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Transoral laser

P D Karkos, M Stavrakas, K Markou
Transoral laser Assisted Microsurgical resection, Radiotherapy or Open partial laryngeal surgery are the management options for early glottic cancer. When endoscopic access is difficult(1-4) , radiotherapy or open surgery seems to be the other available options. The oncological safety of a Flexible Endoscopic Diode Laryngeal Laser Assisted Surgical (FEDLAS) Technique for patients with early glottic cancer and difficult laryngoscopy was tested in a preliminary pilot study. Patients with Grade three or more laryngoscopy(Cormack-Lehane classification)(5) and biopsy proven glottic cancer were included in the study...
October 11, 2016: Clinical Otolaryngology
Meritxell Valls-Mateus, Alexis Ortega, José Luis Blanch, Francesc Sabater, Manuel Bernal-Sprekelsen, Isabel Vilaseca
BACKGROUND AND OBJECTIVES: Previous studies showed good short-term Quality of life (QOL) after Transoral Laser Microsurgery (TLM) for laryngeal cancer. Here, we aimed to evaluate QOL after TLM in the long-term. METHODS: Prospective longitudinal study. Sixty-two consecutive disease-free patients were evaluated using UW-QOL v4 and SF-12 questionnaires, 1 and 5 years after TLM. Changes over time were assessed according to age, location, and tumor size. Long-term VHI-10 was also evaluated...
October 6, 2016: Journal of Surgical Oncology
Shih-Wei Yang, Wei-Chieh Chao, Yun-Shien Lee, Liang-Che Chang, Tsan-Yu Hsieh, Tai-An Chen, Cheng-Ming Luo
The aim of this study is to evaluate the treatment outcome and analyze the associated factors of postoperative recurrence in patients who received transoral laser microsurgery for vocal cord leukoplakia. The demographic, histopathological data were retrospectively reviewed and the factors associated with recurrence of vocal leukoplakia after surgery were analyzed statistically. A total of 44 patients, including 36 males and 8 females, with a mean age of 50.4 ± 13.4 years, were enrolled. All the patients received excision of the vocal leukoplakia by carbon dioxide laser (2-4 Watt, ultrapulse mode) under general anesthesia...
September 29, 2016: Lasers in Medical Science
Y Y Wu, T J Fang, J T C Chang
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Sabapathy Giridhar Suren Krishnan, Kandiah Umapathysivam, Craig Lockwood, John-Charles Hodge
The objective of this systematic review is to synthesize the best available evidence regarding the oncological and survival outcomes (as measured by disease control, disease-free survival, disease-specific survival and overall survival) of transoral robotic surgery (TORS) versus transoral laser microsurgery (TLM) in the treatment of oropharyngeal squamous cell carcinoma in adults (aged 18 years or older). Specifically the review questions are:1 Is there a difference in oncological outcomes between a traditional "Halstedian" en bloc tumor resection technique used in TORS versus a modern segmental tumor dissection technique used in TLM?2 Does one surgical approach confer better oncological outcomes with respect to a particular patient subgroup, such as patients with a positive human papilloma virus status or patient's with different tumor T-stages?...
August 2016: JBI Database of Systematic Reviews and Implementation Reports
George Orthopoulos, Brad S Oriel, C Jeff Siegert, Abraham Lebenthal, John Gooey, P Marco Fisichella
The transoral division of the esophageal-diverticula septum with a linear stapler, with CO2 laser, or with harmonic scalpel under rigid endoscopy has revolutionized the surgical management of Zenker's diverticula. Nevertheless, the open approach still plays a role in select cases. Our goals are to illustrate the techniques and the results of our tailored approach to the surgical management of Zenker's diverticula in U.S. veterans.
October 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Andrew T Day, Parul Sinha, Brian Nussenbaum, Dorina Kallogjeri, Bruce H Haughey
OBJECTIVES/HYPOTHESIS: Evaluate the oncologic outcomes of patients with early and select advanced primary glottic squamous cell carcinoma (SCCa) managed by transoral laser microsurgery (TLM). STUDY DESIGN: Retrospective cohort study. METHODS: Ninety cases of TLM-managed primary glottic SCCa were identified retrospectively using a prospectively collected database. RESULTS: Outcomes of patients with pTis-pT2a disease (n = 65) and pT2b-pT4a disease (n = 25) were, respectively: 5-year local control, 86...
