Treatment Of Laryngeal Carcinoma Research Articles

LncRNA BBOX1-AS1 Contributes to Laryngeal Carcinoma Progression by Recruiting SRSF1 to Maintain EFNB2 mRNA Stability.

Laryngeal cancer is a common malignancy of the larynx with a generally poor prognosis. This study systematically assessed the functional role of lncRNA BBOX1-AS1 in laryngeal carcinoma progression and associated molecular regulatory mechanisms. The proliferation, migration, and invasion of laryngeal carcinoma cells were detected by Cell Counting Kit-8, wound healing, clonal formation, and transwell assays. In addition, the interaction between BBOX1-AS1, Serine/Arginine Splicing Factor 1 (SRSF1), and Ephrin-B2 (EFNB2) mRNA was examined employing RNA immunoprecipitation and RNA pull-down experiments. Furthermore, western blotting, and RT-qPCR assays were adopted to detect the expression levels of BBOX1-AS1, SRSF1, and EFNB2. The impact of BBOX1-AS1 and SRSF1 on EFNB2 mRNA stability was examined using the RNA stability assay. BBOX1-AS1 was highly expressed in human laryngeal carcinoma tissues and cell lines. BBOX1-AS1 knockdown suppressed the growth, proliferation, migration, and invasion of laryngeal carcinoma cells. BBOX1-AS1 maintained the stability of EFNB2 mRNA in laryngeal carcinoma cells by recruiting SRSF1. EFNB2 knockdown inhibited the growth and metastatic function of laryngeal carcinoma cells in vitro. EFNB2 overexpression reversed the influence of BBOX1-AS1 knockdown on laryngeal cancer tumorigenesis. BBOX1-AS1 maintained EFNB2 mRNA stability by recruiting SRSF1, thereby aggravating laryngeal carcinoma malignant phenotypes. BBOX1-AS1 might be a new theoretical target for the treatment of laryngeal carcinoma.

Dysphagia in Open Partial Horizontal Laryngectomy Type IIa: Quantitative Analysis of Videofluoroscopy using the ASPEKT Method.

Open Partial Horizontal Laryngectomy (OPHL) Type IIa surgery is a conservative surgical technique used in the treatment of laryngeal carcinomas. In this pilot study, we aimed to characterize swallowing function and physiology in a series of patients after OPHL Type IIa surgery through comparison to healthy reference values for quantitative measures for videofluoroscopy. We performed retrospective quantitative analysis of videofluoroscopy recordings of thin liquid swallows for a preliminary sample of 10 male patients. Each videofluoroscopy clip was rated in triplicate by trained blinded raters according to the ASPEKT Method (Analysis of Swallowing Physiology: Events, Kinematics and Timing). This preliminary sample of patients with previous OPHL surgery showed functional airway protection, with only 2 patients showing incomplete laryngeal vestibule closure (LVC) and associated airway invasion. However, the majority of patients (90%) showed prolonged latencies to LVC and upper esophageal sphincter (UES) opening. Prolonged durations of LVC and UES opening were also noted, but these were in the direction of compensation rather than impairment. Reduced pharyngeal area at rest was seen in 70% of the sample, and all patients showed poor pharyngeal constriction. Post-swallow residue was a prominent finding in ≥ 75% of these patients. In particular, reduced or absent constriction of the hypopharynx in the region of the pyriform sinuses was noted as a characteristic of swallowing in this sample. The data from these patients suggest that despite functional airway protection, severe swallowing dysfunction involving poor pharyngeal constriction and bolus clearance may be likely after OPHL surgery.

Oridonin inhibited epithelial-mesenchymal transition of laryngeal carcinoma by positively regulating LKB1/AMPK signaling.

