the risk of PCF formation. Our study aimed to evaluate the formation of a PCF following a total laryngectomy in patients that underwent a modified closure technique of their neopharynx. This technique included the recruitment of a flap of the muscular division of the pretracheal fascia that invests the strap muscles as a protective blanket. We called this surgical technique the 'curtain call'. Methods: We conducted a retrospective study for patients who underwent a total laryngectomy in our department between May 2022 and May 2023. Results: Twelve patients were identified. Our results demonstrated that the recruitment of this modified closure technique to cover the neopharynx resulted in a very low rate of postoperative PCF formation (8.3%). Conclusion: The 'curtain call' technique is an excellent method to support the neopharynx with extremely low rates of postoperative chronic dysphagia and with no evidence of impairing the development of esophageal speech. It could sometimes substitute much more time-consuming techniques like major pectoralis flap and supraclavicular flap. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-04343-7.
Collapse
Affiliation(s)
- Alexandros Poutoglidis
- Department of Anatomy and Surgical Anatomy, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, 54124 Greece
| | - Evropi Forozidou
- Department of Otorhinolaryngology-Head and Neck Surgery, ’G. Papanikolaou’ General Hospital, Leoforos Papanikolaou 57010, Thessaloniki, Greece
| | - Georgios Fyrmpas
- Department of Otorhinolaryngology, School of Medicine, Democritus University of Thrace, Alexandroupolis, 69100 Greece
| | - Konstantinos Mantsopoulos
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - George K. Paraskevas
- Department of Anatomy and Surgical Anatomy, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, 54124 Greece
| | - Nikolaos Lazaridis
- Department of Anatomy and Surgical Anatomy, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, 54124 Greece
| | - Stavros Savvakis
- Department of Anatomy and Surgical Anatomy, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, 54124 Greece
| | - Paraskevi Karamitsou
- Department of Otorhinolaryngology-Head and Neck Surgery, ’G. Papanikolaou’ General Hospital, Leoforos Papanikolaou 57010, Thessaloniki, Greece
| |
Collapse
|
5
|
Brown T, Edwards A, Pashley A, Lehn B, Vasani S, Hodge R, Bauer J. Nutritional status and post-operative complications in patients undergoing surgery for advanced pharyngeal or laryngeal cancer. Eur Arch Otorhinolaryngol 2023; 280:5531-5538. [PMID: 37535080 PMCID: PMC10620302 DOI: 10.1007/s00405-023-08139-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/17/2023] [Indexed: 08/04/2023]
Abstract
PURPOSE Malnutrition is an important prognostic indicator of post-operative outcomes in patients undergoing surgery for head and neck cancer, however, limited studies utilize validated nutrition assessment tools to accurately assess risk. The aim of this study was to determine the relationship between nutritional status on post-operative complications and length of stay for patients undergoing either a laryngectomy, pharyngectomy or pharyngolaryngectomy for head and neck cancer. METHODS Patients with head and neck cancer undergoing a laryngectomy, pharyngectomy or pharyngolaryngectomy at a tertiary hospital in Australia were eligible for this retrospective cohort study (n = 40). Nutritional status was assessed by the dietitian on admission using the validated Subjective Global Assessment tool. Clinical outcomes were collected via retrospective chart review and included length of stay and post-operative complications. RESULTS Pre-operative malnutrition incidence was 40%. Malnourished patients had higher incidences of any type of complication (57% vs 44%, p = 0.013) and pressure injury (86% vs 14%, p = 0.011) compared to well-nourished patients. Well-nourished patients had a clinically important shorter median length of stay compared to malnourished patients (17.5 vs 20 days). CONCLUSION Early identification and management of malnutrition is essential to minimize risk of post-operative complications and reduce length of stay and should be considered a key component of prehabilitation programs.
Collapse
Affiliation(s)
- Teresa Brown
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia.
- Department of Dietetics and Food Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.
