Laryngectomy For Laryngeal Cancer Research Articles

Complications of tracheoesophageal bypassing with prosthetics after laryngectomy

Laryngectomy for laryngeal cancer is the treatment of choice in these patients. Rehabilitation of patients with voice impairment is not an easy task. For the purpose of rehabilitation, tracheoesophageal bypass (TEB) is performed. When examining patients with TPS, medical personnel must be protected by personal protective equipment. Patients with PSI are at high risk for aspiration pneumonia. In the context of the COVID-19 pandemic, patients after laryngectomy with tracheoesophageal bypass surgery with prosthetics need to be given special attention. When infected with SARSCoV-2, these patients are at a special risk group. They need special conditions in the clinic – special care and rehabilitation.

Лечение рубцовых стенозов трахеи после ларингэктомии

The aim of the research. To evaluate the results of treatment of patients with cicatricial tracheal stenosis after laryngectomy. Material and methods. A total of 15 patients with cicatricial tracheal stenosis (CTS) and persistent tracheostomy after laryngectomy for laryngeal cancer were treated. The treatment employed an algorithm including bougienage, cryodestruction and stenting, as well as complex bronchodilator therapy aimed at restoring bronchial patency. Cryotherapy of CTS was performed through a tracheostomy with a developed cryoapplicator made of titanium nickelide. Results. The duration of cannula-bearing period after tracheal stenosis was from six months to three years. The length of cicatricial changes ranged from 10 to 55 mm. Tracheal stenosis was detected in the area of the end tracheostomy in 10 patients, at the level of the thoracic trachea in 4 patients, subtotal tracheal injury after laryngectomy in 1 patient. Subcompensated tracheal stenosis was detected in 10 patients, decompensated – in 5, of which 2 patients had this condition combined with tracheomalacia. In case of decompensated stenosis, emergency bougienage of the trachea was performed. Recanalisation and maintenance of the tracheal lumen was carried out according to the proposed treatment regimen. No fatal outcomes were registered during the hospitalisation period. All patients managed to restore adequate breathing and tracheal lumen. Within 6-8 months, 12 patients were decannulated, the rest continued cannula-bearing and free breathing was supported by stenting. The failure of their decannulation was associated with the presence of tracheomalacia and subtotal tracheal stenosis. Conclusion. Surgical correction of CTS in patients after laryngectomy requires an alternative therapeutic approach and differs from those prescribed in the classical version of stenosis. The proposed CTS treatment after extirpation of the larynx is an effective method for restoring the patency of the airways, allowing 80% of patients to restore free breathing without a tracheostomy cannula. The use of the adapted cryoapplicator made of titanium nickelide expands the possibilities of cryosurgery, and the developed method of CTS treatment may be recommended for wide practical application.

YouTube™ as a source of information for patients undergoing laryngectomy: a thematic analysis.

Total laryngectomy and end tracheal stoma formation are often required to treat advanced laryngeal cancer. Resources on the internet are commonly accessed by patients as a source of healthcare information. YouTube™, the most popular video-hosting website, is one such resource. The aims of this study were to assess the thematic content of the most viewed YouTube™ videos concerning laryngectomy for laryngeal cancer and to evaluate user response to these videos. A search of YouTube™ was performed and data were extracted from videos with > 100 views. Upload source, number of views, likes, dislikes and comments were collected and the content of comments was analysed. User response was compared between upload sources using Kruskal-Wallis testing. Inductive thematic analysis of video content was performed to identify overarching themes and subthemes. A total of 96 videos were identified, 16 uploaded by patients, 24 by individual healthcare professionals and 56 by professional healthcare institutions. There were 1214,503 views and no significant differences in the number of views, likes or dislikes between upload sources. Three overarching themes and 17 subthemes were identified. Comments were most frequently characterised as offering praise. YouTube™has been shown to be a popular platform for sharing information about laryngectomy for laryngeal cancer. There is a lack of data concerning the quality of this information, however, and future work should focus on assessing this. Trusted institutions could make use of this medium to disseminate high-quality information to their patients, and to the wider public.

