Pub Date : 2022-04-07DOI: 10.1017/S0022215121004394
Krupal B. Patel, Dustin Silverman, Christine Barron, E. Ozer
Abstract Background Reconstruction of a pharyngoesophageal defect remains a challenging problem, especially with involvement of the neck skin. This study aimed to demonstrate the surgical technique of utilising a butterfly modification of the anterolateral thigh flap. Results Reconstruction of the pharyngoesophageal defect was accomplished using the butterfly modification of the anterolateral thigh free flap. The flap was tubed on the leg while still being attached to the pedicle, to minimise the ischaemia time. Conclusion Butterfly anterolateral thigh free flap allows for multi-layer closure of the neopharynx and can be utilised for reconstruction of pharyngoesophageal and neck skin defects.
{"title":"Anterolateral thigh butterfly free flap for reconstruction of laryngopharyngeal defect: surgical considerations","authors":"Krupal B. Patel, Dustin Silverman, Christine Barron, E. Ozer","doi":"10.1017/S0022215121004394","DOIUrl":"https://doi.org/10.1017/S0022215121004394","url":null,"abstract":"Abstract Background Reconstruction of a pharyngoesophageal defect remains a challenging problem, especially with involvement of the neck skin. This study aimed to demonstrate the surgical technique of utilising a butterfly modification of the anterolateral thigh flap. Results Reconstruction of the pharyngoesophageal defect was accomplished using the butterfly modification of the anterolateral thigh free flap. The flap was tubed on the leg while still being attached to the pedicle, to minimise the ischaemia time. Conclusion Butterfly anterolateral thigh free flap allows for multi-layer closure of the neopharynx and can be utilised for reconstruction of pharyngoesophageal and neck skin defects.","PeriodicalId":22757,"journal":{"name":"The Journal of Laryngology & Otology","volume":"13 1","pages":"878 - 881"},"PeriodicalIF":0.0,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78841615","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}
Pub Date : 2022-04-01DOI: 10.1017/S0022215122000780
E. Fisher, J. Fishman
We are fortunate to have a hard-working team of board members, Cambridge University Press publishing team, senior editors and assistant editors, who allow us to publish a wide variety of papers across subspecialties and related disciplines. This hard work has contributed to our improvement in impact factor and efficient processing of coronavirus disease related papers during the pandemic. We are very grateful to all of our team. Our ‘best paper’ prizes are judged by Liam Flood, Iain Swan, Desmond Nunez and Patrick Bradley. We congratulate the winner and two runners up for their high-quality work. We thank the judges for the considerable time spent on this onerous task, which helps to encourage our authors who dedicate much time and energy on producing their papers. In addition to our senior and assistant editors, we have a loyal team of reviewers, and they contribute regularly to the flow of papers in our submission system. Our reviewers become assistant editors when long-serving colleagues retire, but as retirements are unpredictable, this means that our team contains many reviewers who have contributed a great deal of effort, but no suitable vacancy has arisen to allow a move up to assistant editorship. We use this editorial to thank our reviewer team individually by name here:
{"title":"Thank you to our reviewers and editorial team","authors":"E. Fisher, J. Fishman","doi":"10.1017/S0022215122000780","DOIUrl":"https://doi.org/10.1017/S0022215122000780","url":null,"abstract":"We are fortunate to have a hard-working team of board members, Cambridge University Press publishing team, senior editors and assistant editors, who allow us to publish a wide variety of papers across subspecialties and related disciplines. This hard work has contributed to our improvement in impact factor and efficient processing of coronavirus disease related papers during the pandemic. We are very grateful to all of our team. Our ‘best paper’ prizes are judged by Liam Flood, Iain Swan, Desmond Nunez and Patrick Bradley. We congratulate the winner and two runners up for their high-quality work. We thank the judges for the considerable time spent on this onerous task, which helps to encourage our authors who dedicate much time and energy on producing their papers. In addition to our senior and assistant editors, we have a loyal team of reviewers, and they contribute regularly to the flow of papers in our submission system. Our reviewers become assistant editors when long-serving colleagues retire, but as retirements are unpredictable, this means that our team contains many reviewers who have contributed a great deal of effort, but no suitable vacancy has arisen to allow a move up to assistant editorship. We use this editorial to thank our reviewer team individually by name here:","PeriodicalId":22757,"journal":{"name":"The Journal of Laryngology & Otology","volume":"3 1","pages":"283 - 283"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81497713","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}
