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Total laryngectomy

Hussein Walijee, Alexandria Morgan, Bethan Gibson, Sandeep Berry, Ali Jaffery
Critical Care Unit (CCU) beds are a limited resource and in increasing demand. Studies have shown that complex head and neck patients can be safely managed on a ward setting given the appropriate staffing and support. This retrospective case series aims to quantify the CCU care received by patients following total laryngectomy (TL) at a District General Hospital (DGH) and compare patient outcomes in an attempt to inform current practice. Data relating to TL were collected over a 5-year period from 1st January 2010 to 31st December 2015...
2016: International Journal of Otolaryngology
Joseph C Dort, D Gregory Farwell, Merran Findlay, Gerhard F Huber, Paul Kerr, Melissa A Shea-Budgell, Christian Simon, Jeffrey Uppington, David Zygun, Olle Ljungqvist, Jeffrey Harris
Importance: Head and neck cancers often require complex, labor-intensive surgeries, especially when free flap reconstruction is required. Enhanced recovery is important in this patient population but evidence-based protocols on perioperative care for this population are lacking. Objective: To provide a consensus-based protocol for optimal perioperative care of patients undergoing head and neck cancer surgery with free flap reconstruction. Evidence Review: Following endorsement by the Enhanced Recovery After Surgery (ERAS) Society to develop this protocol, a systematic review was conducted for each topic...
October 13, 2016: JAMA Otolaryngology—Head & Neck Surgery
William A Stokes, Bernard L Jones, Shilpa Bhatia, Ayman J Oweida, Daniel W Bowles, David Raben, Julie A Goddard, Jessica D McDermott, Sana D Karam
BACKGROUND: Although laryngectomy is the treatment of choice for patients with T4 larynx cancer, many patients are unable or unwilling to undergo laryngectomy and instead pursue larynx-preservation strategies combining radiotherapy (RT) and chemotherapy. Herein, the authors analyzed the National Cancer Data Base to evaluate overall survival (OS) between patients treated with surgical and organ-preserving modalities. METHODS: The National Cancer Data Base was queried for patients diagnosed from 2004 through 2012 with T4M0 laryngeal cancer who underwent either laryngectomy (surgery) with adjuvant RT (SRT), chemotherapy starting concurrently within 7 days of RT (CCRT), or multiagent induction chemotherapy starting 43 to 98 days before RT (ICRT)...
October 11, 2016: Cancer
Pauline Mezerette, Élise Lefèvre
The day-to-day management and support of patients undergoing a total laryngectomy has led multi-disciplinary nursing teams to create a therapeutic patient education programme aiming to improve the quality of care and the autonomy of these people. In this context, the eb(2®) dummy is an essential tool.
October 2016: Revue de L'infirmière
Ayşegül Batıoğlu Karaaltın, Zerrin Binbay, Özgür Yiğit, Zehra Dönmez, Umur Yollu
AIM: Larynx cancer patients usually use alcohol besides tobacco. It has been reported earlier that nearly half of the patients who have undergone laryngectomcy after larynx cancer diagnosis still continue to consume alcohol after the operation. The aim of this study is to compare the mood and character features of patients who do or do not consume alcohol during the post-operative period and thus to be able to predict the patients who will continue their alcohol use at the post-operative period...
September 26, 2016: Clinical Otolaryngology
Jaime P Rodrigues, Rolando Pinho, Joao Carvalho
A 57-year-old man with a past medical history of total laryngectomy for squamous cell carcinoma of the larynx was admitted to our institution 5 months after the procedure, for surgical resection of a local recurrence of the tumor. In the postoperative period, endoscopically guided placement of a nasogastric tube was scheduled, after previous failed attempts. Upper gastrointestinal endoscopy revealed an anastomotic dehiscence, 13 cm distal to the incisors, and a foreign body penetrating through the esophageal wall, 20cm distal to the incisors...
October 2016: Revista Española de Enfermedades Digestivas
Sevdegül Mungan, Selçuk Arslan, Eda Küçüktülü, Şafak Ersöz, Bengü Çobanoğlu
We present an extremely rare case of a pleomorphic rhabdomyosarcoma of the true vocal fold. The histopathological diagnosis was confirmed by immunohistochemistry. The patient was treated with radical surgery including total laryngectomy and radical neck dissection followed by postoperative radiotherapy. The clinicopathologic features of this rare malignancy are discussed together with a review of the literature. This case report and literature review highlights the more favorable prognosis of pleomorphic rhabdomyosarcoma in the larynx than in other locations...