August 31, 2016: Laryngoscope
Ihab Atallah, M Krishniah Manjunath, Ahmad Al Omari, Christian Adrien Righini, Paul F Castellanos
OBJECTIVES/HYPOTHESIS: To demonstrate that reconstructive transoral laser microsurgical (R-TLM) techniques can be used for the treatment of symptomatic laryngeal posterior glottic web-based stenosis (PGWS) in a large cohort of patients utilizing a postcricoid mucosal advancement flap (PCMAF). STUDY DESIGN: Retrospective cohort review. METHODS: A consecutive series of patients with PGWS who underwent R-TLM using a PCMAF were reviewed for outcomes...
August 24, 2016: Laryngoscope
G Tirelli, S Zacchigna, F Boscolo Nata, E Quatela, R Di Lenarda, M Piovesana
In the genome era, the achievement of a safe and complete resection of oral cancers remains a challenge for surgeons. Margin length at histopathological examination is still considered the main indicator of oncological radicality. However, this parameter is fraught by major limitations. Cancer aggressiveness, and in particular its ability to spread in the surrounding tissue, most probably influences loco-regional control and prognosis more than margin length. Unfortunately, no molecular markers are currently available to predict tumor aggressiveness pre-operatively...
August 4, 2016: European Archives of Oto-rhino-laryngology
Mohssen Ansarin, Augusto Cattaneo, Luigi De Benedetto, Stefano Zorzi, Francesca Lombardi, Daniela Alterio, Maria Cossu Rocca, Daniele Scelsi, Lorenzo Preda, Fausto Chiesa, Luigi Santoro
BACKGROUND: The purpose of this study was to identify the factors influencing oncologic outcomes for patients with early-intermediate glottic cancer treated by transoral laser microsurgery (TLM). METHODS: This was a retrospective mono-institutional study. A total of 590 patients with cTis-cT3 glottic cancer underwent TLM with curative intent. RESULTS: TLM alone was performed in 538 patients (91.2%) and TLM followed by adjuvant radiotherapy (RT) was done in 52 (8...
July 25, 2016: Head & Neck
Erika Crosetti, Marco Fantini, Giulia Arrigoni, Laura Salonia, Agata Lombardo, Alessio Atzori, Valentina Panetta, Antonio Schindler, Andy Bertolin, Giuseppe Rizzotto, Giovanni Succo
The aim was to investigate telephonic voice intelligibility in patients treated for laryngeal cancer using different approaches. In total, 90 patients treated for laryngeal cancer using different approaches and 12 healthy volunteers were recruited. Each patient and each healthy control read a list of words and sentences during a telephone call. Six auditors listened to each telephonic recording and transcribed the words and sentences they understood. Mean intelligibility rates for each treatment were assessed and compared...
July 19, 2016: European Archives of Oto-rhino-laryngology
Carlos Miguel Chiesa Estomba, Frank Alberto Betances Reinoso, Alejandra Osorio Velasquez, Jose Luis Rodriguez Fernandez, Jose Luis Fariña Conde, Carmelo Santidrian Hidalgo
INTRODUCTION: Transoral laser microsurgery (TLM) has won territory in larynx oncology, establishing itself as an effective option in treatment of glottic, supraglottic, and hypopharynx tumors. Its advantages include limited resections, a reduction in number of tracheostomies, and the use of nasogastric tubes. Moreover, its oncological benefits are similar to those from open surgery in patients with early or advanced stages, when correctly selected. OBJECTIVE: The objective of this study is to review oncologic outcomes obtained with the treatment of a series of glottic tumors, treated by TLM...
July 2016: International Archives of Otorhinolaryngology
Bin Xu, Jihua Wang, Xuping Xiao
Transoral laser microsurgery (TLM) has developed more than 40 years in the treatment of laryngeal cancer. TLM is especially important in the minimally invasive surgery of laryngeal carcinoma. Compared with the traditional open surgery, it is a major breakthrough, which has the significant advantages such as safety, effectiveness, low rate of local recurrence and high rate of larynx preservation. Not only can cure early laryngeal cancer, but also more and more the use of TLM in advanced supraglottic and glottic laryngeal cancer were reported...
February 2016: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Faya Liang, Song Fan, Ping Han, Qian Cai, Peiliang Lin, Renhui Chen, Shitong Yu, Xiaoming Huang
BACKGROUND: Primary tumors of early-stage (T1-2N0M0) head and neck squamous cell carcinoma (HNSCC) can be treated by transoral minimally invasive surgery, but the cervical lymph node lacks corresponding minimally invasive treatment. Therefore, our study was to evaluate the safety and effectiveness of endoscopic-assisted selective neck dissection (EASND) via small lateral neck incision in treatment of early-stage HNSCC. METHODS: From May 2008 to April 2012, 29 patients with early-stage HNSCC were enrolled in this retrospective study...
