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Transoral laser

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https://www.readbyqxmd.com/read/29046085/transoral-laser-surgery-for-laryngeal-carcinoma-has-steiner-achieved-a-genuine-paradigm-shift-in-oncological-surgery
#1
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...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28976011/oncologic-results-and-quality-of-life-in-patients-with-squamous-cell-carcinoma-of-hypopharynx-after-transoral-laser-microsurgery
#2
Li-Ting Hung, Hsin-I Huang, Ling-Wei Wang, Muh-Hwa Yang, Pen-Yuan Chu
OBJECTIVE: Transoral laser microsurgery (TLM) is an alternative method for organ preservation in squamous cell carcinoma of hypopharynx (HPSCC). The purpose of this study was to analyze the oncologic results and quality of life (QOL) in HPSCC patients after TLM. METHODS: Forty-six patients who underwent TLM were included, 34 of them had QOL evaluations. The QOL analyses were measured with EORTC QLQ-C-30, QLQ-H&N35, VHI-30, and MDADI at least 6 months postoperatively...
October 4, 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/28955672/treatment-of-advanced-carcinoma-of-the-larynx-and-hypopharynx-with-laser-followed-by-external-radiotherapy
#3
Lalee Varghese, John Mathew, Subhashini John, Anand Job
INTRODUCTION: Radical laryngeal surgeries for extensive laryngeal and hypopharyngeal tumors often require a permanent tracheostomy, which has an immense impact on the quality of life of patients. A minimally invasive technique such as transoral laser microresection (TLM) followed by radiotherapy can preserve the functions of the voice and swallowing. The aim of this study is to evaluate the role of laser debulking in the treatment of carcinoma of the larynx and hypopharynx, to evaluate the response of the tumor to subsequent radiotherapy, and also to assess the usefulness of laser in avoiding tracheostomy and functional preservation of the voice and swallowing...
September 2017: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28929221/therapeutic-modalities-and-oncologic-outcomes-in-the-treatment-of-t1b-glottic-squamous-cell-carcinoma-a-systematic-review
#4
REVIEW
Federico Maria Gioacchini, Michele Tulli, Shaniko Kaleci, Stefano Bondi, Mario Bussi, Massimo Re
T1a and T1b glottic squamous cell carcinoma (SCC) are often analyzed together by authors who investigate the oncologic outcomes achieved after different therapeutic options. Nevertheless, T1b definitely represents a more advanced tumor stage compared to T1a glottic SCC. The objective of this review was first to analyze the overall success rates in the treatment of patients affected by T1b glottic SCC. Moreover, a subgroup analysis was planned to specifically compare the outcomes obtained with radiotherapy (RT), transoral laser microsurgery (TLM) and open partial laryngectomies (OPL)...
September 19, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28895160/oncologic-outcomes-of-ktp-laser-surgery-versus-radiation-for-t1-glottic-carcinoma
#5
Jamal Ahmed, Ahmed Sherif Gabr Ibrahim, Laura M Freedman, David E Rosow
OBJECTIVES/HYPOTHESIS: To characterize outcomes for patients who underwent transoral microsurgery with potassium titanyl phosphate (KTP) laser resection of early glottic cancers and to compare outcomes with patients who received external beam radiation therapy. STUDY DESIGN: Retrospective cohort study. METHODS: The history of patients with T1 glottic carcinoma treated with curative primary radiation or transoral KTP laser resection was reviewed...
September 12, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28895157/laryngeal-exposure-and-margin-status-in-glottic-cancer-treated-by-transoral-laser-microsurgery
#6
Cesare Piazza, Alberto Paderno, Paola Grazioli, Francesca Del Bon, Nausica Montalto, Pietro Perotti, Riccardo Morello, Marta Filauro, Piero Nicolai, Giorgio Peretti
OBJECTIVE: Laryngeal exposure is one of the most limiting factors in transoral laser microsurgery (TLM) for glottic cancer. We evaluated the correlation between the degree of laryngeal exposure, as assessed by an easy previously described scoring tool (Laryngoscore), and histopathologic surgical margin status after TLM. STUDY DESIGN: Prospective evaluation of 147 patients affected by Tis-T2 glottic cancer treated by TLM with curative intent between January 2012 and April 2016...
September 12, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28873031/surgical-treatment-for-early-stage-glottic-carcinoma-with-involvement-of-the-anterior-commissure
#7
Philipp Wolber, David Schwarz, Thoralf Stange, Magdalene Ortmann, Matthias Balk, Andreas Anagiotos, Antoniu-Oreste Gostian
Objective Assessment of the value of transoral laser microsurgery (TLM) compared with open surgery (OS) for early stage squamous cell carcinoma of the glottic larynx with special regard to involvement of the anterior commissure (AC). Study Design Case series with chart review. Setting Tertiary care otolaryngology clinic. Subjects and Methods Review of clinicopathological data of all patients with previously untreated T1a, T1b, and T2 glottic squamous cell carcinoma of the larynx who were consecutively enrolled over a 10-year period (January 1, 1992, to December 31, 2002)...