| | - Anna Edwards
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
- Department of Dietetics and Food Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
- Department of Nutrition and Dietetics, Toowoomba Hospital, Darling Downs Health, Toowoomba, QLD, Australia
| | - Alice Pashley
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Belinda Lehn
- Department of Speech Pathology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Sarju Vasani
- Department of Ear Nose Throat, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Robert Hodge
- Department of Ear Nose Throat, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Judith Bauer
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
6
|
Rovó L, Szakács L, Castellanos PF, Tóbiás Z, Pfiszterer P, Ambrus A, Csanády M, Bach Á. Extended partial laryngectomy with functional preservation using the rotational crico-thyrotracheopexy. Laryngoscope Investig Otolaryngol 2023; 8:1328-1336. [PMID: 37899879 PMCID: PMC10601548 DOI: 10.1002/lio2.1155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/21/2023] [Accepted: 09/09/2023] [Indexed: 10/31/2023] Open
Abstract
Objectives Glottic tumors with infiltration of the anterior/posterior commissure, and lesions with subglottic, cricoid, or cricoarytenoid joint infiltration have been highly controversial in the past, from the perspective of oncological safety. Although conservation laryngeal resection options exist, most are limited by the extent of resection proscribed by the technique and the postoperative functional results. Oncologically speaking, extended vertical hemilaryngectomy is often the optimal solution. However, limited reconstruction methods often compel total laryngectomy. Methods Eight patients with vocal fold malignancy, which infiltrated the anterior and sometimes the posterior commissure and with subglottic extension and resultant uni/bilateral vocal fold motion impairment, were treated by single stage extended vertical partial laryngectomy with rotational crico-thyrotracheopexy as a functional reconstruction of the laryngeal framework. Patients were evaluated with objective and subjective function tests. Results Histologic examination demonstrated tumor-free margins in every case. Definitive decannulation was successful in all cases within 2 weeks. All patients had a stable and adequate airway during follow-up and reported socially acceptable voice. Oral feeding was possible in seven patients. Conclusion Rotational crico-thyrotracheopexy, as a single stage reconstruction technique, is based on well-vascularized, readily available, appropriately shaped local tissues, without significant donor site morbidity or need for long-term stenting to reconstruct large laryngeal defects after extended vertical hemilaryngectomy for advanced unilateral glottic tumors and is applicable even with supra/subglottic invasion or infiltration of the contralateral vocal fold. An adequate airway can be achieved with socially acceptable voice and safe swallowing without compromising oncologic reliability. Level of Evidence 4 (retrospective case series review).
Collapse
Affiliation(s)
- László Rovó
- Department of Otorhinolaryngology—Head and Neck Surgery, Albert Szent‐Györgyi Faculty of MedicineUniversity of SzegedSzegedHungary
| | - László Szakács
- Department of Otorhinolaryngology—Head and Neck Surgery, Albert Szent‐Györgyi Faculty of MedicineUniversity of SzegedSzegedHungary
| | - Paul F. Castellanos
- Division of Otolaryngology, Department of SurgerySt. Rita's Mercy HospitalLimaOhioUSA
| | - Zoltán Tóbiás
- Department of Otorhinolaryngology—Head and Neck Surgery, Albert Szent‐Györgyi Faculty of MedicineUniversity of SzegedSzegedHungary
| | - Péter Pfiszterer
- Department of Otorhinolaryngology—Head and Neck Surgery, Albert Szent‐Györgyi Faculty of MedicineUniversity of SzegedSzegedHungary
| | - Andrea Ambrus
- Department of Otorhinolaryngology—Head and Neck Surgery, Albert Szent‐Györgyi Faculty of MedicineUniversity of SzegedSzegedHungary
| | - Miklós Csanády
- Department of Otorhinolaryngology—Head and Neck Surgery, Albert Szent‐Györgyi Faculty of MedicineUniversity of SzegedSzegedHungary
| | - Ádám Bach
- Department of Otorhinolaryngology—Head and Neck Surgery, Albert Szent‐Györgyi Faculty of MedicineUniversity of SzegedSzegedHungary
| |
Collapse
|
7
|
Bogdanov V, Posala M, Herzog M. Olfactory rehabilitation via retronasal olfaction using a tracheoesophageal voice prosthesis after total laryngectomy. HNO 2023; 71:19-25. [PMID: 36480048 DOI: 10.1007/s00106-022-01229-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2022] [Indexed: 12/13/2022]
Affiliation(s)
- V Bogdanov
- Department of Otorhinolaryngology, Head and Neck Surgery, Carl-Thiem-Klinikum Cottbus gGmbH, Thiemstr. 111, 03048, Cottbus, Germany.
