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Anesthesia for laryngectomy

Sophie A C Kraaijenga, Oren Lapid, Lisette van der Molen, Frans J M Hilgers, Ludwig E Smeele, Michiel W M van den Brekel
OBJECTIVES/HYPOTHESIS: Head and neck cancer (HNC) patients may develop oropharyngeal dysfunction as result of volume loss or muscle atrophy of the tongue or pharyngeal musculature following treatment with surgery and/or chemoradiotherapy. If intensive swallowing therapy offers no further improvement, and the functional problems persist, transplantation of autologous adipose tissue (lipofilling) might restore functional outcomes by compensating the existing tissue defects or tissue loss...
April 14, 2016: Laryngoscope
Kui-Rong Wang, Yuan-Jing Jia, Shui-Hong Zhou, Qin-Ying Wang, Yang-Yang Bao, Zhi-Ying Feng, Hong-Tian Yao, Jun Fan
The incidence of cutaneous and subcutaneous metastases from atypical laryngeal carcinoids is approximately 20%. However, the pathogenesis and natural history of, and prognostic factors for, the condition remain poorly understood. We reported a 54-year-old female presented with cutaneous and subcutaneous metastases from atypical laryngeal carcinoid. Laryngoscopy revealed a 0.5 × 1.5-cm reddish mass on the laryngeal surface of the epiglottis. Under general anesthesia, a biopsy sample was obtained via suspension laryngoscopy...
February 2016: Medicine (Baltimore)
Ehsan Khadivi, Maryam Daghighi, Kamran Khazaeni, Vahid Reza Dabbagh Kakhki, Leili Zarifmahmoudi, Ramin Sadeghi
INTRODUCTION: Sentinel node mapping has been used for laryngeal carcinoma in several studies, with excellent results thus far. In the current study, we report our preliminary results on sentinel node mapping in laryngeal carcinoma using intra-operative peri-tumoral injection of a radiotracer. MATERIALS AND METHODS: Patients with biopsy-proven squamous cell carcinoma of the larynx were included in the study. Two mCi/0.4 cc Tc-99m-phytate in four aliquots was injected on the day of surgery, after induction of anesthesia, in the sub-mucosal peri-tumoral location using a suspension laryngoscopy...
July 2015: Iranian Journal of Otorhinolaryngology
Bin Han, Yajie Liu, Xiaoqing Zhang, Jun Wang
BACKGROUND: Difficult airway may result in significant morbidity and mortality. Proficient airway evaluation, therefore, is one of the key elements in the safe conduct of anesthesia. A three-dimensional (3D) printing model was recently introduced for medical application. 3D printing is a fast, convenient, and relatively affordable technique. We present a case in which a 3D-printed airway model was successfully used for airway evaluation. CASE PRESENTATION: A 77-year-old man who had previously undergone total laryngectomy was scheduled for resection of a pelvic mass...
January 19, 2016: BMC Anesthesiology
Remco de Bree, Lisa van der Putten, Harm van Tinteren, Jan Wedman, Wim J G Oyen, Luuk M Janssen, Michiel W M van den Brekel, Emile F I Comans, Jan Pruim, Robert P Takes, Monique G G Hobbelink, Renato Valdés Olmos, Bernard F A M van der Laan, Maarten Boers, Otto S Hoekstra, C René Leemans
PURPOSE: The purpose of this study is to evaluate the efficacy of (18)F-FDG-PET as first-line diagnostic investigation, prior to performing a direct laryngoscopy with biopsy under general anesthesia, in patients suspected of recurrent laryngeal carcinoma after radiotherapy. PATIENTS AND METHODS: 150 patients suspected of recurrent T2-4 laryngeal carcinoma at least two months after prior (chemo)radiotherapy with curative intent for resectable disease were randomized to direct laryngoscopy (CWU: conventional workup strategy) or to (18)F-FDG-PET only followed by direct laryngoscopy if PET was assessed 'positive' or 'equivocal' (PWU: PET based workup strategy), to compare the effectiveness of these strategies...
February 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Behzad S Farivar, Dong H Lee, Ahmed Khalil, Sunil Abrol, Lucio Flores
Carotid blowout is a rare fatal complication most commonly observed in head and neck cancer patients, especially after radiation therapy. Traditional surgical approaches carry extremely high morbidity and mortality rates. We present a case of acute hemorrhage from extracranial carotid artery in a 64-year-old man with history of total laryngectomy, tracheostomy, and chemoradiotherapy for laryngeal cancer. Tumor was noted to be encasing and eroding into the internal and common carotid artery with a large soft tissue neck defect...
