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https://www.readbyqxmd.com/read/28328600/management-of-pharyngocutaneous-fistula-with-negative-pressure-wound-therapy
#1
Sérgio Teixeira, Joana Costa, Isabel Bartosch, Bernardo Correia, Álvaro Silva
BACKGROUND: Pharyngocutaneous fistula is a common complication of laryngopharyngeal surgery and is associated with increased morbidity and mortality. Beyond the classical management, negative-pressure wound therapy (NPWT) can be an alternative and effective treatment. CLINICAL REPORT: Two patients with pT3N0M0 squamous cell carcinoma of pyriform sinus were subjected to total laryngectomy and pharyngoesophageal reconstruction of a circular (patient 1) and an anterior wall defect (patient 2) with radial forearm free flap and pectoralis major muscle flap, respectively...
March 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28306586/voice-outcomes-post-total-laryngectomy
#2
Anne Hurren, Nick Miller
PURPOSE OF REVIEW: A consensus and body of robust evidence has developed regarding optimal laryngeal voice outcome measures. This contrasts with a lack of clarity for equivalent assessments in alaryngeal voice. Addressing this situation would enable clinicians to select the best tools currently available to facilitate research, audit and clinical practice. This is important because of the limited knowledge regarding the optimal surgical or reconstruction techniques and rehabilitation regimes for the laryngectomy population...
March 16, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28304095/postoperative-complications-of-total-laryngectomy-in-diabetic-patients
#3
Andrey Filimonov, Jacob S Brady, Aparna Govindan, Aziz Merchant, Jean Anderson Eloy, Soly Baredes, Richard Chan Woo Park
OBJECTIVES/HYPOTHESIS: Analyze postoperative complications of total laryngectomies (TL) in patients with diabetes mellitus and apply these data toward preoperative management of diabetic patients undergoing TL. STUDY DESIGN: Retrospective analysis of surgical outcomes database METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried for TL performed between 2005 and 2013. Comparison of demographics, preoperative comorbidities, and postoperative outcomes in a diabetic versus a nondiabetic cohort was conducted using SPSS software...
March 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28301093/demonstration-of-transoral-robotic-supraglottic-laryngectomy-and-total-laryngectomy-in-cadaveric-specimens-using-the-medrobotics-flex-system
#4
Emily Funk, David Goldenberg, Neerav Goyal
BACKGROUND: Current management of laryngeal malignancies is associated with significant morbidity. Application of minimally invasive transoral techniques may reduce the morbidity associated with traditional procedures. The purpose of this study was to present our investigation of the utility of a novel flexible robotic system for transoral supraglottic laryngectomy and total laryngectomy. METHODS: Transoral total laryngectomy and transoral supraglottic laryngectomy were performed in cadaveric specimens using the Flex Robotic System (Medrobotics, Raynham, MA)...
March 16, 2017: Head & Neck
https://www.readbyqxmd.com/read/28301066/effect-of-daily-fraction-size-on-laryngoesophageal-dysfunction-after-chemoradiation-for-squamous-cell-carcinomas-of-the-larynx-and-hypopharynx
#5
Allen M Chen, Sophia Hsu, Jessica Meshman, Robert Chin, Philip Beron, Elliot Abemayor, Maie St John
BACKGROUND: The purpose of this study was to determine the effect of fraction size on laryngoesophageal dysfunction among patients treated by chemoradiotherapy for laryngeal and hypopharyngeal cancer. METHODS: Forty patients underwent chemoradiotherapy for stage III/IV squamous cell carcinomas of the larynx and hypopharynx. Median radiation dose was 70 Gy (range, 69.3-70.4 Gy) with daily fractionation ranging from 2 Gy to 2.2 Gy. RESULTS: When comparing 2 Gy versus >2 Gy daily fractionation, there was no difference in 2-year overall survival (71% vs 72%; p = ...
March 16, 2017: Head & Neck
https://www.readbyqxmd.com/read/28295658/successful-closure-of-post-tracheostomy-large-chronic-trachea-esophageal-fistula-with-new-over-the-scope-clip
#6
P Rai, R Bhargava
Acquired tracheo-esophageal fistula mostly occurs secondary to malignancy, infection, ruptured diverticula, and injuries.(1) Among the benign conditions, prolonged mechanical ventilation is the most common (47%), followed by injury (17%), prior laryngectomy (17%), and prior esophagostomy (17%).(2) A 19 y male had a road traffic accident and was managed in an intensive care unit with ventilator support and had tracheostomy for 20 days. This article is protected by copyright. All rights reserved.