September 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28854985/-cutting-through-tumour-in-head-and-neck-cancer-still-a-taboo
#8
R de Bree, S M Willems, L M Janssen, M W M van den Brekel
When resecting head and neck tumours, the aim is mostly to strive for en bloc resection with sufficiently large tumour-free margins. If this is not possible, as is frequently the case with transoral laser microsurgery and endonasal endoscopic surgery, multiblock resection can be carried out by cutting through the tumour. With this approach, it is also essential that the final resection margins are tumour-negative. In such cases, surgeon and pathologist together should pay extra attention to tissue orientation and outer resection margins...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28819810/laser-assisted-surgery-of-the-upper-aero-digestive-tract-a-clarification-of-nomenclature-a-consensus-statement-of-the-european-laryngological-society
#9
Marc Remacle, Christoph Arens, Mostafa Badr Eldin, Guillermo Campos, Carlos Chiesa Estomba, Pavel Dulguerov, Ivana Fiz, Anastasios Hantzakos, Jerôme Keghian, Francesco Mora, Nayla Matar, Giorgio Peretti, Cesare Piazza, Gregory N Postma, Vyas Prasad, Elisabeth Sjogren, Frederik G Dikkers
Acronyms and abbreviations are frequently used in otorhinolaryngology and other medical specialties. CO2 laser-assisted transoral surgery of the pharynx, the larynx and the upper airway is a family of commonly performed surgical procedures termed transoral laser microsurgery (TLM). The abbreviation TLM can be confusing because of alternative modes of delivery. Classification and definition of the different types of procedures, performed transorally or transnasally, are proposed by the Working Committee for Nomenclature of the European Laryngological Society, emphasizing the type of laser used and the way this laser is transmitted...
August 17, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28807066/laser-assisted-management-of-a-symptomatic-anterior-pharyngeal-diverticulum
#10
K Pujary, A C Agarwal, R Balakrishnan, A Bhandarkar
BACKGROUND: Dysphagia is a relatively common symptom following laryngectomy. An anterior pharyngeal diverticulum is a rare cause of post-laryngectomy dysphagia. However, it is often an incidental finding on rigid telescopic examination. METHODS AND RESULTS: This article describes two patients with a symptomatic anterior pharyngeal diverticulum. They were treated by transoral micro-endoscopic potassium titanyl phosphate 532 nm laser assisted resection. Both patients could take feeds orally after the procedure without any difficulty...
October 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28757800/case-report-recurrent-mucoepidermoid-carcinoma-of-the-tongue-in-adult-female-patient-with-lung-cancer
#11
Arielle Rubin, John Davis, Karim Jreije, Henry Wu, Randy Oppenheimer
There is a steady rise in incidence of malignant salivary gland tumors in the United States, with mucoepidermoid carcinoma (MEC) the most frequent. Although 40% of MECs are found in the parotid gland, these lesions possess the capacity to develop anywhere along the aerodigestive tract. Here, we present a case of recurrent tongue MEC in a young adult female patient with history of lung malignancy and multiple brain metastases. Without a universally accepted management protocol for recurrent MECs, the current clinical practice uses tumor grade, location, and clinical progression to determine both prognosis and goals of care...
2017: Clinical Medicine Insights. Ear, Nose and Throat
https://www.readbyqxmd.com/read/28741786/ectopic-parathyroid-adenoma-in-the-pyriform-sinus
#12
Jonathan Kim, Maricel Cubangbang, Lacey Adkins, Stanley Chia, Timothy R DeKlotz, Lisa Boyle, Bruce Davidson
BACKGROUND: Ectopic parathyroid glands may complicate the surgical approach to primary hyperparathyroidism. We describe a rare ectopic parathyroid location, the pyriform sinus. METHODS: Three patients, 2 after prior unsuccessful parathyroid exploration, were found to have ectopic parathyroid adenomas in the pyriform sinus. Two cases were identified by 4D-CT of the neck. The other was localized by a technetium 99m sestamibi single photon emission CT (SPECT). In each case, office endoscopy confirmed the lesions...
July 25, 2017: Head & Neck
https://www.readbyqxmd.com/read/28714430/laparoscopic-instrument-use-in-laryngeal-surgery-transoral-resection-of-a-supraglottic-haemangioma
#13
R Bannon, R Gohil, J Manickavasagam
BACKGROUND: Adult laryngeal haemangiomas are rare vascular tumours that have been managed by a variety of surgical techniques. METHODS: This paper describes a case of near-fatal acute airway obstruction secondary to such a lesion, followed by our approach to surgical resection using a laparoscopic bipolar tissue-sealing device. RESULTS: This technique resulted in successful excision of the lesion, with no evidence of recurrence at one year of follow up...
