Anesthesia for laryngectomy

BACKGROUND: Patients who have had laryngectomy require a thorough preoperative assessment for potential stomal stenosis, and an action plan for possible inadvertent displacement of the voice prosthesis (VP) must be considered. We report the anesthetic management of a post-laryngectomy patient undergoing lung resection surgery. The patient had both a laryngectomy and a VP in situ . CASE DESCRIPTION: A 66-year-old man with Parkinson's disease, who had previously undergone total laryngectomy for supraglottic laryngeal cancer, had a cuffed tracheostomy tube and a VP inserted into the tracheoesophageal fistula below it...

Background/Aims/Objectives: To investigate the treatment for adult glottic stenosis using CO2 laser surgery combined with a self-made laryngeal dilator. Material and Methods: A retrospective analysis was performed on 18 patients with glottic stenosis who were treated using CO2 laser surgery combined with a self-made laryngeal dilator in our hospital from January 2018 to December 2020. Results: 4 cases were caused by trauma and one by laryngophthisis. Laryngeal stenosis occurred in 4 and 9 patients respectively after CO2 laser surgery and open partial laryngectomy...

PURPOSE: To examine whether intraoperative dexmedetomidine reduces postoperative delirium (POD) in elderly patients who underwent a laryngectomy. METHODS: Patients were randomly assigned to receive dexmedetomidine or a saline placebo infused during surgery. The study period was July 2020 to January 2022. Participants were elderly individuals (≥65 years) who underwent a laryngectomy. Immediately after induction of anesthesia, a 0.5 μg.kg-1 bolus of study solution was administered for 10 min, followed by a maintenance infusion of 0...

Tracheoesophageal (TE) puncture with voice prosthesis placement is a common method for vocal rehabilitation in patients who have undergone total laryngectomy. Tracheoesophageal voice prosthesis (TEP) placement after laryngectomy, known as secondary TE puncture, is traditionally done in the operating room, using rigid esophagoscopy. Traditional secondary TEP placement carries a number of downsides including risks associated with general anesthesia, high cost, and technical challenges associated with anatomical variables...

RATIONALE: Tracheal diverticulum is a rare airway-related particular occurrence, and the forcible tube insertion may cause tracheal ruptures during tracheotomy. Therefore, fiberoptic bronchoscopy (FOB) should be used routinely on all patients undergoing tracheal intubation or tracheotomy. PATIENT CONCERNS: A 60-year-old male with laryngeal neoplasms was scheduled for partial laryngectomy using a suspension laryngoscope in July 2020. All operations were performed under general anesthesia through orotracheal intubation...

BACKGROUND: To investigate the outcomes of using the residual thyroid cartilage for laryngeal function reconstruction in early glottic laryngeal carcinoma. METHODS: From March 2017 to June 2022, 21 patients with glottic carcinoma who underwent laryngeal function reconstruction were analyzed retrospectively. The operation was performed under general anesthesia. Reconstruction of ipsilateral hemilarynx defect by downward movement of ipsilateral residual thyroid cartilage plate...

Historically, surgery was the first-choice therapy for early, intermediate and advanced laryngeal squamous cell carcinoma (LSCC). Partial laryngeal surgery has evolved in recent decades and was influenced by many historic events and the development of new technologies. Partial laryngectomies may be performed by open, endoscopic or transoral robotic approaches. In this historic paper, we describe the evolution of open partial laryngectomy techniques, indications and surgical outcomes. Since the first partial laryngectomy in 1788, many U...

Background: Resection of pharyngeal or laryngeal tumors often results in mucosal defects. Which may lead to excessive suture line tension and pharyngocutaneous fistula. The incidence of pharyngocutaneous fistula formation after total laryngectomy is relatively common. In order to reduce the tension of the suture line, a variety of flaps were introduced to repair the defect. Every flap has some defects. For example, the free skin flap may require microvascular anastomosis technology and relatively increase the operation time...

Laryngectomy is a common surgery for an oncosurgeon, but underlying carotid compromise is a serious concern for anesthesiologists, making this routine procedure a high-risk one. The utmost vigilance of the anesthesiologist is demanded by the surgery to prevent morbidities such as hemiplegia, hemiparesis, or speech abnormalities that may occur due to perfusion insufficiency secondary to the mechanical blockage of the carotid arteries. Hence, an undiagnosed case of carotid artery block may result in disastrous consequences for the patient, surgeon, and anesthesiologist...

Objective: To investigate the clinical features of cases with emergency thyroid surgery. Methods: Nineteen cases treated with emergency thyroid surgery from May 2014 to May 2019 were analysed retrospectively, including 9 males and 10 females, aged from 24-79 years old. Among them, 6 cases had nodular goitres and 13 cases had thyroid malignancies. One case underwent tracheal stenting before operation. Emergency thyroid surgery was due to severe dyspnea in all cases. Treatment outcomes and prognoses of patients were evaluated...