November 2014: Annals of Vascular Surgery
Yu Miyazaki, Nobuyasu Komasawa, Haruka Omoto, Shinichiro Miyazaki, Haruki Kido, Toshiaki Minami
We report the successful awake tracheal intubation in a patient with hypopharyngeal cancer and gastroesophageal regurgitation with the TaperGuard Evac tracheal tube (TaperGuard) and Pentax-AWS Airwayscope (AWS). A 63-year-old man with hypopharyngeal cancer with invasion to the glottis was scheduled for total laryngectomy under general anesthesia. He had undergone thoracic esophagectomy and could not maintain supine position due to severe gastroesophageal regurgitation. To avoid vomiting after induction of anesthesia, we planned awake intubation in the sitting position with the AWS...
June 2014: Masui. the Japanese Journal of Anesthesiology
Jennifer L Bergeron, Nausheen Jamal, Andrew Erman, Dinesh K Chhetri
PURPOSE: Tracheoesophageal puncture (TEP) is an effective rehabilitation method for postlaryngectomy speech and has already been described as a procedure that is safely performed in the office. We review our long-term experience with office-based TEP over the past 7 years in the largest cohort published to date. MATERIALS AND METHODS: A retrospective chart review was performed of all patients who underwent TEP by a single surgeon from 2005 through 2012, including office-based and operating room procedures...
September 2014: American Journal of Otolaryngology
Manabu Kitano, Nobuyasu Komasawa, Junko Nakahira, Shunsuke Fujiwara, Shinichi Tatsumi, Toshiaki Minami
We report our experience of successful nasotracheal intubation with a spiral tube, by using the Pentax-AWS Airwayscope (AWS) with a gum-elastic bougie (GEB) in a patient with invasive recurrent tongue cancer. The patient was a 55-year-old man who had undergone partial resection of the tongue and cervical lymphadenectomy, and was scheduled for extended resection of the tongue and larynx under general anesthesia. Sufficient mask ventilation with the head-tilt and chin-lift maneuver was achieved. We first inserted AWS gently and visualized the glottis...
April 2014: Masui. the Japanese Journal of Anesthesiology
Edward J Damrose, Do-Yeon Cho, Richard L Goode
OBJECTIVES: This report aimed to describe a novel and efficient method of tracheoesophageal puncture using a hybrid device assembled from 2 commercially available puncture kits; to demonstrate the utility of this technique in the performance of primary and secondary procedures, under general and local anesthesia, with and without flap reconstruction; and to evaluate the efficacy of concurrent puncture and valve placement. METHODS: Thirty-four patients who underwent either primary or secondary tracheoesophageal puncture for voice restoration...
August 2014: Annals of Otology, Rhinology, and Laryngology
Christopher J Britt, Dylan Lippert, Rachael Kammer, Charles N Ford, Seth H Dailey, Timothy McCulloch, Gregory Hartig
OBJECTIVE: Evaluate the safety and efficacy of in-office secondary tracheoesophageal puncture (TEP) technique using transnasal esophagoscopy (TNE) and the Seldinger technique in conjunction with a cricothyroidotomy kit for placement. STUDY DESIGN: Case series with chart review. SETTING: Academic medical center. SUBJECT AND METHODS: A retrospective chart review was performed on 83 subjects who underwent in-office secondary TEP...
May 2014: Otolaryngology—Head and Neck Surgery
Kiyoaki Tsukahara, Kazuhiro Nakamura, Ray Motohashi, Minoru Endo, Hiroki Sato, Mamoru Suzuki
CONCLUSION: A procedure with no exploratory puncture using an endotracheal tube, sharp-tipped trocar, flexible fiberscope, and flexible guidewire is useful for inserting the Provox(®)2 prosthesis. OBJECTIVES: The purpose of the present study was to examine the necessity of exploratory puncture in consideration of operating time, complications, and voice rehabilitation. METHODS: Insertion of the Provox(®)2 was conducted using an endotracheal tube, sharp-tipped trocar, flexible fiberscope, and flexible guidewire under general anesthesia...
December 2013: Acta Oto-laryngologica
Rajko M Jović
The strategy of organ preservation by applying chemoradiotherapy in the treatment of laryngeal carcinoma, which has been extensively used since 1990s, is now being reviewed regarding its further justification. Despite good results in other localization of head and neck cancer, it has not met the expectations in case of laryngeal cancer. One explanation is the lower participation of human papillomavirus type 16 in the etiology of laryngeal cancer. A lot of developing countries base their concept on primary surgery with subsequent radiotherapy, because the cost of operations for cancer of the larynx is much lower than in developed countries...