Radiotherapy-Chemotherapy Related Heart Diseases in Surgical Setting

Introduction: The numbers of healed or long term survivor’s cancer patients are increasing. Radiotherapy and chemotherapy can induce heart damages even after many years. Cancer patient is a chronic patient and frequently requires prolonged anti-cancer therapies and repeated interventions of oncologic surgery during the course of his disease. According to Guideline on “Perioperative Cardiovascular Evaluation and Management of Patients Undergoing non-cardiac Surgery”, the perioperative cardiologic management can determine changes that can take time and that can include the decision to change medical therapies, the decision to perform further cardiovascular interventions or the decision to recommend alternative therapeutic strategies. The consequent delay of the planned surgery to allow the assessment and significant changes in cardiologic management, will negatively affect outcome also with a negative impact on the costs for the time extension of the hospitalization. Case report: We present a male caucasian patient of 51 years, smoker, hypertensive, with an history of resection of the right lung for lung microcytoma at age 27 years, treated with chemotherapy and radiotherapy (1988). He was admitted (2012) into our Institute to undergo total surgical laryngectomy for laryngeal cancer. At the perioperative cardiovascular assessment for non-cardiac surgery we found a total atrio-ventricular block and triple vessel coronary artery disease. The planned surgery was delayed, a dual-chamber pacemaker was implanted and the patient underwent surgical myocardial revascularization with triple coronary artery bypass grafting. Consequently, according to the decision of surgeons and oncologists the patient underwent radiation therapy instead of laryngeal surgery. Conclusion: In cancer patients we recommend the cardiologic surveillance, also for several years, after radiotherapy and chemotherapy to detect and treat in time heart damages. This appears clinically and economically cost-effective because it can reduce the hospitalization time in surgical setting for oncologic time-sensitive procedures.

Carotid Blow-Out Masquerading as Gastrointestinal Hemorrhage: A Case Report

Tracheo-esophageal prostheses (TEP) are commonly used for speech restoration following laryngectomy for laryngeal cancer. The device is placed through the tracheoesophageal wall into the esophagus superior to the tracheal stoma. We report a case of a ruptured carotid artery presenting as a gastrointestinal bleed. The diagnosis was elusive for a while as initial extensive workup for a source of gastrointestinal bleeding was unsuccessful. To the best of our knowledge, this is the first reported case of a TEP device causing a carotid blow out. This case highlights the importance of looking for atypical sources of bleeding when routine investigations do not provide an etiology. doi: http://dx.doi.org/10.4021/jmc1163w

Carotid Blow-Out Masquerading as Gastrointestinal Hemorrhage: A Case Report

Tracheo-esophageal prostheses (TEP) are commonly used for speech restoration following laryngectomy for laryngeal cancer. The device is placed through the tracheoesophageal wall into the esophagus superior to the tracheal stoma. We report a case of a ruptured carotid artery presenting as a gastrointestinal bleed. The diagnosis was elusive for a while as initial extensive workup for a source of gastrointestinal bleeding was unsuccessful. To the best of our knowledge, this is the first reported case of a TEP device causing a carotid blow out. This case highlights the importance of looking for atypical sources of bleeding when routine investigations do not provide an etiology. J Med Cases. 2013;4(5):277-279 doi: https://doi.org/10.4021/jmc1163w