Pub Date : 2022-03-31DOI: 10.1017/S002221512200069X
E. Abelardo, R. Gravelle, M. Scannell, P. Shastri, M. Vandekar, G. Davies, L. Volpini, V. Prabhu
Abstract Objective To assess the impact of the coronavirus disease 2019 pandemic on head and neck urgent suspected cancer referral pathways in rural areas of Wales. Method A retrospective audit was conducted of 2234 head and neck urgent suspected cancer referrals received from January 2019 to November 2020. Results The referrals dropped by 35 per cent in 2020 compared to the same period in 2019. The time from general practitioner referral to the first ENT appointment improved during the pandemic (8.0 vs 10.0 days; p < 0.001). Of referrals, 92.1 per cent were seen within a 14-day period in 2020, compared with 79.6 per cent in 2019 (p < 0.001). There were no differences between 2020 and 2019 in terms of: the (confirmed cancer) conversion rate (10.6 per cent vs 9.7 per cent; p = 0.60), general practitioner referral to multidisciplinary team discussion time (35.5 vs 41.5 days; p = 0.40) or general practitioner referral to initiation of treatment time (68.0 vs 78.0 days; p = 0.16). Conclusion Whilst coronavirus disease 2019 reduced the number of overall head and neck urgent suspected cancer referrals, the pathways were generally unchanged, if not slightly improved, in rural Wales.
{"title":"Impact of coronavirus disease 2019 on head and neck urgent suspected cancer referral pathways in rural Wales","authors":"E. Abelardo, R. Gravelle, M. Scannell, P. Shastri, M. Vandekar, G. Davies, L. Volpini, V. Prabhu","doi":"10.1017/S002221512200069X","DOIUrl":"https://doi.org/10.1017/S002221512200069X","url":null,"abstract":"Abstract Objective To assess the impact of the coronavirus disease 2019 pandemic on head and neck urgent suspected cancer referral pathways in rural areas of Wales. Method A retrospective audit was conducted of 2234 head and neck urgent suspected cancer referrals received from January 2019 to November 2020. Results The referrals dropped by 35 per cent in 2020 compared to the same period in 2019. The time from general practitioner referral to the first ENT appointment improved during the pandemic (8.0 vs 10.0 days; p < 0.001). Of referrals, 92.1 per cent were seen within a 14-day period in 2020, compared with 79.6 per cent in 2019 (p < 0.001). There were no differences between 2020 and 2019 in terms of: the (confirmed cancer) conversion rate (10.6 per cent vs 9.7 per cent; p = 0.60), general practitioner referral to multidisciplinary team discussion time (35.5 vs 41.5 days; p = 0.40) or general practitioner referral to initiation of treatment time (68.0 vs 78.0 days; p = 0.16). Conclusion Whilst coronavirus disease 2019 reduced the number of overall head and neck urgent suspected cancer referrals, the pathways were generally unchanged, if not slightly improved, in rural Wales.","PeriodicalId":22757,"journal":{"name":"The Journal of Laryngology & Otology","volume":"59 1","pages":"540 - 546"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88707316","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}
Pub Date : 2022-03-29DOI: 10.1017/S0022215122000883
E. Çetinkaya, A. Yavuz, G. Ozturk, S. Ay, D. Aydenizoz, O. T. Selcuk, H. Eyigor
Abstract Objective This study investigated the relationship between physical dimensions of the Eustachian tube and the emergence of primary attic cholesteatoma. Methods A total of 31 patients with unilateral attic cholesteatoma were selected for radiological comparison. Standard point measurements as well as specific measurements were performed using imaging software. The length, narrowest diameter and bony segment volume, and pharyngeal orifice diameter of both sides of the Eustachian tube (attic cholesteatoma and healthy control ears) were measured and compared. Results Comparison of the values did not reveal any statistically significant difference between the attic cholesteatoma ears and the healthy control ears in terms of: Eustachian tube height, narrowest diameter, bony segment volume or pharyngeal orifice diameter. Conclusion No statistically significant difference was found between the cholesteatoma ears and the healthy control ears in terms of the osseous Eustachian tube size. The findings indicate that the Eustachian tube bony segment dimensions and pharyngeal orifice diameter are not factors in attic cholesteatoma development.
