Chemoradiotherapy is the standard treatment of choice is chemoradiotherapy for locally advanced laryngeal cancer in cases in which the organ function needs to be conserved. Surgical treatment with larynx preservation is only conducted in a limited number of cases. There seems to be no standard organ-preserving surgery for locally advanced laryngeal cancers in cases involving conditions such as vocal cord fixation and/or cricoid cartilage destruction. We devised a novel operation that preserves the swallowing function and the airway. The operation is performed in two stages. In the first stage, the tumor is resected with the aim of preserving the swallowing function. In the second stage, the airway is reconstructed. This operation was performed for patients with T4a disease and vocal cord paralysis who expressed a strong desire for their laryngeal function to be preserved.
{"title":"A Laryngeal Function Preserving Operation for T4a Laryngeal Cancer in Patients with Vocal Cord Paralysis","authors":"Y. Asada","doi":"10.5426/larynx.29.62","DOIUrl":"https://doi.org/10.5426/larynx.29.62","url":null,"abstract":"Chemoradiotherapy is the standard treatment of choice is chemoradiotherapy for locally advanced laryngeal cancer in cases in which the organ function needs to be conserved. Surgical treatment with larynx preservation is only conducted in a limited number of cases. There seems to be no standard organ-preserving surgery for locally advanced laryngeal cancers in cases involving conditions such as vocal cord fixation and/or cricoid cartilage destruction. We devised a novel operation that preserves the swallowing function and the airway. The operation is performed in two stages. In the first stage, the tumor is resected with the aim of preserving the swallowing function. In the second stage, the airway is reconstructed. This operation was performed for patients with T4a disease and vocal cord paralysis who expressed a strong desire for their laryngeal function to be preserved.","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114998321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background : With regard to the vascular anatomy, it is well known that a non-recurrent inferior laryngeal nerve(NRILN)is always associated with the aberrant subclavian artery(ASCA). As we previously reported in 2001, preoperative CT scans of the neck allowed us to recognize the ASCA and predict an NRILN. In 2016, we also reported in 2016 that approaching the vagal nerve first before dissecting the paratracheal region is essential for the preservation of the NRILN. As we have practiced these methods, we would like to review our clinical results in NRILN cases retrospectively and to verify the efficacy of this approach in avoiding vocal cord paralysis. Materials and Results: Between May 1995 and June 2016, 2739 patients underwent thyroid or esophageal cancer surgery, in which the right inferior laryngeal nerve was confirmed visually during the surgery. Furthermore, 16 of these patients were diagnosed as having an NRILN. For them, the vagal nerve was approached first in order to preserve the NRILN. Postoperative laryngeal fiberscopy revealed no temporary, incomplete or complete vocal cord paralysis in any of the cases involving patients with the NRILN. Conclusions: The preoperative diagnosis of ASCA, the prediction of an NRILN, and the procedure of approaching the vagal nerve first, were effective for avoiding vocal cord paralysis in the patients with an NRILN. Vocal cord paralysis is an important factor that is associated with the deterioration of a patient’s QOL.