March 10, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28277334/social-and-quality-of-life-impact-using-a-voice-prosthesis-after-laryngectomy
#7
Lizz Summers
PURPOSE OF REVIEW: This review is intended to give an up-to-date overview of key developments in the evidence base relating specifically to the social and quality of life (QOL) impact of using a voice prosthesis, with reflections on the impact on clinical practice. RECENT FINDINGS: Recent studies have shed light on the role of social support on psychological adjustment after laryngectomy, developing the existing evidence base on psychological sequelae. Investigations into the relationship between voice intensity/intelligibility and voice handicap/QOL may suggest a relationship for some patients, and current tools for measuring these constructs are evaluated...
March 8, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28268924/modeling-of-pharyngoesophageal-segment-during-tracheoesophageal-phonation-in-total-laryngectomy-patients-with-preliminary-validation
#8
Teng Zhang, Siwei Bai, Ian Cook, Michal Szczesniak, Julia Maclean, Socrates Dokos
For patients with large or recurrent laryngeal cancer, total laryngectomy surgery is usually performed. In the absence of a larynx, tracheoesophageal (TE) voice is the gold standard for alaryngeal phonation. The mechanisms underlying TE voice are unknown, but pharyngoesophageal (PE) segment vibration has been shown to play a key role. The aim of this study was to systematically explore the mechanics of PE segment vibration during TE phonation. A 2D axisymmetric finite-element model with two domains representing the air and PE wall was developed...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28266295/simultaneous-total-esophagectomy-and-anterior-mediastinal-tracheostomy-for-recurrent-laryngeal-cancer-extended-to-the-superior-mediastinum
#9
Marius Fodor, Marcel Cosgarea, Lucian Fodor
Recurrent laryngeal cancer has an incidence of 25-50% and a 23-35% fiveyear survival rate. Surgery is the best treatment in order to control local recurrence. Herein, we present our surgical strategy for a patient with a history of modified radical laryngectomy for laryngeal cancer and with recurrent tumor at the cervical tracheostomy site extended to the thoracic trachea and esophagus. The wide resection included the sternal manubrium, the upper thoracic trachea, the entire esophagus and the upper mediastinal lymph nodes...
January 2017: Chirurgia
https://www.readbyqxmd.com/read/28259450/modality-specific-target-definition-for-laryngeal-and-hypopharyngeal-cancer-on-fdg-pet-ct-and-mri
#10
Hans Ligtenberg, Elise Anne Jager, Joana Caldas-Magalhaes, Tim Schakel, Frank A Pameijer, Nicolien Kasperts, Stefan M Willems, Chris H J Terhaard, Cornelis P J Raaijmakers, Marielle E P Philippens
BACKGROUND AND PURPOSE: The goal of this study was to improve target definition by deriving modality-specific margins for clinical target volumes (CTV) for laryngeal and hypopharyngeal cancer on CT, MRI and 18-FDG-PET. MATERIAL AND METHODS: Twenty-five patients with T3/T4 laryngeal/hypopharyngeal cancer underwent CT, MRI and 18-FDG-PET scans before laryngectomy. HE-sections were obtained from the surgical specimen and tumor was delineated (tumorHE). The GTVs on CT and MRI were delineated in consensus...
March 1, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28252821/transoral-laser-microsurgery-or-total-laryngectomy-for-recurrent-squamous-cell-carcinoma-of-the-larynx-retrospective-analysis-of-199-cases
#11
Bernhard G Weiss, Mattis Bertlich, Martin Canis, Friedrich Ihler
BACKGROUND: Surgical treatment options for local recurrences of laryngeal cancer can be either organ-preserving surgery or total laryngectomy. The purpose of this study was to present our evaluation of the treatment with transoral laser microsurgery (TLM) in comparison to laryngectomy. METHODS: We conducted a retrospective review of 199 consecutive patients with recurrent laryngeal cancer at 1 tertiary referral center. RESULTS: The 5-year overall survival, disease-specific survival, and local control rates were 64...