- Smell & Taste Clinic, Department of Otorhinolaryngology, "Technische Universität Dresden", Dresden, Germany.
| | - M Posala
- Department of Otorhinolaryngology, Head and Neck Surgery, Carl-Thiem-Klinikum Cottbus gGmbH, Thiemstr. 111, 03048, Cottbus, Germany
| | - M Herzog
- Department of Otorhinolaryngology, Head and Neck Surgery, Carl-Thiem-Klinikum Cottbus gGmbH, Thiemstr. 111, 03048, Cottbus, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, Martin-Luther-University, Halle - Wittenberg, Halle (Saale), Germany
| |
Collapse
|
8
|
Mialland A, Atallah I, Bonvilain A. Toward a robust swallowing detection for an implantable active artificial larynx: a survey. Med Biol Eng Comput 2023; 61:1299-1327. [PMID: 36792845 DOI: 10.1007/s11517-023-02772-8] [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: 02/17/2022] [Accepted: 01/04/2023] [Indexed: 02/17/2023]
Abstract
Total laryngectomy consists in the removal of the larynx and is intended as a curative treatment for laryngeal cancer, but it leaves the patient with no possibility to breathe, talk, and swallow normally anymore. A tracheostomy is created to restore breathing through the throat, but the aero-digestive tracts are permanently separated and the air no longer passes through the nasal tracts, which allowed filtration, warming, humidification, olfaction, and acceleration of the air for better tissue oxygenation. As for phonation restoration, various techniques allow the patient to talk again. The main one consists of a tracheo-esophageal valve prosthesis that makes the air passes from the esophagus to the pharynx, and makes the air vibrate to allow speech through articulation. Finally, swallowing is possible through the original tract as it is now isolated from the trachea. Yet, many methods exist to detect and assess a swallowing, but none is intended as a definitive restoration technique of the natural airway, which would permanently close the tracheostomy and avoid its adverse effects. In addition, these methods are non-invasive and lack detection accuracy. The feasibility of an effective early detection of swallowing would allow to further develop an implantable active artificial larynx and therefore restore the aero-digestive tracts. A previous attempt has been made on an artificial larynx implanted in 2012, but no active detection was included and the system was completely mechanic. This led to residues in the airway because of the imperfect sealing of the mechanism. An active swallowing detection coupled with indwelling measurements would thus likely add a significant reliability on such a system as it would allow to actively close an artificial larynx. So, after a brief explanation of the swallowing mechanism, this survey intends to first provide a detailed consideration of the anatomical region involved in swallowing, with a detection perspective. Second, the swallowing mechanism following total laryngectomy surgery is detailed. Third, the current non-invasive swallowing detection technique and their limitations are discussed. Finally, the previous points are explored with regard to the inherent requirements for the feasibility of an effective swallowing detection for an artificial larynx. Graphical Abstract.
Collapse
Affiliation(s)
- Adrien Mialland
- Institute of Engineering and Management Univ. Grenoble Alpes, Univ. Grenoble Alpes, CNRS, Grenoble INP, Gipsa-lab, 38000, Grenoble, France.
| | - Ihab Atallah
- Institute of Engineering and Management Univ. Grenoble Alpes, Otorhinolaryngology, CHU Grenoble Alpes, 38700, La Tronche, France
| | - Agnès Bonvilain
- Institute of Engineering and Management Univ. Grenoble Alpes, Univ. Grenoble Alpes, CNRS, Grenoble INP, Gipsa-lab, 38000, Grenoble, France
| |
Collapse
|
9
|
Laccourreye O, Garcia D, Mudry A. Total laryngectomy for laryngeal cancer 150 years after its first description: A boon more than a calamity: A STROBE analysis. Eur Ann Otorhinolaryngol Head Neck Dis 2023; 140:25-29. [PMID: 36210325 DOI: 10.1016/j.anorl.2022.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To illustrate the boon rather than a calamity that total laryngectomy can be for a patient with laryngeal cancer in the 21st century. MATERIAL AND METHOD An observational retrospective analysis using the STROBE guideline compared two cohorts of patients with previously untreated cancer, managed by total laryngectomy: the first consisting of 123 patients collected by Morell Mackenzie during the fifteen years (1873-1887) following the initial description, and the second consisting of 53 patients consecutively treated in a French university otorhinolaryngology department during the fifteen years (2006-2020) preceding the 150th anniversary of the first performance. The main endpoint was the comparison of survival and locoregional control estimates (Kaplan-Meier life table method). Secondary endpoints comprised mortality estimates and causes, adjuvant treatments, and phonation modalities. RESULTS The 26.2%, 13.1%, and 13.1% 1-, 3-, and 5-year actuarial survival estimates in the Makenzie cohort increased to 88.6%, 68.4%, and 60.9% in the recent French cohort (P<0.0001). The 50.1%, 40.4%, and 34.7% 1-, 3-, and 5-year actuarial locoregional control estimates in the Mackenzie cohort increased to 83.7% (P<0.0001). The 77.7% overall mortality in the Mackenzie cohort decreased to 37.7% (P<.0001). In the Mackenzie cohort, 97.8% of deaths were related to postoperative complications and locoregional recurrence, compared to 50% in the recent French cohort. Distant metastasis, metachronous second primary tumor and intercurrent diseases, not mentioned in the Mackenzie cohort, generated 45% of deaths in the French cohort. Adjunctive treatment was not used in the Mackenzie cohort, whereas neck dissection and postoperative radiation therapy were associated in respectively 98.1% and 69.8% of cases in the French cohort. Phonation was not documented in the Mackenzie cohort; 50% of survivors in the French cohort used a phonatory implant. CONCLUSIONS The 20th century witnessed an incredible turn-around. Total laryngectomy, with limited indications, has transformed the etiology of deaths and no longer leaves patients "in a state of abject misery" as Morell Mackenzie put it in 1888.