Oridonin is the main bioactive component of Rabdosia rubescens, and its anticancer activity has been reported in a variety of cancers. However, the molecular mechanism of oridonin in laryngeal carcinoma remains unclear. In the present study, the cytotoxic effect of oridonin on laryngeal carcinoma Hep-2 and TU212 cell lines were initially detected by modified MTT assay. The results showed that oridonin had a dose-dependent anti-proliferative effect on laryngeal carcinoma Hep-2 and TU212 cells. Next, we found that oridonin significantly inhibited the migration and invasion of human laryngeal carcinoma Hep-2 and TU212 cell lines by wound healing assay and transwell assay. Subsequently, the results of quantitative real-time PCR assay and western blotting assay confirmed that oridonin upregulated the expression of E-cadherin while downregulated the expression of N-cadherin in a concentration-dependent manner at mRNA and protein levels. In addition, phosphorylation levels of liver kinase B1 (p-LKB1) and AMP-activated protein kinase (p-AMPK) were also elevated upon oridonin treatment. To further verify the role of LKB1/AMPK signaling pathway in laryngeal carcinoma, overexpression of LKB1 was constructed by plasmid transfection. The data exhibited that overexpression of LKB1 could further reinforce the increase of E-cadherin level and decrease of N-cadherin level mediated by oridonin. Additionally, AMPK inhibitor compound C could reverse anti-metastatic effect of oridonin on laryngeal carcinoma, and antagonise EMT expression. In contrast, AMPK activator AICAR presented the opposite effect. In conclusion, our study revealed that oridonin could remarkably reverse the epithelial-mesenchymal transition of laryngeal carcinoma by positively regulating LKB1/AMPK signaling pathway, which suggested that oridonin may be a potential candidate for the treatment of laryngeal carcinoma in the future.

Oxidative Stress and Inflammation Biomarkers in Postoperative Pain Modulation in Surgically Treated Patients with Laryngeal Cancer—Pilot Study

(1) Background: Surgical treatment of laryngeal carcinoma includes different types of laryngectomies with neck dissection. Surgical tissue damage triggers an inflammatory response, leading to the release of pro-inflammatory molecules. This increases reactive oxygen species production and decreases antioxidant defense mechanisms, leading to postoperative oxidative stress. The aim of this study was to assess the correlation between oxidative stress (malondialdehyde, MDA; glutathione peroxidase, GPX; superoxide dismutase, SOD) and inflammation (interleukin 1, IL-1; interleukin-6, IL-6; C–reactive protein, CRP) parameters and postoperative pain management in patients surgically treated with laryngeal cancer. (2) Methods: This prospective study included 28 patients with surgically treated laryngeal cancer. Blood samples were taken for the analysis of oxidative stress and inflammation parameters before the operative treatment and after the operative treatment (1st postoperative day and 7th postoperative day). The concentrations of MDA, SOD, GPX, IL-1, IL-6, and CRP in the serum were determined by coated enzyme-linked immunosorbent assay (ELISA). The visual analog scale (VAS) was used for pain assessment. (3) Results and conclusion: There was a correlation between oxidative stress and inflammation biomarkers and postoperative pain modulation in surgically treated patients with laryngeal cancer. Age, more extensive surgery, CRP values, and use of tramadol were predictors for oxidative stress parameters.

Advances in imaging methods and treatment of laryngeal carcinoma

Laryngeal cancer is more common in men. In recent decades, with the development of radiology, in the diagnosis and treatment of laryngeal cancer, in recent years, a series of emerging minimally invasive and even non-invasive techniques have been used for diagnosis and treatment. However, in the treatment of middle and advanced laryngeal cancer, how to ensure the quality of life of patients at the same time, but also effectively improve the quality of life of patients, this problem is still unsolved. This paper summarizes the clinical application of this disease, and makes a preliminary discussion on it, hoping to play a certain guiding role in the treatment of this disease.

A Treatment Decision Support Model for Laryngeal Cancer Based on Bayesian Networks.

The increase in diagnostic and therapeutic procedures in the treatment of oncological diseases, as well as the limited capacity of experts to provide information, necessitates the development of therapy decision support systems (TDSS). We have developed a treatment decision model that integrates available patient information as well as tumor characteristics. They are assessed according to their relevance in evaluating the optimal therapy option. Our treatment model is based on Bayesian networks (BN) which integrate patient-specific data with expert-based implemented causalities to suggest the optimal therapy option and therefore potentially support the decision-making process for treatment of laryngeal carcinoma. To test the reliability of our model, we compared the calculations of our model with the documented therapy from our data set, which contained information on 97 patients with laryngeal carcinoma. Information on 92 patients was used in our analyses and the model suggested the correct treatment in 419 out of 460 treatment modalities (accuracy of 91%). However, unequally distributed clinical data in the test sets revealed weak spots in the model that require revision for future utilization.