March 2, 2017: Head & Neck
https://www.readbyqxmd.com/read/28236331/positron-emission-tomography-ct-prediction-of-occult-nodal-metastasis-in-recurrent-laryngeal-cancer
#12
Andrew Rosko, Andrew Birkeland, Andrew Shuman, Mark Prince, Carol Bradford, Gregory Wolf, Francis Worden, Avraham Eisbruch, Ashok Srinivasan, Ka Kit Wong, Matthew E Spector
BACKGROUND: The purpose of this study was to evaluate the predictive value of positron emission tomography (PET)-CT in identifying occult nodal metastasis in clinically and radiographically N0 patients with recurrent laryngeal cancer undergoing salvage laryngectomy. METHODS: Retrospective review of 46 clinically and radiographically N0 patients with recurrent laryngeal cancer who underwent a PET-CT examination before salvage laryngectomy with neck dissection from January 1, 2002, to December 31, 2014, was performed...
February 25, 2017: Head & Neck
https://www.readbyqxmd.com/read/28230917/total-laryngectomy-with-primary-tracheoesophageal-puncture-intraoperative-versus-delayed-voice-prosthesis-placement
#13
Rachelle A Robinson, Virginia A Simms, Elizabeth C Ward, Molly K Barnhart, Sophie J Chandler, Robert I Smee
BACKGROUND: Studies support using intraoperative voice prosthesis insertion performed at the time of primary tracheoesophageal puncture (TEP) during laryngectomy. However, none have compared intraoperative voice prosthesis insertion with delayed voice prosthesis insertion. The purpose of this study was to prospectively examine patient, services, and cost benefits of intraoperative versus delayed voice prosthesis placement. METHODS: Voice prosthesis use, duration to the first voice prosthesis change, early communication, and costs were compared between 14 patients who underwent a laryngectomy and who received intraoperative voice prosthesis placement, and 10 patients who underwent initial catheter stenting and then delayed voice prosthesis insertion...
February 23, 2017: Head & Neck
https://www.readbyqxmd.com/read/28227129/modeling-of-pharyngoesophageal-segment-during-tracheoesophageal-phonation-in-total-laryngectomy-patients-with-preliminary-validation
#14
Teng Zhang, Siwei Bai, Ian Cook, Michal Szczesniak, Julia Maclean, Socrates Dokos, Teng Zhang, Siwei Bai, Ian Cook, Michal Szczesniak, Julia Maclean, Socrates Dokos, Siwei Bai, Michal Szczesniak, Socrates Dokos, Ian Cook, Julia Maclean, Teng Zhang
For patients with large or recurrent laryngeal cancer, total laryngectomy surgery is usually performed. In the absence of a larynx, tracheoesophageal (TE) voice is the gold standard for alaryngeal phonation. The mechanisms underlying TE voice are unknown, but pharyngoesophageal (PE) segment vibration has been shown to play a key role. The aim of this study was to systematically explore the mechanics of PE segment vibration during TE phonation. A 2D axisymmetric finite-element model with two domains representing the air and PE wall was developed...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28224630/the-current-status-of-human-laryngeal-transplantation-in-2017-a-state-of-the-field-review
#15
REVIEW
Giri Krishnan, Charles Du, Jonathan M Fishman, Andrew Foreman, David G Lott, Gregory Farwell, Peter Belafsky, Suren Krishnan, Martin A Birchall
OBJECTIVES: Human laryngeal allotransplantation has long been contemplated as a surgical option following laryngectomy, but there is a paucity of information regarding the indications, surgical procedure, and patient outcomes. Our objectives were to identify all human laryngeal allotransplants that have been undertaken and reported in the English literature and to evaluate the success of the procedure. DATA SOURCES: MEDLINE, Embase, Current Index to Nursing and Allied Health Literature, Web of Science and Scopus, and the Gray literature...