September 2013: Medicinski Pregled
Rong Hu, Wen Xu, Honggang Liu, Xuejun Chen
OBJECTIVES: To describe an atypical case of laryngeal chondrosarcoma of arytenoid cartilage presenting as bilateral vocal fold immobility and to avoid potential missed diagnosis. METHODS: Our case study included a detail history, physical and radiological examination, laryngeal electromyography (LEMG), and surgical treatment and pathology analysis. We compared it with the previously discussed cases of chondrosarcoma of arytenoid cartilage in the literature. RESULTS: Chondrosarcomas of the arytenoid cartilage is rare, and to date only approximately 10 cases have been reported...
January 2014: Journal of Voice: Official Journal of the Voice Foundation
Steven M Sperry, Christopher H Rassekh, Ollivier Laccourreye, Gregory S Weinstein
IMPORTANCE: Supracricoid partial laryngectomy (SCPL) is an essential technique in the armamentarium of modern laryngeal organ preservation surgery. OBJECTIVE, DESIGN, SETTING: Retrospective case series to review the oncologic outcomes following SCPL in a large US-based cohort treated by a single surgeon in a tertiary-care university hospital. PARTICIPANTS: A total of 96 consecutive patients with primary or recurrent squamous cell carcinoma of the larynx undergoing SCPL from 1992 to 2010...
November 2013: JAMA Otolaryngology—Head & Neck Surgery
Aaron Centric, Amanda Hu, Yolanda D Heman-Ackah, Venu Divi, Robert T Sataloff
OBJECTIVES: The 585-nm pulsed-dye laser (PDL) is used for in-office treatment of recurrent respiratory papillomatosis (RRP), premalignant/early malignant lesions, vascular lesions, and proliferative lesions of the larynx. Reported advantages of this technique include avoidance of general anesthesia, improved efficiency, lower overall cost, and treatment of the anterior commissure with minimal web formation. Our objective was to review our experience with office-based PDL procedures for laryngeal lesions...
March 2014: Journal of Voice: Official Journal of the Voice Foundation
David P Lau, Chin Boon Chng, Chee Kong Chui
BACKGROUND: A new device is described for secondary tracheoesophageal puncture (TEP). We hypothesize that the device can be used to create the puncture, size, and insert the voice prosthesis in antegrade fashion in a single procedure suitable for office-based use. METHODS: A measurement and insertion device (MAID) was designed with the hypothesis in mind and tested on 3 pigs while they were under general anesthesia. RESULTS: The procedure was easy and successful in all 3 animals...
June 2014: Head & Neck
Takahiro Fukuhara, Kazunori Fujiwara, Kenichi Nomura, Naritomo Miyake, Hiroya Kitano
OBJECTIVES: We clarify and demonstrate the utility of our new method of voice prosthesis insertion using puncture from the esophageal lumen. METHODS: Our new reverse puncture method using a flexible endoscope can be performed in an outpatient clinic under local anesthesia. We conducted a clinical trial with patients with head and neck cancer between April 2010 and February 2012. Our study focused on the following three points: 1) the percentage of patients for whom the procedure was successful; 2) the duration of the operation; and 3) any adverse effects...
March 2013: Annals of Otology, Rhinology, and Laryngology
Meijin Nakayama, Akiko Watanabe, Takashi Matsuki, Etsuyo Tamura, Yutomo Seino, Sanae Okabe, Tabito Okamoto, Shunsuke Miyamoto, Makito Okamoto
OBJECTIVE: Supracricoid laryngectomy with Cricohyoidoepiglottopexy (SCL-CHEP) is a functional organ preservation surgery for laryngeal cancers. Post-operative laryngeal function is generally promising. Some patients, however, cannot attain satisfactory functional results because of an excessively wide neoglottis resulting in an insufficient neoglottal closure. Autologous buccal fat augmentation was conducted to correct the insufficiency. PATIENTS AND METHODS: Two patients underwent intervention...
October 2013: Auris, Nasus, Larynx
Itzhak Brook
Receiving sedation while undergoing a diagnostic procedure or general anesthesia for surgery is challenging for neck breathers including laryngectomees. Unfortunately, most medical personnel including nurses, medical technicians, surgeons, and anesthesiologists caring for laryngectomees before, during, and after surgery are not familiar with their unique anatomy, how they speak, and how to manage their airways during and after the operation. Methods to improve the care are discussed. Educating medical personnel about these issues can improve the care of neck breathers...
June 2012: Anesthesia and Analgesia
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