Bilateral ocular ischemic syndrome following treatment for laryngeal carcinoma

A 72-year-old male with a history of atherosclerosis and radiation therapy for laryngeal cancer presented with complaints of decreased vision. The exam of the right eye was notable for neovascularization of the iris and significant vaso-occlusive disease of the retina, with non-perfusion of the peripheral retina (Figure 1A). Classical large dot-blot hemorrhages were present in the mid-periphery of left retina consistent with the diagnosis of bilateral Ocular Ischemia Syndrome (OIS) (Figure 1B). Fluorescein angiography demonstrated more severe OIS of the right retina, with global peripheral capillary drop out and optic disc and diffuse vascular leakage (Figure 1C). Far peripheral capillary drop out was seen in the left eye with leaking neovascular vessels near the disc (Figure 1D). CT angiography showed arterial occlusive disease with impairment of carotid artery perfusion of the clinoid segment of the right internal carotid artery on axial CT angiogram, mirroring the severity of retinal ischemia between the two eyes (Figure 2).

S2490 Discovery of Gastric Adenocarcinoma During PEG Tube Placement in Patient With Epiglottic Squamous Cell Carcinoma

Introduction: Multiple primary neoplasms constitute up to 2-17% of cancer diagnoses. Etiological factors such as genetics, lifestyle choices, and immune status have a significant impact on the likelihood of patients developing synchronous multiple primary tumors. The timing of diagnosis for the different cancers has a major impact on disease management, treatment plans, and patient outcomes. We report a patient who was diagnosed with gastric adenocarcinoma at the time of percutaneous endoscopic gastrostomy (PEG) tube placement for dysphagia secondary to squamous cell carcinoma of the anterior epiglottis. Case Description/Methods: A 77-year-old male presented to the outpatient surgery center for upper endoscopy with PEG tube placement. Two months prior, the patient was diagnosed with p16 negative invasive squamous cell carcinoma of the anterior epiglottis. He was referred for PEG tube placement for nutrition supplementation due to 5 months of progressive dysphagia and protein calorie malnutrition with an unintentional weight loss of 50 lbs. Past social history was significant for tobacco dependence with 52 pack years and alcohol dependence. At the time of PEG tube placement, endoscopy revealed a 1.5 cm excavated lesion at the gastric incisura. Biopsy was performed to rule out malignancy. PEG tube was successfully placed. The gastric biopsy was consistent with diffuse type signet ring gastric adenocarcinoma. PET scan 1 month prior to PEG tube placement did not show any foci of abnormal FDG uptake outside of the primary lesion in the epiglottis. Patient is currently undergoing treatment for laryngeal carcinoma with chemotherapy and radiation. Assessment and treatment for gastric cancer diagnosis will be deferred until completion of treatment for laryngeal carcinoma (Figure). Discussion: Concurrent laryngeal and gastric cancer is a unique diagnosis that has not been well reported in the literature. However, given the strong association for both malignancies with chronic alcohol and tobacco use, it is not unreasonable for both to occur in the same patient in an independent manner. The literature has shown that signet ring cell carcinomas have significantly lower 18F-FDG uptake than other forms of gastric cancer. These findings highlight the importance of completing a full endoscopic evaluation in all patients undergoing endoscopy even for procedures as straightforward as PEG tube placement.Figure 1.: Esophagogastroduodenoscopy showing gastric adenocarcinoma at the gastric incisura.

CO2-TOLMS for laryngeal cancer in the elderly, pushing the boundaries of partial laryngectomy

IntroductionCO2 transoral laser microsurgery (CO2-TOLMS) has pushed the indications of partial surgery of the larynx regardless the age of the patient. ObjectiveTo evaluate the complications and the oncologic and functional outcomes of CO2-TOLMS in patients older and younger than 70 years. MethodsRetrospective analysis of 1244 consecutive laryngeal carcinomas treated with CO2-TOLMS. Complications, length of hospitalization, functional and survival outcomes were evaluated. ResultsThe mean age was 64.2 ± 11.1 years (20–96). Four hundred and sixteen patients were older than 70 years and 104 older than 80 years. The main location was the glottis (912), followed by the supraglottis (332). There were no differences in pT classification between the age groups.No differences were observed in voice outcomes. A higher rate of signs of aspiration at the glottic location was observed for those older than 70 years (2.1 % vs 5 %, p = 0.027). The need for definitive gastrostomy in supraglottic tumours was higher in those older than 70 years (0 % vs 6.5 %, p: 0.001). In the glottis, no differences in tracheostomy or gastrostomy rates were observed.Five-year overall survival was lower in the older than 70 years. No differences in disease-specific survival were observed in early stages for both locations, but a lower survival was observed in stage III glottic cancer for the older than 70 years. ConclusionsCO2-TOLMS is a valid treatment for laryngeal carcinomas in the elderly, with a reduced number of complications and good functional and oncologic outcomes.