{"title":"The relationship between dimensions of the Eustachian tube and acquired attic cholesteatoma","authors":"E. Çetinkaya, A. Yavuz, G. Ozturk, S. Ay, D. Aydenizoz, O. T. Selcuk, H. Eyigor","doi":"10.1017/S0022215122000883","DOIUrl":"https://doi.org/10.1017/S0022215122000883","url":null,"abstract":"Abstract Objective This study investigated the relationship between physical dimensions of the Eustachian tube and the emergence of primary attic cholesteatoma. Methods A total of 31 patients with unilateral attic cholesteatoma were selected for radiological comparison. Standard point measurements as well as specific measurements were performed using imaging software. The length, narrowest diameter and bony segment volume, and pharyngeal orifice diameter of both sides of the Eustachian tube (attic cholesteatoma and healthy control ears) were measured and compared. Results Comparison of the values did not reveal any statistically significant difference between the attic cholesteatoma ears and the healthy control ears in terms of: Eustachian tube height, narrowest diameter, bony segment volume or pharyngeal orifice diameter. Conclusion No statistically significant difference was found between the cholesteatoma ears and the healthy control ears in terms of the osseous Eustachian tube size. The findings indicate that the Eustachian tube bony segment dimensions and pharyngeal orifice diameter are not factors in attic cholesteatoma development.","PeriodicalId":22757,"journal":{"name":"The Journal of Laryngology & Otology","volume":"46 1","pages":"866 - 870"},"PeriodicalIF":0.0,"publicationDate":"2022-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78156679","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}
Pub Date : 2022-03-18DOI: 10.1017/S0022215121004461
S. Thiagarajan, M. Gupta, P. Sathe, G. Gill, S. Ghosh-Laskar, K. Prabhash, D. Chaukar
Abstract Objective Surgery is the recommended treatment for resectable T4a laryngeal and hypopharyngeal carcinoma. Non-surgical treatment is an option in a select few patients. Method This retrospective study was undertaken to assess the treatment outcomes in patients with resectable T4a carcinoma of the larynx and hypopharynx who received either surgical or non-surgical treatment at our institute and to assess factors influencing these outcomes. Results A total of 120 patients were included in the study. They were divided into groups A, B and C based on the presence of extralaryngeal spread through laryngeal membrane, cartilage or both. The overall survival was better among patients who received surgery than those who received non-surgical treatment in the three groups. The factor influencing overall survival was the treatment given in the form of surgical versus non-surgical treatment. Conclusion Surgery is the preferred treatment for T4a laryngeal and hypopharyngeal carcinoma, even in patients with extralaryngeal spread without cartilage erosion.