2016: Case Reports in Otolaryngology
Jared A Shenson, Jennifer N Craig, Sarah L Rohde
OBJECTIVE: Total laryngectomy (TL) is a high-cost procedure with patients at risk for significant postoperative health care use. Face-to-face preoperative counseling provided by speech-language pathologists is a relatively inexpensive intervention that may improve care quality and decrease costs. We evaluated if preoperative counseling for patients undergoing TL was associated with differences in length of stay (LOS), use of the emergency department (ED), or unplanned readmissions within 30 days of discharge...
September 27, 2016: Otolaryngology—Head and Neck Surgery
M J Awan, S J Zakem, M C Ward, M Machtay, N Riaz, J J Caudell, N E Dunlap, D Isrow, J Dault, K A Higgins, J J Beitler, F Siddiqui, A Trotti, N Lee, S Koyfman, D E Heron, M Yao
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Mary Worthen, Mia Jusufbegovic, Jeffrey M Bumpous, Andrew Vaughn, Elizabeth Cash, Xiu Yang, Craig Fichandler, Paul Tennant
OBJECTIVE: To assess the prevalence of invasive fungal elements in the specimens of patients who underwent salvage total laryngectomy for chondroradionecrosis (CRN) in the absence of recurrent or persistent malignancy. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary academic medical center. METHODS: One hundred fifty-nine patients were identified who underwent salvage total laryngectomy. Pathology reports were reviewed, and all laryngectomy specimens that did not contain residual malignancy were reevaluated for evidence of invasive fungal elements...
September 26, 2016: Laryngoscope
Caner Kiliç, Ümit Tunçel, Metin Kaya, Ela Cömert, Samet Özlügedik
AIM: This study was to present long-term oncological results, as well as the variables, that can increase nodal metastasis and reduce survival in patients diagnosed in the early and late stages of laryngeal cancer. METHODS: A total of 85 patients were included in the study. These patients were grouped as supracricoid partial laryngectomy (PL), supraglottic horizontal PL, and vertical frontolateral PL. Furthermore, at least 3 years of the long-term outcomes of the patients in these 3 groups were compared...
October 2016: Journal of Craniofacial Surgery
Chang Jiang Li, Lei Cheng, Haitao Wu, Lei Tao, Liang Zhou
Ideal speech restoration remains a difficult challenge for patients undergoing laryngectomy so far. Our aim was to explore the feasibility of neoglottic reconstruction with sternohyoid muscles on upper-tracheal orifice after total laryngectomy which can obtain relatively ideal voice rehabilitation. Fifteen male patients are laryngectomized, of whom eight with standard total laryngectomy and seven underwent nonstandard total laryngectomy with epiglottis conserved. After laryngectomy, the upper margin of the anterior hypopharyngeal mucosa (postcricoid mucosa) was stitched to the posterior margin of upper-tracheal orifice and a triangle-shaped neoglottis on upper-tracheal orifice was reconstructed using bilateral sternohyoid muscles near the hyoid bone which were sutured to the posterior wall and bilateral of upper-tracheal orifice...
August 24, 2016: European Archives of Oto-rhino-laryngology
Sirshak Dutta, Kaustuv Das Biswas, Soumya Ghatak, Dibakar Haldar, Indranil Sen, Ramanuj Sinha
Primary laryngeal carcinoma is a common cancer, predominantly affecting males. Hypothyroidism is an undesirable sequela of both surgery and radiotherapy, the two most commonly used modalities of treatment. For advanced cases, standard treatment protocol includes total laryngectomy and neck dissection along with pre- or postoperative radiotherapy. Hemithyroidectomy is also routinely performed as an integral part of total laryngectomy. In the present study, assessment of the function of the remaining half of the thyroid gland has been done in cases of total laryngectomies in combination with uni- or bilateral neck dissection and pre- or postoperative radiotherapy...
August 2016: Ear, Nose, & Throat Journal
Paul Paddle, Inna Husain, Lauren McHugh, Ramon Franco
OBJECTIVES/HYPOTHESIS: A total laryngectomy (TL) is performed as a primary or salvage therapy for laryngeal carcinoma. Pharyngotomy closure after TL is typically performed using manual sutures. Automatic stapling devices are routinely used in thoracoabdominal surgery, but have not been widely accepted for use in pharyngotomy closure. Previously described closed stapling techniques of pharyngeal closure do not allow direct evaluation of surgical margins and are limited to endolaryngeal disease...