February 22, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28207586/open-partial-laryngectomy-after-failure-of-chemo-radiation-indications-oncologic-and-functional-outcomes
#16
Geoffrey Mortuaire, Dominique Chevalier, François Mouawad
PURPOSE OF REVIEW: Early-stage squamous cell carcinoma of the larynx can be successfully treated with radiotherapy or surgery (transoral or open approaches). Oncologic results are comparable while functional results may be different according to the volume of resection. In some countries radiotherapy is often preferred as primary treatment. In case of recurrence, surgical salvage is the only option. Careful examination, endoscopic assessment, computed tomography or magnetic resonance imaging are necessary to assess superficial and deep extensions into the larynx, including cartilage framework and to restage the tumor...
April 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28203135/successful-treatment-of-hepatocellular-carcinoma-complicated-by-fanconi-anemia
#17
Koji Takahashi, Eiichiro Suzuki, Masayuki Yokoyama, Masanori Inoue, Toru Wakamatsu, Tomoko Saito, Yuko Kusakabe, Sadahisa Ogasawara, Yoshihiko Ooka, Akinobu Tawada, Yuhei Nagao, Chiaki Nakaseko, Tetsuhiro Chiba
A 42-year-old woman with liver tumors was referred to our hospital. Her condition was complicated by Fanconi anemia, and she had undergone total laryngectomy 8 years ago. On admission, contrast-enhanced computed tomography revealed hypervascular tumors in the right hepatic lobe. Ultrasound-guided tumor biopsy revealed that the tumor comprised moderately differentiated hepatocellular carcinoma. Although the patient exhibited preserved liver function (Child-Pugh A), complete blood count revealed severe pancytopenia...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28196713/acellular-dermal-graft-pharyngeal-repair-augmentation-after-laryngectomy
#18
Patrik Pipkorn, Parul Sinha, Joseph Zenga, Evan Graboyes, Bruce H Haughey
PURPOSE: Pharyngocutaneous fistula (PCF) after laryngectomy continues to be a serious complication, especially after radiation. Recruitment of non-radiated tissue into the surgical defect may decrease the risk of fistula. These techniques however have significant morbidity and increases operative time. We hypothesized that using acellular dermal graft to reinforce the pharyngeal closure could decrease the risk of fistula, without the added morbidity of a vascularized flap. METHODS: We performed a retrospective chart review of all patients that underwent a laryngectomy between 2005 and 2015 at an acedemic tertiary referral center...
February 2, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28182267/effect-of-postoperative-radiotherapy-on-survival-for-surgically-managed-pt3n0-and-pt4an0-laryngeal-cancer-analysis-of-the-national-cancer-data-base
#19
Evan M Graboyes, Kevin Y Zhan, Elizabeth Garrett-Mayer, Eric J Lentsch, Anand K Sharma, Terry A Day
BACKGROUND: The current study was conducted to determine the effect of postoperative radiotherapy (PORT) on overall survival in patients with surgically managed pT3-T4aN0 laryngeal squamous cell carcinoma (SCC). METHODS: A review of the National Cancer Data Base from 2004 through 2013 was performed. Patients with surgically managed pT3-4aN0 laryngeal SCC with negative surgical margins were included. Univariable and multivariable Cox regression analyses were used to determine factors associated with survival...
February 9, 2017: Cancer
https://www.readbyqxmd.com/read/28177327/functional-outcomes-of-supraglottic-squamous-cell-carcinoma-treated-by-transoral-laser-microsurgery-compared-with-horizontal-supraglottic-laryngectomy-in-patients-younger-and-older-than-65-years
#20
C M Chiesa Estomba, F A Betances Reinoso, A I Lorenzo Lorenzo, J L Fariña Conde, J Araujo Nores, C Santidrian Hidalgo
The treatment of supraglottic carcinoma remains a controversial issue. Five accepted surgical and non-surgical oncological treatments have been currently established: standard horizontal supraglottic laryngectomy (HSL), supraglottic CO2 laser microsurgery (TLM), transoral robotic surgery, radiotherapy alone and radiotherapy in combination with chemotherapy. Some studies have shown that complications of head and neck surgeries increase significantly in patients over 65 years compared to younger patients. We designed a retrospective analysis to assess the rate of complications and functional outcomes of patients treated by TLM and HSL in cases of T1-T3 supraglottic squamous cell carcinomas (SCC) in a tertiary University Hospital...
December 2016: Acta Otorhinolaryngologica Italica
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