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Microscopic Laryngeal Surgery

Nicola Lombardo, Teodoro Aragona, Said Alsayyad, Girolamo Pelaia, Rosa Terracciano, Rocco Savino
Voice quality outcome becomes an important factor in the choice of the therapeutic option. The differences between radiotherapy and laser cordectomy have been extensively debated in the literature. We analyzed the vocal outcomes after carbon dioxide (CO2 ) laser cordectomy and radiotherapy treatment for T1a-b early glottic cancer by means of objective and subjective voice evaluation. A retrospective study was performed on 56 cancer patients, 30 treated with cordectomy and 26 with radiotherapy. All patients underwent laser cordectomy which was performed under general anesthesia using a surgical microscope in laryngeal suspension...
January 2018: Lasers in Medical Science
A T Harris, A Tanyi, R D Hart, J Trites, M H Rigby, J Lancaster, A Nicolaides, S M Taylor
Transoral laser microsurgery applies to the piecemeal removal of malignant tumours of the upper aerodigestive tract using the CO2 laser under the operating microscope. This method of surgery is being increasingly popularised as a single modality treatment of choice in early laryngeal cancers (T1 and T2) and occasionally in the more advanced forms of the disease (T3 and T4), predominantly within the supraglottis. Thomas Kuhn, the American physicist turned philosopher and historian of science, coined the phrase 'paradigm shift' in his groundbreaking book The Structure of Scientific Revolutions...
January 2018: Annals of the Royal College of Surgeons of England
Xiaoli Yuan, Jiahua Lv, Hang Dong, Jiuhui Wang
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was 'Does cervical lymph node recurrence after oesophagectomy or definitive chemoradiotherapy for thoracic oesophageal squamous cell carcinoma benefit from salvage treatment?' Altogether, 659 articles were found using the reported search, of which 8 represented the best evidence to answer the clinical question. The authors, journal, date, country of publication, patient group studied, study type, relevant outcomes and results of these articles were tabulated...
May 1, 2017: Interactive Cardiovascular and Thoracic Surgery
T S Santos, R Estêvão, L Antunes, V Certal, J C Silva, E Monteiro
OBJECTIVE: To evaluate the clinical and histopathological factors affecting the prognosis of patients with squamous cell locoregional advanced laryngeal cancer. METHODS: A retrospective chart review was conducted of 121 patients with locoregional advanced laryngeal cancer, primarily treated with surgery from 2007 to 2011. Disease-free survival and overall survival rates were analysed as oncological outcomes. Prognostic variables, namely gender, pharyngeal invasion, pathological assessment of tumour and nodal stage, adjuvant therapy, margin status, nodal extracapsular extension, tumour differentiation, lymphovascular and perineural invasion, and predominant growth pattern, were also analysed...
October 2016: Journal of Laryngology and Otology
Francesco Mattioli, Livio Presutti, Marco Caversaccio, Marco Bonali, Lukas Anschuetz
Objective We aimed to develop and validate an ex vivo dissection station for endolaryngeal surgery suitable for different kinds of laryngeal specimen and any type of operating technique (CO2 laser, cold instruments by endoscopic or microscopic techniques). Study Design Experimental construction and validation of a highly specialized dissection station. Setting Laboratory and international dissection course. Methods We designed a lightweight dissection station made of polycarbonate resin approved for use with a CO2 laser...
June 2017: Otolaryngology—Head and Neck Surgery
Tao Li, Gang Zhou, Yang Yang, Zhi-Dong Gao, Peng Guo, Zhan-Long Shen, Xiao-Dong Yang, Qi-Wei Xie, Ying-Jiang Ye, Ke-Wei Jiang, Shan Wang
BACKGROUND: Intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) has been widely applied during thyroid surgery. However, the safe range of stimulation intensity for IONM remains undetermined. METHODS: Total thyroidectomies were performed on twenty dogs, and their RLNs were stimulated with a current of 5-20 mA (step-wise in 5 mA increments) for 1 min. The evoked electromyography (EMG) of vocal muscles before and after supramaximal stimulation were recorded and compared...
August 5, 2016: Chinese Medical Journal
C Arens, S Voigt-Zimmermann
The present article gives an overview of the current state of laryngeal surgery of benign lesions without claiming completeness and with a focus on the ENT board exam. Laryngeal procedures are highly endoscopic and microscopic based. New instruments and high-resolution endoscopic imaging techniques may substitute the typical Kleinsasser approach in the near future. Additionally, new flexible endoscopes may initiate a new era of so-called "office-based surgery". Furthermore, a consistent education of the public about performing vocal hygiene is necessary to prevent the rise of laryngeal diseases...