August 22, 2016: Laryngoscope
Jia-Shiou Liao
Purpose: This study investigated the acoustic properties of 6 Taiwan Southern Min vowels produced by 10 laryngeal speakers (LA), 10 speakers with a pneumatic artificial larynx (PA), and 8 esophageal speakers (ES). Method: Each of the 6 monophthongs of Taiwan Southern Min (/i, e, a, ɔ, u, ə/) was represented by a Taiwan Southern Min character and appeared randomly on a list 3 times (6 Taiwan Southern Min characters × 3 repetitions = 18 tokens). Each Taiwan Southern Min character in this study has the same syllable structure, /V/, and all were read with tone 1 (high and level)...
August 17, 2016: American Journal of Speech-language Pathology
Nille Birk Wulff, Elo Andersen, Claus Andrup Kristensen, Christian Hjort Sørensen, Birgitte Charabi, Preben Homøe
OBJECTIVE: The primary aims were to determine the rates of and prognostic factors for overall survival, disease specific survival and disease free survival following salvage total laryngectomy. DESIGN: Retrospective longitudinal study. SETTING: Tertiary medical centers. PARTICIPANTS: 142 patients in Eastern Denmark undergoing salvage total laryngectomy for squamous cell carcinoma of the larynx or hypopharynx. MAIN OUTCOME MEASURES: Five-year overall survival, 5-year disease specific survival, 5-year disease free survival and prognostic factors for these outcomes...
August 18, 2016: Clinical Otolaryngology
Y Pointreau, C Lafond, F Legouté, P Trémolières, S Servagi-Vernat, P Giraud, P Maingon, G Calais, M Lapeyre
Intensity-modulated radiotherapy is the gold standard in the treatment of larynx cancers (except T1 glottic tumour). Early T1 and T2 tumours may be treated by exclusive radiation or surgery. For tumours requiring total laryngectomy (T2 or T3), induction chemotherapy followed by exclusive radiotherapy or concurrent chemoradiotherapy is possible. For T4 tumour, surgery must be proposed. The treatment of lymph nodes is based on the initial treatment of the primary tumour. In non-surgical procedure, in case of sequential radiotherapy, the curative dose is 70Gy and the prophylactic dose is 50Gy...
September 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Peiliang Lin, Xiaoming Huang, Chushan Zheng, Qian Cai, Zhong Guan, Faya Liang, Yiqing Zheng
The aim of this study was to evaluate the predictive value of magnetic resonance imaging (MRI) in detecting thyroid gland invasion (TGI) in patients with advanced laryngeal or hypopharyngeal carcinoma. In a retrospective chart review, 41 patients with advanced laryngeal or hypopharyngeal carcinoma underwent MRI scan before total laryngectomy and ipsilateral or bilateral thyroidectomy during the past 5 years. The MRI findings were compared with the postoperative pathological results. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated...
August 12, 2016: European Archives of Oto-rhino-laryngology
S Sharma, D A Chaukar, S G Laskar, N Kapre, A Deshmukh, P Pai, P Chaturvedi, A D'Cruz
OBJECTIVE: This study aimed to assess the utility of onlay pectoralis major myofascial flap in preventing pharyngocutaneous fistula following salvage total laryngectomy. METHODS: A retrospective analysis was performed of 172 patients who underwent salvage laryngectomy for recurrent carcinoma of the larynx or hypopharynx between 1999 and 2014. One hundred and ten patients underwent primary closure and 62 patients had pectoralis major myofascial flap onlay. RESULTS: The overall pharyngocutaneous fistula rate was 43 per cent, and was similar in both groups (primary closure group, 43...
September 2016: Journal of Laryngology and Otology
B Henriques De Figueiredo, C Fortpied, J Menis, J L Lefebvre, L Barzan, D de Raucourt, L Geoffrois, L Giurgea, P Hupperets, C R Leemans, L Licitra, F Rolland, M Tesselaar, J B Vermorken, V Grégoire
The long-term results of the EORTC 24954 trial comparing sequential versus alternating chemotherapy and radiotherapy (RT) for patients with locally advanced laryngeal and hypopharyngeal cancer are reported. From 1996 to 2004, 450 patients were randomly assigned (1-1) to a sequential arm (SA = induction cisplatin-5fluorouracil followed by a 70Gy-RT for the responders or a total laryngectomy and post-operative RT for the non-responders) and an alternating arm (AA = cisplatin-5fluorouracil alternated with three 2-week courses of 20 Gy-RT for a total dose of 60 Gy)...
September 2016: European Journal of Cancer
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