当科における喉頭垂直部分切除術の臨床的検討

目的：喉頭機能温存治療である喉頭垂直部分切除術（以下：部切術）に関して，病変制御，喉頭温存と共に術後の喉頭機能を評価することで部切術の有用性を検討すること。対象と方法：慈恵医大第三病院耳鼻咽喉科において部切術を施行した5症例。術後病変の再発，転移の観察と共に最長発声持続時間の測定とGRBASスコア等を用いて術後の喉頭機能評価を行った。結果：TNM分類では，声門型T2N0 1例，放射線治療後rT2N0 1例，T3N0 2例であり，声門上型ではT2N0 1例であり，全例M0であった。垂直部分切除が5例に施行された。術中，内視鏡を用いて内腔から明視下に切除を行うことと，舌骨付き胸骨舌骨筋弁を用いて輪状軟骨再建を行う工夫を行った。術後局所感染のために1例に喉頭全摘術を施行したため喉頭温存率は4/5例（80%）であったが，観察期間中（34～87か月，平均64.6か月）全例局所再発なく非担癌生存中である。術後の喉頭機能ではGRBAS評価において気息性の成分が強かったが，最長発声持続時間は全例14秒以上であり日常生活上の会話に支障はみられなかった。嚥下機能では，すべての症例で誤嚥性肺炎をきたしたものはなく気管切開孔は閉鎖され唾液のクリアランスも良好であり普通食の摂食が可能であった。結語：喉頭部分切除術は局所制御率が高く，術後の音声，嚥下機能に関しても化学放射線療法に比較して著しく劣るものではなかった。喉頭部分切除術は放射線治療後の救済手術としてばかりでなく，放射線治療に対する抵抗性が危惧されるようなT2および一部のT3症例に対して初回治療として用いることは有用であると思われる。

Endobronchial mascara brush

An 80-year-old woman presented to her local casualty department with sudden onset of increasing dyspnoea and wheeze having been applying her make-up. She had a history of previous laryngectomy for laryngeal cancer 15 years earlier with no recurrence and no history of primary lung disease. On …

Successful closure of pharyngo-cutaneous and phayryngo-tracheal fistulas using removable hypopharyngeal stent after laryngectomy for laryngeal carcinoma

Placement of removable stents to close pharyngo-cutaneous and tracheo-pharyngeal fistulas after laryngectomy has not been reported before. This case presents the feasibility of removable esophageal stent in closing pharyngo-cutaneous and tracheo-pharyngeal fistulas after laryngectomy for laryngeal cancer. Consecutive patients who underwent placement of removable esophageal stent for closing pharyngo-cutaneous and tracheo-pharyngeal fistulas after laryngectomy for laryngeal cancer. Three patients underwent successful stent placement in the hypopharynx. The stents were well tolerated. Patient one had the stent for 14 months, leading to complete healing of the fistula. Removal was successful. The second patient was palliated but died 8 weeks after stent placement. The third patient has successful palliation of his tracheo-esophageal fistula and the stent is being exchanged every 3-4 months to palliate his fistula. Closure of pharyngo-cutaneous and tracheo-esophageal fistulas is feasible with esophageal removable stents. These stents provide alternative options when dealing with these challenging problems.

Frontlateral Partial Laryngectomy for Laryngeal Cancer Using the Sternohyoid Muscle with Hyoid Bone Assisted with Endoscope

Frontlateral Partial Laryngectomy for Laryngeal Cancer Using the Sternohyoid Muscle with Hyoid Bone Assisted with Endoscope

Investigation of QOL after laryngectomy using the UW-QOL questionnaire with chinese patients

OBJECTIVE To assess the postoperative QOL(Quality of Life) of Chinese laryngeal cancer patients who have undergone a partial or total laryngectomy, and to analyze their prognostic factors, as well as to assess the feasibility of using the University of Washington Quality of Life (UW-QOL) questionnaire in QOL studies of laryngeal cancer patients. METHODS Using the UW-QOL questionnaire, a survey was conducted in patients treated by a partial or total laryngectomy for laryngeal cancer. RESULTS Questionnaires were sent to 142 patients who were diseasefree for more than half a year after surgery. Replies were received from 130 patients (91% response rate) with 118 patients completing the questionnaire. These patients were divided into 2 groups: a partial-laryngectomy group (n=81; excluding cordectomy) and a total-laryngectomy group (n=37). The composite QOL scores of the partial-laryngectomy group (692.3±127.9) were higher than those of total-laryngectomy group (636.4±140.0), showing a statistically significant difference (P<0.05). The partial-laryngectomy group (74.3±23.8; 80.9±20.3) was better than the total-laryngectomy group (40.3±25.8; 69.6±27.1) in speech and appearance (P<0.001; P<0.05); but the total-laryngectomy group (92.6±13.0) was superior to the partial-laryngectomy group (83.0±20.5) in pain (P<0.01). Six factors including cancer stage, operative modality, complications, postoperative radiotherapy or chemotherapy, living partners and chronic disease before or after operation were related to postlaryngectomy QOL. CONCLUSION Partial laryngectomy is superior to total laryngectomy in speech, appearance and overall QOL. Besides operative modality, cancer stage, complications, postoperative radiotherapy or chemotherapy, living partners and chronic diseases before or after operation are factors influencing postlaryngectomy QOL. As a whole, the UW-QOL questionnaire is a good instrument for studying QOL of laryngeal cancer patients in China, and it can be used to explore the QOL outcomes obtained from different reconstructive techniques.