{"title":"Outcomes of surgical versus non-surgical treatment of resectable T4a laryngeal and hypopharyngeal carcinoma","authors":"S. Thiagarajan, M. Gupta, P. Sathe, G. Gill, S. Ghosh-Laskar, K. Prabhash, D. Chaukar","doi":"10.1017/S0022215121004461","DOIUrl":"https://doi.org/10.1017/S0022215121004461","url":null,"abstract":"Abstract Objective Surgery is the recommended treatment for resectable T4a laryngeal and hypopharyngeal carcinoma. Non-surgical treatment is an option in a select few patients. Method This retrospective study was undertaken to assess the treatment outcomes in patients with resectable T4a carcinoma of the larynx and hypopharynx who received either surgical or non-surgical treatment at our institute and to assess factors influencing these outcomes. Results A total of 120 patients were included in the study. They were divided into groups A, B and C based on the presence of extralaryngeal spread through laryngeal membrane, cartilage or both. The overall survival was better among patients who received surgery than those who received non-surgical treatment in the three groups. The factor influencing overall survival was the treatment given in the form of surgical versus non-surgical treatment. Conclusion Surgery is the preferred treatment for T4a laryngeal and hypopharyngeal carcinoma, even in patients with extralaryngeal spread without cartilage erosion.","PeriodicalId":22757,"journal":{"name":"The Journal of Laryngology & Otology","volume":"1 1","pages":"1087 - 1095"},"PeriodicalIF":0.0,"publicationDate":"2022-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80550120","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}
Pub Date : 2022-03-17DOI: 10.1017/s0022215122000718
L. Flood
Although copyrighted in 2017 to Thieme India, and promised here in 2019, it is only recently that this book has appeared in the UK. It will be obvious that a book of this size, devoted to such a highly specialised topic, must be ‘the last word’ (or at least so until the next technological advance). Each chapter is multi-authored, with a major contribution from Tamil Nadu, India. We all know that Indian surgeons have a unique degree of exposure to nasopharyngeal angiofibromas. This is particularly well illustrated in a table listing established eponymous classification systems. These are based on retrospective reviews of between 12 and 36 patients, with one exception. That is the author’s personal experience of no fewer than 242 endoscopic resections, the vast majority of tumours being stage 2c. This implies involvement of the infratemporal fossa, and any of other such sites as the cheek, pterygoid region, greater wing of sphenoid or inferior orbital fissure. The book emphasises the obvious advantages of endoscopic resection over open approaches, and proposes a novel classification system. There is a very comprehensive review of management, ranging from imaging, haemostasis, complications of surgery and salvage of damage to the internal carotid artery. The external and transcranial approaches do still form two chapters, and a final chapter covers adjuvant treatment modalities and future prospects. These include advances in radiotherapy, gamma knife and Cyberknife surgery, chemotherapy, sclerotherapy and embolisation, hormones, and growth factors and receptor modulators. This chapter closes by reminding us of the challenge to all researchers, the rarity of juvenile nasopharyngeal angiofibromas, with only a few thousand cases in all the world literature. Few of us will be tackling this tumour. All we are required to do is spot it before being tempted to biopsy that curious lesion. This otologist has personally only diagnosed one single case in 32 years of consultant practice. Just at the end of septal surgery and turbinate reduction, that ancient headlight (in the days before rigid endoscopy) suggested something behind that turbinate. Surely not, but wisdom suggested a computed tomography (CT) scan before sampling it. This is a high-quality book with superb illustrations of imaging and endoscopic sinus surgery. Particularly impressive is a series of three-dimensional volume rendering CT scans, colourised to show the vasculature and tumour extent, all printed in a very appealing large format. Again, mercifully, few of us will have to tackle such tumours, but it would pay any trainee to read, at the least, the first half of this book, before a higher examination. This will long be the definitive text on this subject, and it is a remarkable achievement for the editors.