July 1, 2016: Surgical Endoscopy
M Riga, L Chelis, V Danielides, T Vogiatzaki, T-L Pantazis, D Pantazis
OBJECTIVE: The optimal treatment of patients with T3 laryngeal carcinoma is controversially challenged by open partial laryngectomies (OPL), transoral laser microsurgery (TLM) and radiation therapy alone (RT) or combined with chemotherapy (ChRT). Treatment guidelines, experts' opinions and clinical studies are highly contradictory. The aim of this study is to compare the primary outcomes of the available treatment methods and identify the sources of variance among studies. METHODS: A review of the literature published in the time period 2003-2015 was conducted via the PubMed database (www...
June 10, 2016: European Journal of Surgical Oncology
Chengyuan Wang, Summit Kundaria, Juan Fernandez-Miranda, Umamaheswar Duvvuri
OBJECTIVES/HYPOTHESIS: To illustrate detailed anatomy of the extracranial portion of the glossopharyngeal nerve in the parapharyngeal space as encountered during transoral surgery. STUDY DESIGN: Prospective cadaveric dissection. All dissections were performed transorally and confirmed with transcervical dissection. METHODS: Eight color-injected cadaveric heads (16 sides) were dissected to demonstrate the course and anatomy of the glossopharyngeal nerve...
September 2016: Laryngoscope
Marco Lucioni, Andy Bertolin, Marco Lionello, Luciano Giacomelli, Guido Ghirardo, Giuseppe Rizzotto, Gino Marioni
OBJECTIVES/HYPOTHESIS: To retrospectively analyze our experience of transoral laser microsurgery (TLM) for treating postoperative laryngeal obstruction (POLO) after supracricoid and supratracheal laryngectomy (open partial horizontal laryngectomy [OPHL]) types 2 and 3, and to investigate potential relationships between patients' clinical features and their functional outcomes. STUDY DESIGN: A retrospective cohort study. METHODS: The prognostic influence of clinical and surgical parameters on functional outcomes was investigated in a univariate statistical setting in terms of decannulation rate (DR), time to tracheostomy closure (TTC), and number of laser procedures required (NLP)...
June 3, 2016: Laryngoscope
Quentin Charbonnier, Anne-Sophie Thisse, Laurent Sleghem, François Mouawad, Dominique Chevalier, Cyril Page, Geoffrey Mortuaire
BACKGROUND: The oncologic impact of surgical margins after transoral laser microsurgery (TLM) for T1 and T2 glottic carcinoma is controversial. The purpose of this study was to assess the prognostic value of margin status in terms of local control. METHODS: Records of 266 patients treated from 1990 to 2013 were evaluated. Patients with previous cordectomy or without preoperative CT scan were excluded from the study. RESULTS: A total 110 patients (85 T1a, 8 T1b, and 17 T2) were enrolled...
June 1, 2016: Head & Neck
Fatma Tülin Kayhan, Selçuk Güneş, Arzu Karaman Koç, Ayşe Pelin Yiğider, Kamil Hakan Kaya
OBJECTIVES: Laryngoceles are air-filled sacs which communicate with the laryngeal lumen. When filled with mucus or pus, they are called laryngomucoceles and laryngopyoceles, respectively. Transoral robotic surgery (TORS) is a new and remarkable technique that expands its usefullness in otorhinolaryngology. Conventional treatments for laryngoceles were previously performed using external approaches, with aesthetically unfavorable and less function-sparing results. Transoral laser microsurgical approaches for laryngoceles were seldom reported...
June 2016: Journal of Craniofacial Surgery
A Butler, M H Rigby, J Scott, J Trites, R Hart, S M Taylor
BACKGROUND: The purpose of this study was to evaluate the functional and oncological outcomes of patients treated for T3 laryngeal squamous cell carcinoma. Specifically comparing transoral laser microsurgery and radiotherapy/chemoradiotherapy treatment modalities. METHOD: A retrospective review of patients treated for T3 laryngeal SCC between 2002 and 2010 was undertaken. RESULTS: Forty-nine patients were included. 15 cases were glottic, (9 treated with TLM, 6 with RT/CRT), 33 supraglottic (6 treated with TLM, 27 with RT/CRT) and 1 subglottic subsite (treated with RT/CRT)...
2016: Journal of Otolaryngology—Head & Neck Surgery
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