Sultan Pradhan: Voice conservation surgery for laryngeal and hypopharyngeal cancer

Abstract

Dr. Pradhan is a head and neck oncologist and surgeon who tries to cover diVerent aspects of this special tumour entity. The book is well-balanced and clearly organized. But being a European laryngologist and oncological head and neck surgeon I was amazed and rather disappointed about the missing references to several important European laryngologists especially to Oskar Kleinsasser, who is not mentioned in this book. He is the originator of microlaryngoscopy and endolaryngeal microsurgery. Besides, the names of other European authors who are mentioned are incorrectly written. Chapter 1 presents a historical survey listing up various milestones with a special focus on the development of partial and total laryngectomy. In chapter 2 the author proceeds with clear but simplifying explanations of the basics of laryngeal anatomy and patterns of tumor spread, providing a fundamental knowledge indispensable to the treatment of laryngeal and hypopharyngeal cancer. The text is supported by several illustrations which help to understand the described zones. In the third chapter on diagnosis and staging the author brieXy addresses the clinical basic and routine laryngological examination and presents the advantages of imaging techniques (CT/MRI) in larger tumours. An evaluation of voice quality before and after voice conservation in spite of the topic suggested by the title is missing. The authors' opinion that laryngologists should be “discouraged” from performing excisional biopsy during microlaryngoscopy before the patient is referred to a head and neck surgeon does not seem to be compatible to present European standards. Treatment strategies for laryngeal carcinoma have undergone important changes with the development of a much wider range of treatment options in recent years. The presented photos in this, but also in other chapters, are of varying quality. In chapter 4 Dr. Pradhan lists up important factors that inXuence treatment decision, e.g. T-stage or site of the primary. He points out that treatment decision is also inXuenced by the patient’s preferences (shared decision making). Several clear but often too simple algorithms in decision-making can be of some help for the treating physician. Chapter 5 deals with open partial laryngectomy describing procedures for glottic cancer where resection is carried out in the vertical plane across the glottis, for early supraglottic cancer with resection in the horizontal plane above the glottis, and for glotto-supraglottic cancer with a combination of vertical and horizontal partial laryngectomies which includes supracricoid partial laryngectomy with crico-hyoidopexie and three-quarter laryngectomy. Once more the sketches do not show the real extend of the tumours and its necessary resection margins. The drawings are not a suYcient help how to perform the surgery. The author always summarizes international, mostly Anglo-American experience in diVerent treatment options for each stage of the disease before giving a personal view. Reconstruction of the glottis is not mentioned in a suYcient way to point out its importance of providing voice quality to continue life even as a professional speaker. Chapter 6 which I would have set as chapter 5 informs about transoral endoscopic resection for carcinoma in situ and early cancer of the glottic and supraglottic level including oropharyngeal and hypopharyngeal cancers. These operations are performed with laser only. Set-up and safety measures are described and the indications and limitations demonstrated. Chapter 7 presents the near-total laryngectomy where voice as well as nasal respiration is H. K. Glanz (&) Head and Neck Surgery, University Hospitals Giessen and Marburg GmbH, Campus Giessen, Giessen, Germany e-mail: hiltrud.k.glanz@hno.med.uni-giessen.de