Collapse
Affiliation(s)
- O Laccourreye
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale HEGP, université Paris Cité, AP-HP, 20-40, rue Leblanc, 75015 Paris, France.
| | - D Garcia
- Hôpital Français, Sô1 Phuong Mai, Dong Da District, Hanoi, Vietnam
| | - A Mudry
- Department of Otolaryngology, Head & Neck Surgery, Stanford University School of Medicine, 801 Welch Road, Stanford, CA, 94305-5739, USA
| |
Collapse
|
10
|
Kozhanov AL, Kozhanov LG. [Historical and modern aspects of rehabilitation of voice function after laryngectomy]. Vestn Otorinolaringol 2023; 88:64-70. [PMID: 36867146 DOI: 10.17116/otorino20228801164] [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: 03/04/2023]
Abstract
The literature review presents historical and modern aspects of the rehabilitation of vocal function after laryngectomy, in particular, external devices, tracheopharyngeal bypass surgery, esophageal speech, tracheoesophageal bypass surgery without the use of a prosthetic device, voice prostheses are described. The advantages and disadvantages of each voice restoration technique, functional results, complications, prosthesis designs, their service life, bypass techniques, methods of prevention and treatment of damage to the valve apparatus of the prosthesis by colonies of microorganisms, fungal flora are analyzed.
Collapse
Affiliation(s)
- A L Kozhanov
- City Clinical Oncological Hospital No. 1, Moscow, Russia
| | - L G Kozhanov
- City Clinical Oncological Hospital No. 1, Moscow, Russia.,Pirogov Russian National Research Medical University, Moscow, Russia
| |
Collapse
|
11
|
Bogdanov V, Posala M, Herzog M. [Olfactory rehabilitation via retronasal olfaction using a tracheoesophageal voice prosthesis after total laryngectomy. German version]. HNO 2022; 70:878-885. [PMID: 36239758 DOI: 10.1007/s00106-022-01228-z] [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: 08/08/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Despite the variety of existing methods for olfactory rehabilitation after total laryngectomy, olfactory disability remains one of the main factors limiting quality of life for laryngectomees. OBJECTIVE Considering the need for a socially acceptable rehabilitation method that is suitable for everyday use, this study sought to elucidate whether retronasal olfaction during phonation through a tracheoesophageal voice prosthesis is possible. MATERIALS AND METHODS The odor identification of 22 laryngectomees was assessed using the Sniffin' Sticks test battery (12 odors), while performing an established method of olfactory rehabilitation-"polite yawning"-or while transnasal expiration or phonation through the tracheoesophageal fistula (TF). To facilitate the latter, a novel Expiratory Nasal Airflow M‑Maneuver (ENAMM) was developed. RESULTS All 21 non-anosmic laryngectomees included in the study were able to identify odors retronasally. While only 6 of 22 patients (27.3%) could perform the nasal expiration through the TF, all patients could easily perform phonation using ENAMM after proper instruction. The odor identification scores with the ENAMM technique did not statistically differ from ones with "polite yawning" (5.4 ± 3.1 vs. 6.4 ± 3.2, p = 0.279). The ENAMM was easy to learn and showed a tendency of increasing olfactory scores over time, possibly due to a learning effect. CONCLUSIONS Study results show that retronasal olfaction using a voice prosthesis after total laryngectomy is possible and suggest the potential of ENAMM as a method of olfactory rehabilitation for laryngectomy patients.