{"title":"Juvenile Nasopharyngeal Angiofibroma N Janakiram (ed) Thieme, 2019 ISBN 978 9 38506 276 6 pp 304 Price €94.99 US$109.99","authors":"L. Flood","doi":"10.1017/s0022215122000718","DOIUrl":"https://doi.org/10.1017/s0022215122000718","url":null,"abstract":"Although copyrighted in 2017 to Thieme India, and promised here in 2019, it is only recently that this book has appeared in the UK. It will be obvious that a book of this size, devoted to such a highly specialised topic, must be ‘the last word’ (or at least so until the next technological advance). Each chapter is multi-authored, with a major contribution from Tamil Nadu, India. We all know that Indian surgeons have a unique degree of exposure to nasopharyngeal angiofibromas. This is particularly well illustrated in a table listing established eponymous classification systems. These are based on retrospective reviews of between 12 and 36 patients, with one exception. That is the author’s personal experience of no fewer than 242 endoscopic resections, the vast majority of tumours being stage 2c. This implies involvement of the infratemporal fossa, and any of other such sites as the cheek, pterygoid region, greater wing of sphenoid or inferior orbital fissure. The book emphasises the obvious advantages of endoscopic resection over open approaches, and proposes a novel classification system. There is a very comprehensive review of management, ranging from imaging, haemostasis, complications of surgery and salvage of damage to the internal carotid artery. The external and transcranial approaches do still form two chapters, and a final chapter covers adjuvant treatment modalities and future prospects. These include advances in radiotherapy, gamma knife and Cyberknife surgery, chemotherapy, sclerotherapy and embolisation, hormones, and growth factors and receptor modulators. This chapter closes by reminding us of the challenge to all researchers, the rarity of juvenile nasopharyngeal angiofibromas, with only a few thousand cases in all the world literature. Few of us will be tackling this tumour. All we are required to do is spot it before being tempted to biopsy that curious lesion. This otologist has personally only diagnosed one single case in 32 years of consultant practice. Just at the end of septal surgery and turbinate reduction, that ancient headlight (in the days before rigid endoscopy) suggested something behind that turbinate. Surely not, but wisdom suggested a computed tomography (CT) scan before sampling it. This is a high-quality book with superb illustrations of imaging and endoscopic sinus surgery. Particularly impressive is a series of three-dimensional volume rendering CT scans, colourised to show the vasculature and tumour extent, all printed in a very appealing large format. Again, mercifully, few of us will have to tackle such tumours, but it would pay any trainee to read, at the least, the first half of this book, before a higher examination. This will long be the definitive text on this subject, and it is a remarkable achievement for the editors.","PeriodicalId":22757,"journal":{"name":"The Journal of Laryngology & Otology","volume":"37 1","pages":"470 - 470"},"PeriodicalIF":0.0,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86451580","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}
Pub Date : 2022-03-16DOI: 10.1017/S0022215122000755
L. Varghese, V. Malleshappa, B. Yadav, R. Kurien, V. Rupa
Abstract Objective To determine risk factors affecting mortality in acute invasive fungal sinusitis. Method This observational cohort study was conducted over a five-year period. Results Of 109 recruited patients, 90 (82.6 per cent) had diabetes mellitus. Predominant fungi were zygomycetes (72.6 per cent) with Rhizopus arrhizus being most common. Of the patients, 12.8 per cent showed a positive biopsy report from radiologically normal sinuses. Factors affecting mortality on multivariate analysis were: female sex (p = 0.022), less than two weeks between symptoms and first intervention (p = 0.01), and intracranial involvement (p = 0.034). Other factors significant on univariate analysis were: peri-orbital swelling (p = 0.016), restricted ocular movements (p = 0.053), intracranial symptoms (p = 0.008), posterior disease (p = 0.058), imaging showing ocular involvement (p = 0.041), fungus being zygomycetes (p = 0.050) and post-operative cavity infection (p = 0.032). Bilateral, palatal and retromaxillary involvement were not associated with poor prognosis. Conclusion Diagnosis of acute invasive fungal sinusitis requires a high index of clinical suspicion. Recognition of factors associated with poor prognosis can help when counselling patients, and can help initiate urgent intervention by debridement and antifungal therapy. Post-operative nasal and sinus cavity care is important to reduce mortality.