June 2016: Laryngo- Rhino- Otologie
Shun-Ichi Chitose, Kiminori Sato, Mioko Fukahori, Shintaro Sueyoshi, Takashi Kurita, Takeharu Ono, Buichiro Shin, Ryota Mihashi, Hirohito Umeno
OBJECTIVES/HYPOTHESIS: Transoral laser microsurgery (TLM) for hypopharyngeal cancer results in a lower incidence of complications than conventional open surgery. However, additional knowledge regarding the histoanatomical characteristics of the hypopharynx is necessary to prevent severe complications during TLM. The purpose of this study is to investigate the histoanatomical characteristics of the hypopharynx for TLM. STUDY DESIGN: Histoanatomical study. METHODS: Whole organ serial sections of three hypopharynges and larynges from autopsy cases were subjected to hematoxylin & eosin and Elastica van Gieson staining...
August 2016: Laryngoscope
Nurten Kucuk, Murat Sari, Ahmet Midi, Ali Cemal Yumusakhuylu, Ozan Findik, Adem Binnetoglu
OBJECTIVES: In laryngeal cancer, which comprises 25% of head and neck cancer, chemotherapy has come into prominence with the increase in organ-protective treatments. With such treatment, salvage surgery has increased following recurrence; the incidence of pharyngocutaneous fistula has also increased in both respiratory and digestive system surgery. We investigated the effects of recombinant human growth hormone on pharyngocutaneous fistula closure in Sprague-Dawley rats, based on an increase in amino acid uptake and protein synthesis for wound healing, an increase in mitogenesis, and enhancement of collagen formation by recombinant human growth hormone...
December 2015: Clinical and Experimental Otorhinolaryngology
Anna Mucha-Małecka, Krzysztof Składowski, Dariusz Lange
The aim of the study was to assess the prognostic value of postoperative histopathological factors as well as the clinical usefulness of the modified risk score for recurrence. In a group of 197 patients with laryngeal cancer who underwent surgery followed by radiation therapy, partial resection was performed in 21.5% of patients and total resection in 78.5%. The majority of patients had T3 or T4 (74%) and N0 (63%) cancer. Macroscopically positive margins were reported in 10% of patients after partial resection and in 7% of patients after total resection, whereas microscopically positive margins were observed in 31% and 20% of cases, respectively...
September 2015: Polish Journal of Pathology: Official Journal of the Polish Society of Pathologists
Enyinnaya Ofo, Selvam Thavaraj, Daron Cope, James Barr, Karan Kapoor, Jean-Pierre Jeannon, Richard Oakley, Claire Lock, Edward Odell, Ricard Simo
Differentiated thyroid cancer (DTC) accounts for over 90 % of thyroid malignancies, and is frequently associated with central neck compartment nodal metastasis that requires a therapeutic central compartment neck dissection (CCND) for clinically evident nodes. Current knowledge on the expected lymph node yield from a CCND is limited, compared with data on the lateral neck. The aim of our study was to accurately quantify nodal yield from the cadaveric central neck compartment. Twenty-eight cadaveric necks were dissected and the central neck compartment was subdivided into four regions: pre-laryngeal (delphian), pre-tracheal, right and left para-tracheal regions...
September 2016: European Archives of Oto-rhino-laryngology
Masashi Nagata, Hiroyuki Ito, Tomohiko Matsuzaki, Hideyuki Furumoto, Tetsuya Isaka, Teppei Nishii, Tomoyuki Yokose, Haruhiko Nakayama
Plexiform schwannoma is an infrequent variant of schwannoma characterized grossly and microscopically by multi-nodular growth. Although plexiform schwannoma has such growth patterns, it is a benign tumor as well as a conventional schwannoma. It rarely infiltrates adjacent organs or arises from the organ itself. In this report, we describe a case in which plexiform schwannoma involved the tracheal wall and left recurrent laryngeal nerve to a great extent. As it was expected to be difficult to achieve complete resection even if the longer tracheal resection were performed, we preserved the trachea and resected as much of the tumor as possible...
2015: Surgical Case Reports
Yasunao Kogashiwa, Hiroyuki Sakurai, Yoshihiro Akimoto, Dai Sato, Tetsuya Ikeda, Yoshifumi Matsumoto, Yorihisa Moro, Toru Kimura, Yasuhiro Hamanoue, Takehiro Nakamura, Koichi Yamauchi, Koichiro Saito, Masashi Sugasawa, Naoyuki Kohno
BACKGROUND: Sentinel node navigation surgery is gaining popularity in oral cancer. We assessed application of sentinel lymph node navigation surgery to pharyngeal and laryngeal cancers by evaluating the combination of contrast-enhanced ultrasonography and indocyanine green fluorescence in animal models. METHODS: This was a prospective, nonrandomized, experimental study in rabbit and swine animal models. A mixture of indocyanine green and Sonazoid was used as the tracer...