Collapse
Affiliation(s)
- V Bogdanov
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Carl-Thiem-Klinikum Cottbus gGmbH, Thiemstr. 111, 03048, Cottbus, Deutschland. .,Interdisziplinäres Zentrum Riechen und Schmecken, Klinik für Hals-Nasen-Ohren-Heilkunde, Technische Universität Dresden, Dresden, Deutschland.
| | - M Posala
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Carl-Thiem-Klinikum Cottbus gGmbH, Thiemstr. 111, 03048, Cottbus, Deutschland
| | - M Herzog
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Carl-Thiem-Klinikum Cottbus gGmbH, Thiemstr. 111, 03048, Cottbus, Deutschland.,Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Martin-Luther-Universität Halle - Wittenberg, Halle (Saale), Deutschland
| |
Collapse
|
12
|
Kawata-Shimamura Y, Eguchi H, Kawabata-Iwakawa R, Nakahira M, Okazaki Y, Yoda T, Grénman R, Sugasawa M, Nishiyama M. Biomarker discovery for practice of precision medicine in hypopharyngeal cancer: a theranostic study on response prediction of the key therapeutic agents. BMC Cancer 2022; 22:779. [PMID: 35841085 PMCID: PMC9288037 DOI: 10.1186/s12885-022-09853-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 07/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hypopharyngeal cancer is a relatively rare malignancy with poor prognosis. Current chemotherapeutic algorithm is still far from personalized medicine, and the identification of the truly active therapeutic biomarkers and/or targets is eagerly awaited. METHODS Venturing to focus on the conventional key chemotherapeutic drugs, we identified the most correlative genes (and/or proteins) with cellular sensitivity to docetaxel (TXT), cisplatin (CDDP) and 5-fluorouracil (5-FU) in the expression levels, through 3 steps approach: genome-wide screening, confirmation study on the quantified expression levels, and knock-down and transfection analyses of the candidates. The probable action pathways of selected genes were examined by Ingenuity Pathway Analysis using a large-scale database, The Cancer Genome Atlas. RESULTS The first genome-wide screening study derived 16 highly correlative genes with cellular drug sensitivity in 15 cell lines (|R| > 0.8, P < 0.01 for CDDP and 5-FU; |R| > 0.5, P < 0.05 for TXT). Among 10 genes the observed correlations were confirmed in the quantified gene expression levels, and finally knock-down and transfection analyses provided 4 molecules as the most potent predictive markers-AGR2 (anterior gradient 2 homolog gene), and PDE4D (phosphodiesterase 4D, cAMP-specific gene) for TXT; NINJ2 (nerve Injury-induced protein 2); CDC25B (cell division cycle 25 homolog B gene) for 5-FU- in both gene and protein expression levels. Overexpression of AGR2, PDE4D signified worse response to TXT, and the repressed expression sensitized TXT activity. Contrary to the findings, in the other 2 molecules, NINJ2 and CDC25, there observed opposite relationship to cellular drug response to the relevant drugs. IPA raised the potential that each selected molecule functionally interacts with main action pathway (and/or targets) of the relevant drug such as tubulin β chain genes for TXT, DNA replication pathway for CDDP, and DNA synthesis pathway and thymidylate synthetase gene for 5-FU. CONCLUSION We newly propose 4 molecules -AGR2, PDE4D,NINJ2 and CDC25B) as the powerful exploratory markers for prediction of cellular response to 3 key chemotherapeutic drugs in hypopharyngeal cancers and also suggest their potentials to be the therapeutic targets, which could contribute to the development of precision medicine of the essential chemotherapy in hypopharyngeal patients. (339 words).
Collapse
Affiliation(s)
- Yumiko Kawata-Shimamura
- Department of Head and Neck Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.,Research Center for Genomic Medicine, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.,Department of Oral Surgery, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Hidetaka Eguchi
- Research Center for Genomic Medicine, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.,Intractable Disease Research Center, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Reika Kawabata-Iwakawa
- Division of Integrated Oncology Research, Gunma University Initiative for Advanced Research, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Mitsuhiko Nakahira
- Department of Head and Neck Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan
| | - Yasushi Okazaki
- Research Center for Genomic Medicine, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.,Intractable Disease Research Center, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Tetsuya Yoda
- Department of Oral Surgery, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.,Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Reidar Grénman
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Turku and Turku University Hospital, PO Box 52, 20521, Turku, Finland
| | - Masashi Sugasawa
- Department of Head and Neck Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan
| | - Masahiko Nishiyama
- Research Center for Genomic Medicine, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan. .,Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan. .,Higashi Sapporo Hospital, 7-35, 3-3 Higashi-Sapporo, Shiroishi-ku, Sapporo, 003-8585, Japan.
| |
Collapse
|