We evaluated the tissue reduction effects using monopolar microelectrodes (MME) coupled to a radiofrequency (RF) generator in arytenoid edema caused by postoperative radiotherapy in larynx. This is a retrospective transversal study, which included 15 patients with supraglottic laryngeal carcinoma. All the patients had undergone a partial horizontal laryngectomy and bilateral neck dissection followed by postoperative radiotherapy. The studied group of patients presented laryngeal stenosis defined by arytenoid edema as a complication, requiring permanent tracheostomy for mean of 12 months...

BACKGROUND: Sugammadex is a synthetic γ-cyclodextrin derivative designed to selectively bind to steroidal neuromuscular blocking agents and reverse their effects. Although many cases of sugammadex-induced anaphylaxis have been reported, few studies have investigated the underlying mechanism. CASE PRESENTATION: A 55-year-old Japanese man underwent a laryngectomy under general anesthesia. One month before laryngectomy, he had undergone laryngoscopy under general anesthesia and received sugammadex administration without causing hypersensitivity...

Purpose: To determine the relationships between postoperative delirium (POD) and postoperative activities of daily living (ADL) and mortality in patients undergoing laryngectomy. We hypothesized that POD would reduce postoperative ADL and increase postoperative mortality. Patients and Methods: The prospective study included older participants (age ≥65 y) undergoing total laryngectomy, partial laryngectomy, total laryngectomy plus neck dissection, or partial laryngectomy plus neck dissection under general anesthesia...

BACKGROUND: The purpose of this study was to examine the effects of an intraoperative MgSO4 infusion on arterial oxygenation and lung mechanics in patients with moderate COPD undergoing cancer larynx surgery under general anesthesia (GA). Our primary outcome was arterial oxygenation determined by the PaO2 and PaO2 /FiO2 . The secondary outcomes were lung mechanics (peak airway pressure, airway plateau pressure, dead space, lung compliance, airway resistance) and postoperative complications...

Background: Whether laryngeal cancer is directly implanted into the lungs during orotracheal intubation is still unclear. Therefore, this study aimed to find whether orotracheal intubation is an independent risk factor for postoperative pulmonary metastasis in patients undergoing laryngectomy. Patients and Methods: Medical records from January 1, 2006, to December 31, 2016, were reviewed. According to similar propensity scores, patients who received orotracheal intubation (tracheal intubation group, n = 515) were matched 1:1 with those who received tracheotomy (tracheotomy group, n = 326) in the induction of general anesthesia...

Dysphagia, one of the major complications of neuromuscular diseases such as Parkinson's disease and amyotrophic lateral sclerosis (ALS), decreases quality of life and may lead to malnutrition or aspiration pneumonia. Although recent reports have suggested that surgical aspiration prevention improves quality of life and enables oral intake, the selection of appropriate aspiration prevention techniques has rarely been discussed. In this report, we present the cases of three patients with neuromuscular diseases who underwent surgical aspiration prevention; we selected the surgical techniques based on analysis of the dysphagia mechanisms, disease progression, and general condition in each case...

INTRODUCTION: Management of tracheostomy and laryngectomy is an important skill for physicians who often care for patients with multiple, comorbid, chronic medical conditions. There is little published literature on training for tracheostomy and laryngectomy care during nonsurgical specialty residencies. This project was designed to assess and improve comfort with, knowledge of, proficiency in tracheostomy and laryngectomy care. METHODS: This prospective observational study comprised 122 physician trainees from internal medicine, emergency medicine, and anesthesia training programs at the University of Arkansas for Medical Sciences participating in a simulation-based curriculum from April 2016 to December 2016...

Adenoid Cystic Carcinoma of larynx is extremely rare location. We herein describe an unusual clinical and radiological presentation of ACCL and review recent literature. We report a case of a 38-year-old woman with history of asthma, presented to our department with acute inspiratory dyspnea that required an emergency tracheotomy. Physical examination revealed a large anterior cervical mass without any lymphadenopathy suspecting thyroid origin. Cervical Computed Scan showed a tumor process between the thyroid lobe, the left edge of the subglottic area and first tracheal rings filling all the lumen, discussing either a laryngo-tracheal or thyroid origin...

BACKGROUND: The application of specific devices to seal the tracheal stoma in laryngectomized patients is critical for optimal pulmonary and phonatory rehabilitation. Indeed, an excessive stomal depth is one of the main causes of rehabilitation failure. In this context, division of the sternal heads of the sternocleidomastoid muscle (SCM) is a common technique, usually performed during the laryngectomy. METHODS: We perform a myotomy of the sternal head of the SCM in deep and narrow tracheal stoma as a secondary procedure under local anesthesia, and here we describe the surgical steps of this procedure...

Objective: To compare the effectiveness of lidocaine administration (intravenous injection, dripping via the tracheostomy tube, and spraying into the tracheostomy incision) on postoperative coughing after partial laryngectomy. Patients and methods: A total of 115 male patients with laryngeal carcinoma scheduled for partial laryngectomy under general anesthesia were randomized into three groups. In group I (n=35), 2% lidocaine hydrochloride (1.5 mg/kg) was slowly infused intravenously. In group II (n=40), 2% lidocaine hydrochloride (1...