{"title":"Risk factors and predictors of mortality in acute invasive fungal sinusitis – a single-institution experience","authors":"L. Varghese, V. Malleshappa, B. Yadav, R. Kurien, V. Rupa","doi":"10.1017/S0022215122000755","DOIUrl":"https://doi.org/10.1017/S0022215122000755","url":null,"abstract":"Abstract Objective To determine risk factors affecting mortality in acute invasive fungal sinusitis. Method This observational cohort study was conducted over a five-year period. Results Of 109 recruited patients, 90 (82.6 per cent) had diabetes mellitus. Predominant fungi were zygomycetes (72.6 per cent) with Rhizopus arrhizus being most common. Of the patients, 12.8 per cent showed a positive biopsy report from radiologically normal sinuses. Factors affecting mortality on multivariate analysis were: female sex (p = 0.022), less than two weeks between symptoms and first intervention (p = 0.01), and intracranial involvement (p = 0.034). Other factors significant on univariate analysis were: peri-orbital swelling (p = 0.016), restricted ocular movements (p = 0.053), intracranial symptoms (p = 0.008), posterior disease (p = 0.058), imaging showing ocular involvement (p = 0.041), fungus being zygomycetes (p = 0.050) and post-operative cavity infection (p = 0.032). Bilateral, palatal and retromaxillary involvement were not associated with poor prognosis. Conclusion Diagnosis of acute invasive fungal sinusitis requires a high index of clinical suspicion. Recognition of factors associated with poor prognosis can help when counselling patients, and can help initiate urgent intervention by debridement and antifungal therapy. Post-operative nasal and sinus cavity care is important to reduce mortality.","PeriodicalId":22757,"journal":{"name":"The Journal of Laryngology & Otology","volume":"181 1","pages":"1320 - 1327"},"PeriodicalIF":0.0,"publicationDate":"2022-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86813255","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}
Pub Date : 2022-03-02DOI: 10.1017/S0022215122000652
E. Halliday, Ajith George
Abstract Objective Heat from transoral laser microsurgery can cause tissue shrinkage, impacting the surgical margin. This study aimed to compare shrinkage between cold steel and carbon dioxide laser resections of laryngeal lesions. Methods A European Laryngological Society type II resection was performed on 10 mm ‘lesions’ marked on both the true and false folds of fresh-frozen human larynxes; specifically, laser resection was performed on the right side and cold steel resection on the left side. Results Twenty-eight larynxes were included. Tissue shrinkage was significantly higher in laser resection (35–45 per cent) compared to cold steel resection (8–14 per cent) (p < 0.0001). In most cases, there was no significant difference in shrinkage between true and false fold sites. Conclusion This study demonstrates that specimen shrinkage is significantly higher in laser resections. This shrinkage will affect the size of the surgical margin; surgeons and pathologists should be aware of this when considering positive and close margins.
{"title":"Quantifying the shrinkage of laryngeal laser excisions: a case control study","authors":"E. Halliday, Ajith George","doi":"10.1017/S0022215122000652","DOIUrl":"https://doi.org/10.1017/S0022215122000652","url":null,"abstract":"Abstract Objective Heat from transoral laser microsurgery can cause tissue shrinkage, impacting the surgical margin. This study aimed to compare shrinkage between cold steel and carbon dioxide laser resections of laryngeal lesions. Methods A European Laryngological Society type II resection was performed on 10 mm ‘lesions’ marked on both the true and false folds of fresh-frozen human larynxes; specifically, laser resection was performed on the right side and cold steel resection on the left side. Results Twenty-eight larynxes were included. Tissue shrinkage was significantly higher in laser resection (35–45 per cent) compared to cold steel resection (8–14 per cent) (p < 0.0001). In most cases, there was no significant difference in shrinkage between true and false fold sites. Conclusion This study demonstrates that specimen shrinkage is significantly higher in laser resections. This shrinkage will affect the size of the surgical margin; surgeons and pathologists should be aware of this when considering positive and close margins.","PeriodicalId":22757,"journal":{"name":"The Journal of Laryngology & Otology","volume":"44 1","pages":"1265 - 1270"},"PeriodicalIF":0.0,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90224993","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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