Percutaneous laryngeal elevation technique to achieve excellent hypopharyngeal exposure in transoral surgery

IF 1.6 4区 医学 Q2 OTORHINOLARYNGOLOGY Auris Nasus Larynx Pub Date : 2024-10-30 DOI:10.1016/j.anl.2024.10.014
Satoshi Koyama, Toru Kimura, Ryohei Donishi, Kenkichiro Taira, Takahiro Fukuhara, Kazunori Fujiwara
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Abstract

Endoscopic laryngopharyngeal surgery (ELPS) is a transoral surgery performed for the treatment of early-stage pharyngeal and supralaryngeal cancer. In Japan, ELPS is often chosen for transoral resection of hypopharyngeal cancer. However, in cases of trismus, exposing the hypopharynx even with ELPS using a curved laryngoscope may not be possible. Thus, we developed the percutaneous laryngeal elevation technique (PLET). The PLET is easy to perform because it only requires the addition of a percutaneous suture on the larynx and lifting the larynx ventrally. The PLET could dramatically improve hypopharynx exposure and allow us to perform ELPS on a patient with hypopharyngeal cancer experiencing severe trismus. A 64-year-old man was referred to our hospital for the treatment of hypopharyngeal cancer (cTisN0M0). He had severe trismus because of past surgery and radiotherapy for buccal mucosa cancer. Mouth-opening surgery was performed initially, followed by ELPS. However, the hypopharynx was insufficiently exposed, and the entire tumor could not be visualized. The PLET was performed, which dramatically improved the exposure and allowed us to resect the tumor with sufficient surgical margin. In this case, no intra- and postoperative PLET-related complications were observed. Thus, the PLET is an easy and safe technique for improving hypopharyngeal exposure.
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在经口手术中实现良好咽下暴露的经皮喉抬高技术。
内窥镜喉咽手术(ELPS)是一种经口手术,用于治疗早期咽癌和上喉癌。在日本,ELPS 通常用于下咽癌的经口切除术。然而,在三咽部畸形的情况下,即使使用弧形喉镜进行 ELPS,也可能无法暴露下咽部。因此,我们开发了经皮喉提升技术(PLET)。PLET 操作简便,只需在喉部加一条经皮缝合线,然后向腹侧提升喉部即可。PLET可显著改善下咽暴露,使我们能够为一名出现严重三凹的下咽癌患者实施ELPS。一名 64 岁的男性因下咽癌(cTisN0M0)转诊至我院接受治疗。由于曾接受过颊面黏膜癌手术和放疗,他出现了严重的口角歪斜。首先进行了张口手术,然后是 ELPS。然而,下咽部暴露不足,无法看到整个肿瘤。我们进行了PLET手术,大大改善了暴露情况,使我们能够以足够的手术切缘切除肿瘤。在该病例中,术中和术后均未观察到与 PLET 相关的并发症。因此,PLET 是一种简单安全的改善下咽暴露的技术。
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来源期刊
Auris Nasus Larynx
Auris Nasus Larynx 医学-耳鼻喉科学
CiteScore
3.40
自引率
5.90%
发文量
169
审稿时长
30 days
期刊介绍: The international journal Auris Nasus Larynx provides the opportunity for rapid, carefully reviewed publications concerning the fundamental and clinical aspects of otorhinolaryngology and related fields. This includes otology, neurotology, bronchoesophagology, laryngology, rhinology, allergology, head and neck medicine and oncologic surgery, maxillofacial and plastic surgery, audiology, speech science. Original papers, short communications and original case reports can be submitted. Reviews on recent developments are invited regularly and Letters to the Editor commenting on papers or any aspect of Auris Nasus Larynx are welcomed. Founded in 1973 and previously published by the Society for Promotion of International Otorhinolaryngology, the journal is now the official English-language journal of the Oto-Rhino-Laryngological Society of Japan, Inc. The aim of its new international Editorial Board is to make Auris Nasus Larynx an international forum for high quality research and clinical sciences.
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