September 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28695624/life-quality-improvement-in-hoarse-patients-with-early-glottic-cancer-after-transoral-laser-microsurgery
#14
Li-Jen Hsin, Wan-Ni Lin, Tuan-Jen Fang, Li-Ang Lee, Chung-Jan Kang, Bing-Shan Huang, Chien-Yu Lin, Kang-Hsing Fan, Ngan-Ming Tsang, Cheng-Lung Hsu, Joseph Tung-Chieh Chang, Chun-Ta Liao, Tzu-Chen Yen, Kai-Ping Chang, Hsiu-Feng Chuang, Hsueh-Yu Li
BACKGROUND: The purpose of this study was to evaluate the recovery kinetics of voice and quality of life (QOL) over time in patients with early glottic cancer who underwent transoral laser microsurgery (TLM). METHODS: A prospective cohort study was conducted in which acoustic and aerodynamic voice assessments and QOL analyses were done using health-related questionnaires (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30-questions [EORTC-QLQ-C30] and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck 35-questions [EORTC-QLQ-H&N35]) were administered at designated times...
July 11, 2017: Head & Neck
https://www.readbyqxmd.com/read/28669304/gland-preservation-in-patients-undergoing-sialoendoscopy
#15
Virginie Achim, Tyler J Light, Peter E Andersen
Objective Sialoendoscopy is a minimally invasive technique for the treatment of obstructive sialadenitis. We aim to describe treatment considerations and report our ultimate rate of gland preservation. Study Design Case series with chart review. Setting Academic tertiary hospital. Subject and Methods A total of 128 consecutive sialoendoscopy cases for obstructive sialadenitis between 2009 and 2015 were evaluated. Procedures included endoscopic stricture dilation, basket-assisted stone retrieval, Holmium laser lithotripsy, and combined endoscopic transoral stone excision...
July 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28631160/role-of-imaging-in-the-follow-up-of-t2-t3-glottic-cancer-treated-by-transoral-laser-microsurgery
#16
Filippo Marchi, Cesare Piazza, Marco Ravanelli, Giovanna Gaggero, Giampiero Parrinello, Alberto Paderno, Pietro Perotti, Marta Filauro, Roberto Maroldi, Giorgio Peretti
An unblinded retrospective analysis of prospectively collected data was carried out on 138 patients affected by glottic pT2 and selected pT3 squamous cell carcinomas (SCC) treated by transoral laser microsurgery (TLM). The entire cohort was divided into two groups: Group A included 78 "high-risk" patients (pT2 with impaired vocal cord mobility, pT3 for anterior paraglottic and/or pre-epiglottic space invasion, presence of angioembolization, perineural spread, and positive lymph nodes in the neck) who underwent postoperative surveillance by endoscopy and imaging (CT or MR), while Group B included 60 "low-risk" patients (pT2 with absence of the above-mentioned features) who underwent endoscopic follow-up alone...
June 19, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28583473/predictors-of-local-recurrence-of-glottic-cancer-in-patients-after-transoral-laser-microsurgery
#17
Chia-Fan Chang, Pen-Yuan Chu
BACKGROUND: Transoral laser microsurgery (TLM) is used to treat early and select cases of moderately advanced glottic cancer, with results equivalent to those of conventional conservative surgery and radiotherapy (RT). As surgeons and researchers become more experienced and familiar with TLM, they can focus on mechanisms to earlier detect local recurrence, to more effectively preserve laryngeal function. This study analyzed the predictors of local recurrence in glottic cancer patients who underwent TLM...
July 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28558451/-treatment-of-glottic-cancer-involving-the-anterior-commissure-by-transoral-co-2-laser-surgery
#18
J J Li, J L Zhang, F Y He, S C Tang, Z F Zhu, W X Chen
Objective: To study the clinical outcome of transoral CO(2) laser surgery for glottic cancer involving the anterior commissure. Methods: Thirty-two cases of glottic cancer involving the anterior commissure treated by transoral CO(2) laser surgery between March 2009 and December 2013 were retrospectively reviewed. Among these cases, 27 were T1bM0M0, 5 were T2N0M0. All cases were followed-up for more than 3 years. Results: All the 32 cases were successfully treated. Perioperative complications included injuries in the soft palate mucosa(13/32, 40...
May 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28530251/impact-of-resection-margin-status-on-oncological-outcomes-after-co2-laser-cordectomy
#19
P Aluffi Valletti, F Taranto, A Chiesa, F Pia, G Valente
The management of positive resection margins in micro-endoscopic glottic laser surgery remains a controversial and critical point. This study aims to assess the impact of margin status after transoral laser surgery on local control, survival and organ preservation rates; the decision- making process and treatment options in cases with positive margins are also discussed. We retrospectively reviewed the clinical and histological records of 308 consecutive patients with primary early glottic carcinoma (T1a, T1b, selected T2) and treated with endoscopic laser cordectomy...
May 22, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28516973/salivary-lithotripsy-in-the-era-of-sialendoscopy
#20
P Capaccio, S Torretta, L Pignataro, M Koch
The traditional management of obstructive salivary disorders has been replaced by minimally-invasive gland-preserving techniques including shock-wave lithotripsy, sialendoscopy, interventional radiology and endoscopically video-assisted trans-oral and cervical stone retrieval, of which sialendoscopy is considered to be the method of first choice. Primary endoscopically controlled stone extraction without prior fragmentation is only possible in 15-20% of cases; in more than 80%, fragmentation is necessary because of the size, impactation and location of the stone, or an alternative treatment such as transoral duct surgery or combined approaches are required...
April 2017: Acta Otorhinolaryngologica Italica
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