Laryngectomy-still state of the art?
[Laryngectomy-still state of the art?] HNO. 2019 Nov 12;: Authors: Vahl JM, Schuler PJ, Greve J, Laban S, Knopf A, Hoffmann TK Abstract Total laryngectomy provides a curative approach for patients with advanced laryngeal and hypopharyngeal cancer without distant metastasis. Especially in stage cT4a disease, laryngectomy is superior to primary radio(chemo)therapy in retrospective studies. Further relevant indications for the procedure are tumor-related laryngeal dysfunction such as dysphagia and aspiration, as well as cancer recurrence after primary radio(chemo)therapy. The surgical procedure is highly standardized, with an appropriate safety profile. The subsequent loss of voice must be compensated by voice rehabilitation (voice prosthesis, ructus). The current overview provides information about indications for laryngectomy, preoperative clinical diagnostics, the surgical procedure, complications, alternative treatment, rehabilitation, and prognosis. Total laryngectomy remains a standard procedure in modern head and neck oncology. PMID: 31720696 [PubMed - as supplied by publisher]
In this study 32 patients treated by laryngectomy with partial pharyngectomy and adjuvant radiotherapy underwent fibreoptic endoscopic evaluation of swallowing at 6 and 12 weeks after completion of treatment. Majority of them had delayed transit of bolus, dryness and edema and 6 of them had pharyngeal stenosis, 2 had fibrotic band and 2 had adynamic pharyngeal segments. These findings were the cause of dysphagia. The frequency of occurrence of the above findings and their association with extent of resection of pharyngeal mucosa and adjuvant treatment have been documented. Bilateral neck dissection, post operative ch...
Conclusions In the span of a very short time—less than a decade—robotic head and neck surgery has transformed the management of the head and neck cancer, and it seems clear that the future of treatment for these cancers lies in a multimodal approach in which TORS is likely to play an important role. Nevertheless, it is important to keep in mind that the current indications for TORS are limited and long-term data on the safety and oncological outcomes are needed to better understand the true role of TORS in treatment of head and neck cancer. Nonetheless, the emergence of ever more advanced robotic instruments i...
AbstractHypopharynx cancer has the worst prognosis of all head and neck squamous cell cancers. Since the 1990s, a treatment shift has appeared from a total laryngectomy towards organ preservation therapies. Large randomized trials evaluating treatment strategies for hypopharynx cancer, however, remain scarce, and frequently this malignancy is evaluated together with larynx cancer. Therefore, our aim was to determine trends in incidence, treatment and survival of hypopharynx cancer. We performed a population-based cohort study including all patients diagnosed with T1 –T4 hypopharynx cancer between 1991 and 2010 in the...
ConclusionsLaryngeal and hypopharyngeal cancer incidence rates vary by sex, age, neighborhood income, community size, and health region. Resection rates vary by age, sex, and health region. These disparities warrant further evaluation to improve the quality of delivered care in Ontario.
We examined patients with advanced laryngeal and hypophary ngeal tumors from our overall trial of patients with locoregionally advanced head and neck cancer.
Conclusion Primary TL/TPL remains the gold standard treatment for T4 larynx or hypopharynx cancer. It provides satisfactory oncologic and functional outcomes.
This cohort study uses data from a trial comparing cetuximab and radiotherapy vs radiotherapy alone for patients with oropharyngeal cancer to investigate the rate of laryngeal preservation and laryngectomy-free survival in the subgroup of patients with locoregionally advanced SCC of the larynx or hypopharynx.
Abstract There are controversial data on oncological and surgical outcome after major head and neck cancer surgery in the elderly. The aim of this study was to evaluate the outcome of elderly cancer patients after total laryngectomy in combination with neck dissection. A total of 58 patients separated into two age groups (28
ConclusionThere is a syndrome of late neurological effects after RT, salvage surgery, and pharyngeal instrumentation that is associated with high morbidity and mortality. © 2015 Wiley Periodicals, Inc. Head Neck, 2015
Conclusions. Intratumoral lymphatic vessel density is predictive of PFS and OS in locally advanced laryngeal/hypopharyngeal cancer. This article is protected by copyright. All rights reserved.