{"title":"The Preoperative Diagnosis of an NRILN could Reduce the Risk of Vocal Cord Paralysis after the Surgery","authors":"Y. Kimura, A. Watanabe, M. Taniguchi","doi":"10.5426/larynx.29.94","DOIUrl":"https://doi.org/10.5426/larynx.29.94","url":null,"abstract":"Background : With regard to the vascular anatomy, it is well known that a non-recurrent inferior laryngeal nerve(NRILN)is always associated with the aberrant subclavian artery(ASCA). As we previously reported in 2001, preoperative CT scans of the neck allowed us to recognize the ASCA and predict an NRILN. In 2016, we also reported in 2016 that approaching the vagal nerve first before dissecting the paratracheal region is essential for the preservation of the NRILN. As we have practiced these methods, we would like to review our clinical results in NRILN cases retrospectively and to verify the efficacy of this approach in avoiding vocal cord paralysis. Materials and Results: Between May 1995 and June 2016, 2739 patients underwent thyroid or esophageal cancer surgery, in which the right inferior laryngeal nerve was confirmed visually during the surgery. Furthermore, 16 of these patients were diagnosed as having an NRILN. For them, the vagal nerve was approached first in order to preserve the NRILN. Postoperative laryngeal fiberscopy revealed no temporary, incomplete or complete vocal cord paralysis in any of the cases involving patients with the NRILN. Conclusions: The preoperative diagnosis of ASCA, the prediction of an NRILN, and the procedure of approaching the vagal nerve first, were effective for avoiding vocal cord paralysis in the patients with an NRILN. Vocal cord paralysis is an important factor that is associated with the deterioration of a patient’s QOL.","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122726233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Examination of dysphagia at home by otolaryngologists","authors":"Kengo Kato, Y. Katori","doi":"10.5426/LARYNX.29.45","DOIUrl":"https://doi.org/10.5426/LARYNX.29.45","url":null,"abstract":"","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"11 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132605758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Higashino, Shuji Oomura, N. Suzuki, S. Nishikawa, R. Kawata
Purpose : We investigated the clinical features according to the subsites of supraglottic carcinoma. Patients and Methods : We investigated 123 cases of supraglottic carcinoma treated that were at Osaka Medical College from 1999 to 2015. The cases involved five subsites: the arytenoid, false vocal cord, infrahyoid epiglottis, epiglottis, and the aryepiglottic fold. We investigated the associations between the subsites and characteristics of the patients, including age, primary symptoms, tumor stage and disease-specific survival. Results : The subsites of the patients were as follows: the arytenoid, n=42; false vocal cord, n=34; infrahyoid epiglottis, n=20; epiglottis, n=16; and the aryepiglottic fold, n=11. The primary symptoms of the whole study population were as follows, hoarseness, n=56 (46 %); sore throat, n=40 (33%); cervical tumor, n=27 (22%); foreign body sensation, n=26 (21%). There were differences according to the subsites. The prevalence of T3-4 advanced carcinoma was approximately 61% in all subsites, while the prevalence of cervical lymph node metastasis was ranged from 53% to 82%. The disease-specific survival rates according to the subsites were as follows: arytenoid, 68 .6%; false vocal cord, 74 .5%; infrahyoid epiglottis, 87 .5%; epiglottis, 60 .0%, and aryepiglottic fold, 43 .6%. Conclusion : The different subsites of supraglottic carcinoma were associated with considerably different clinical features. An understanding of the clinical features of supraglottic carcinoma is important for early detection and appropriate treatment.
{"title":"The Clinical Features According to the Subsites of Supraglottic Carcinoma","authors":"M. Higashino, Shuji Oomura, N. Suzuki, S. Nishikawa, R. Kawata","doi":"10.5426/LARYNX.29.85","DOIUrl":"https://doi.org/10.5426/LARYNX.29.85","url":null,"abstract":"Purpose : We investigated the clinical features according to the subsites of supraglottic carcinoma. Patients and Methods : We investigated 123 cases of supraglottic carcinoma treated that were at Osaka Medical College from 1999 to 2015. The cases involved five subsites: the arytenoid, false vocal cord, infrahyoid epiglottis, epiglottis, and the aryepiglottic fold. We investigated the associations between the subsites and characteristics of the patients, including age, primary symptoms, tumor stage and disease-specific survival. Results : The subsites of the patients were as follows: the arytenoid, n=42; false vocal cord, n=34; infrahyoid epiglottis, n=20; epiglottis, n=16; and the aryepiglottic fold, n=11. The primary symptoms of the whole study population were as follows, hoarseness, n=56 (46 %); sore throat, n=40 (33%); cervical tumor, n=27 (22%); foreign body sensation, n=26 (21%). There were differences according to the subsites. The prevalence of T3-4 advanced carcinoma was approximately 61% in all subsites, while the prevalence of cervical lymph node metastasis was ranged from 53% to 82%. The disease-specific survival rates according to the subsites were as follows: arytenoid, 68 .6%; false vocal cord, 74 .5%; infrahyoid epiglottis, 87 .5%; epiglottis, 60 .0%, and aryepiglottic fold, 43 .6%. Conclusion : The different subsites of supraglottic carcinoma were associated with considerably different clinical features. An understanding of the clinical features of supraglottic carcinoma is important for early detection and appropriate treatment.","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127676783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The surgical treatment of laryngeal cancer has made significant advances, including treatment with func-tional larynx sparing approaches including transoral endoscopic based approaches and partial laryngeal resec-tions that preserve larynx function. The utility and success of these approaches depends on the integration of surgical therapy with other therapies, including speech and swallowing rehabilitation, as well as radiation and chemotherapy. This presentation will focus on the treatment of laryngeal cancer with function sparing surgical approaches, and how to maximize benefit of surgical therapy by integration with other therapies. Emphasis will be placed on extending the indications for primary surgical therapy by maximizing support with other therapeutic modalities and supportive therapies.