2015: PloS One
Lijing Ma, Yang Xiao, Jingying Ye, Qingwen Yang, Jun Wang
OBJECTIVE: To study the efficacy of treatment with microsurgery in combination with local injection of type A botulinum toxin for vocal process granuloma. METHOD: 28 patients with vocal process granuloma received endotracheal intubation under general anesthesia. The lesion was removed with micro-scissor and CO2 laster under a self-retaining laryngoscope and microscope. The incision and mucous membrane surrounding the wound was closed with 8-0 absorbable suture. 4-point injection of botulinum toxin type A 8-15 u was then performed along the thyroarytenoid muscle and arytenoid muscle of the same side...
January 2015: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Kewei Jiang, Yi Zhu, Gang Zhou, Yingjiang Ye, Qiwei Xie, Xiaodong Yang, Shan Wang
BACKGROUND: Various energy based surgical devices (ESD) like electrotome have been widely applied in thyroid surgery. This is the first canine model to determine the safety margin of using the electrotome near the recurrent laryngeal nerve (RLN) to prevent injury to this nerve during thyroid surgery. METHODS: Eighteen healthy male dogs were divided equally into three groups according to the distance between electrotome application and the RLN: Group A (5 mm), Group B (3 mm), Group C (1 mm)...
2015: International Journal of Clinical and Experimental Medicine
Daniel T Friedrich, Marc O Scheithauer, Jens Greve, Uma Duvvuri, Fabian Sommer, Thomas K Hoffmann, Patrick J Schuler
INTRODUCTION: Transoral surgery of the larynx is commonly performed with a rigid laryngoscope, a microscope, and a laser. We investigated the potential utility of a flexible, single-port, robot-assisted and physician-controlled endoscopic system to enable easy, transoral surgical access to the larynx. METHODS: Transoral laryngeal surgery was performed in human cadavers (n = 4) using the Flex System and compatible flexible instruments. Anatomical landmarks were identified, and mock surgical procedures were performed...
August 2015: Annals of Otology, Rhinology, and Laryngology
Toshizo Koizumi, Katsunari Yane, Toshiaki Yamanaka, Tadashi Kitahara
Background. Subcutaneous lipomas that occur in the trunk and proximal extremities are commonly dissected by low-invasive method. However, a standard surgical method for lipomas of the epiglottis has been absent. Microscopic laryngeal surgery is appropriate to extirpate small epiglottic lipomas. However, microscopic laryngeal surgery may be insufficient for giant epiglottic lipomas because there is restricted visualization of the operating field of the tumor under the microscope. Furthermore, microscopic surgical instruments are very small to manipulate giant lipomas, and it would be excessive to approach these lipomas via external cervical incisions...
2014: Case Reports in Otolaryngology
Nwanmegha Young, Mikhail Wadie Abdelmessih, Clarence Sasaki
OBJECTIVE: The predictability of laryngeal cancer spread is due in part to connective tissue membranes. These membranes function as barriers to cancer and divide the larynx into subunits. The field of laryngeal conservation surgery is based on these concepts. The quadrangular membrane plays an important role, hindering the lateral spread of cancer in the larynx. The composition of this membrane has not been well described in the literature. In this study, we examine basic characteristics of the quadrangular membrane using histological techniques...
November 2014: Annals of Otology, Rhinology, and Laryngology
Esraa Mosalleum, Amir Afrogheh, Sacha Stofberg, Abraham Fourie Bezuidenhout, Johann Schneider, Jos Hille
Sarcomas of the larynx are exceedingly uncommon, of which primary laryngeal osteosarcomas are the rarest. To date, 25 cases of primary laryngeal osteosarcomas have been reported in the literature. Laryngeal osteosarcomas may closely simulate sarcomatoid carcinomas, since both entities share clinical, histological and immunohistochemical features. Herein, we report a case of primary laryngeal osteosarcoma in a 55 year old male, focusing on the importance of light microscopic, immunohistochemical and ultrastructural features in accurately establishing the diagnosis...
March 2015: Head and Neck Pathology
Ela Cömert, Ümit Tunçel, Ayşen Dizman, Yıldız Yükselen Güney
OBJECTIVE: To evaluate the oncologic results of transoral endolaryngeal microscopic diode laser surgery (MDLS) and radiotherapy (RT) for T1 and T2 glottic carcinoma. STUDY DESIGN: Case series with planned chart review. SETTING: Ankara Oncology Education and Research Hospital. SUBJECTS AND METHODS: The study was conducted on a series of 140 cases of early glottic carcinoma (T1, T2) treated with MDLS or RT. The tumors were defined according to T stage and the involvement of the anterior commissure (AC)...
May 2014: Otolaryngology—Head and Neck Surgery
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