Tracheoesophageal Puncture in Irradiated Patients

Tracheoesophageal puncture (TEP) with use of a voice prosthesis is widely accepted as an excellent method of postlaryngectomy vocal rehabilitation. Many patients with advanced cancer require postoperative radiotherapy (RT), while other cancer patients have been treated with RT as a primary treatment and come to laryngectomy for salvage. The influence of RT on outcome of the TEP procedure with respect to successful speech and potential complications has not been widely discussed. We retrospectively reviewed 77 consecutive cases of TEP in patients who had received RT and laryngectomy for laryngeal cancer. All cases had a minimum of 6 months of follow-up. All 77 patients were successful in obtaining speech with the TEP, and 75 (97%) continued to be TEP users thereafter. Eight patients (10%) developed complications in the course of treatment. There was no mortality. In selected patients, TEP after RT is a relatively safe and effective method of vocal rehabilitation.

Clinical outcomes of total laryngectomy for laryngeal carcinoma

Controversy exists as to the management of advanced laryngeal carcinoma. In general primary radical surgery is favoured. The aim of this study was to analyse the clinical outcome of patients having total laryngectomy for cancer of larynx. This study was a retrospective case note review and questionnaires were used for evaluating voice handicap. These laryngectomies included in this study were performed by the senior author (CJW) from January 2001 till June 2007 at Leeds General Infirmary, Leeds. Some of the patients had partial or total pharyngectomy in addition to total laryngectomy. In this study a total of 59 patients were included. Seventeen (28.8%) of these patients had preoperative radiotherapy and laryngectomy was performed for residual or recurrent disease. The initial TNM staging of the tumour ranged from T(1)N(0) to T(4)N(2C). Tracheoesophageal puncture for speech prosthesis was done in 48/59 (81.4%) patients. Post-operative complications were seen in 30.5% (18/59) patients. In this study group 9 patients (15.2%) developed pharyngocutaneous fistulas. For communication 31/51 (60.8%) patients were using speech valves. In this study 30.4% had minimal, 26.1% moderate and the rest 43.4% feeling severely handicapped with regards to voice use after total laryngectomy. Five year survival after laryngectomy in this study was 65.2%. Long term disease control and survival is achievable with total laryngectomy with or without postoperative radiotherapy with minimal risks in patients with advanced carcinoma of larynx.

Laryngectomy for Cancer of Larynx with Modified Technique and Attempted Formation of Skin Graft Tube in Place of Larynx

The LaryngoscopeVolume 32, Issue 6 p. 446-450 Articles Laryngectomy for Cancer of Larynx with Modified Technique and Attempted Formation of Skin Graft Tube in Place of Larynx Dr. R. H. Goldthwaite, Dr. R. H. Goldthwaite Camp Benning, GaSearch for more papers by this author Dr. R. H. Goldthwaite, Dr. R. H. Goldthwaite Camp Benning, GaSearch for more papers by this author First published: June 1922 https://doi.org/10.1288/00005537-192206000-00003AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume32, Issue6June 1922Pages 446-450 RelatedInformation