{"title":"Integrating Surgical Management of Laryngeal Cancer in a Team Based Approach","authors":"J. Califano","doi":"10.5426/LARYNX.28.108","DOIUrl":"https://doi.org/10.5426/LARYNX.28.108","url":null,"abstract":"The surgical treatment of laryngeal cancer has made significant advances, including treatment with func-tional larynx sparing approaches including transoral endoscopic based approaches and partial laryngeal resec-tions that preserve larynx function. The utility and success of these approaches depends on the integration of surgical therapy with other therapies, including speech and swallowing rehabilitation, as well as radiation and chemotherapy. This presentation will focus on the treatment of laryngeal cancer with function sparing surgical approaches, and how to maximize benefit of surgical therapy by integration with other therapies. Emphasis will be placed on extending the indications for primary surgical therapy by maximizing support with other therapeutic modalities and supportive therapies.","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"85 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121804114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Quality of Life after Treatment for Advanced Laryngeal Cancer","authors":"B. Yueh","doi":"10.5426/LARYNX.28.107","DOIUrl":"https://doi.org/10.5426/LARYNX.28.107","url":null,"abstract":"","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126582011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Association between the Metabolic Tumor Volume and the Prognosis in Patients with Laryngeal Carcinoma","authors":"矢吹 健一郎","doi":"10.5426/LARYNX.28.57","DOIUrl":"https://doi.org/10.5426/LARYNX.28.57","url":null,"abstract":"","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129509552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We performed transoral videolaryngoscopic surgery (TOVS) for hypopharyngeal and supraglottic cancer after induction chemotherapy. The data of 24 patients with hypopharyngeal and supraglottic cancer were retrospectively analyzed. The main tumor site was the hypopharynx in 20 cases and the supraglottis in 4 cases. The number of patients with stage II, III, IVA and IVB tumors were 3 , 4 , 15 and 2 , respectively. Although the mean observation period was relatively short (33 months), the 3-year overall survival was 86%, the disease-specific survival was 94% and the laryngeal preservation rate was 94%. The oncological results and laryngeal preservation rate were excellent. The pathological findings showed that caution must be taken against local recurrence because of possible satellite residual cancer. In principle, the resection area should be set according to the original tumor extension. Although the resection area was reduced in some cases, we cannot conclude whether or not the resection area can be safely reduced in all cases. We also examined the need for adjuvant (chemo) radiotherapy. If the resection area was set according to the original tumor extension, negative margin, pT1-2 and pN0-1 , adjuvant radiation therapy may be preserved.
{"title":"Transoral Videolaryngoscopic Surgery for Hypopharyngeal and Supraglottic Cancer after Induction Chemotherapy","authors":"伸吾 田中, 雅之 冨藤, 幸仁 荒木, 彰浩 塩谷","doi":"10.5426/LARYNX.28.61","DOIUrl":"https://doi.org/10.5426/LARYNX.28.61","url":null,"abstract":"We performed transoral videolaryngoscopic surgery (TOVS) for hypopharyngeal and supraglottic cancer after induction chemotherapy. The data of 24 patients with hypopharyngeal and supraglottic cancer were retrospectively analyzed. The main tumor site was the hypopharynx in 20 cases and the supraglottis in 4 cases. The number of patients with stage II, III, IVA and IVB tumors were 3 , 4 , 15 and 2 , respectively. Although the mean observation period was relatively short (33 months), the 3-year overall survival was 86%, the disease-specific survival was 94% and the laryngeal preservation rate was 94%. The oncological results and laryngeal preservation rate were excellent. The pathological findings showed that caution must be taken against local recurrence because of possible satellite residual cancer. In principle, the resection area should be set according to the original tumor extension. Although the resection area was reduced in some cases, we cannot conclude whether or not the resection area can be safely reduced in all cases. We also examined the need for adjuvant (chemo) radiotherapy. If the resection area was set according to the original tumor extension, negative margin, pT1-2 and pN0-1 , adjuvant radiation therapy may be preserved.","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133842835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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