MiRNA-21-5p Accelerates EMT and Inhibits Apoptosis of Laryngeal Carcinoma via Inhibiting KLF6 Expression.

The incidence of laryngeal carcinoma accounts for 1 to 5% of systemic malignancies and ranks second among head and neck malignancies. Screening more effective targets are meaningful for the treatment of laryngeal carcinoma. The purpose was to research the action of miR-21-5p in the occurrence of laryngeal carcinoma. Genecards combined with g:profiler was used for cluster analysis to predict gene-related miRNAs. Q-PCR assay was performed for measuring the level of miR-21-5p and Kruppel-like factor 6 (KLF6). miR-21-5p-mimic, miR-21-5p-inhibitor and sh-KLF6 were transfected using LipofectamineTM 2000. Both CCK-8 and EdU experiments were undertaken to detect cell proliferation ability. Western blot was used to detect apoptosis and epithelial-mesenchymal transition (EMT) related proteins. Wound healing assay and transwell assay were undertaken for migration and invasion, respectively. Three online software (ENCORI, miRWalk, and miRDB) were applied to screen the downstream of miR-21-5p. At the same time, a dual-luciferase reporter experiment was processed to verify the binding. Finally, a rescue experiment was applied to reveal the mediating role of miR-21-5p and KLF6. MiR-21-5p expressed highly in laryngeal carcinoma tissues and cell lines. Knockdown of miR-21-5p reduced the EMT, while enhancing apoptosis of laryngeal carcinoma cell lines. MiR-21-5p targeted KLF6 with negative relationships. The rescue assay results confirmed that sh-KLF6 rescued the action of miR-21-5p knockdown in developing laryngeal carcinoma cells. MiR-21-5p promotes the occurrence and development of laryngeal cancer by targeting KLF6. This finding may provide new insights into miRNA as a biomarker for diagnosing and treating laryngeal carcinoma in the future.

Brusatol inhibits laryngeal cancer cell proliferation and metastasis via abrogating JAK2/STAT3 signaling mediated epithelial-mesenchymal transition

AimsThis study aimed at investigating the role of Brusatol (BR) on human laryngeal squamous carcinoma cell (Hep-2) to study its underlying mechanism through in vitro and in vivo approaches. Materials and methodIn the present research, we employed various cell-based assays, such as cell proliferation, apoptosis, cell cycle assessment, migration and invasion assays were used to examine the anti-tumor effect of BR on Hep-2 cells. Immunohistochemistry (IHC), qRT-PCR and Western blotting were performed to study the underlying molecular mechanisms. To validate our in vitro findings we used a subcutaneous tumor-bearing model of Balb/c mice with Hep-2 cells of laryngeal carcinoma (LC) to study the inhibitory effect of BR on Hep-2 cells in vivo. Key findingsThe results indicated that BR markedly inhibited the viability, migration and invasion capacity of Hep-2 cells, with no significant toxic effect on normal Human bronchial epithelial cell line (BEAS-2B). Also, BR induced cellular apoptosis by blocking the cells in S phase to suppress cell proliferation. Immunohistochemistry results revealed that BR inhibited the protein expression levels of epithelial-mesenchymal transition (EMT)-related markers. Mechanistically, western blotting results exhibited that BR could suppress the protein expression of both JAK2/STAT3 and their phosphorylation levels. Our in vivo experiments further validated the anti-tumor effect of BR on Hep-2 cells in vitro, where BR suppressed the growth of xenograft laryngeal tumor without apparent toxicity. SignificanceThe present study highlights the anti-LC effect of BR by possibly abrogating JAK2/STAT3 signaling mediated EMT process. BR may be a promising therapeutic candidate for the treatment of LC.

Stainless steel quantum dots and its resonance fluorescence impact as new therapeutic agents for Laryngeal carcinoma treatment: In vitro study

In the present work, the novel stainless-steel grade 304 QDs was synthesized by laser ablation in water to treat Laryngeal carcinoma in vitro, for the first time without an external laser source or magnet for hyperthermia. The characterizations of QDs include absorption, morphology, quantitative analysis by atomic absorption spectrometer, and phase identification. Characterizations of QDs reveal that QDs possess resonance fluorescence property at NIR band and the valence of Chromium (Cr) is + 3. Adding 10 µL of a diluted solution of QDs to the cell culture medium suppresses both cell proliferation & VEGF gene expression significantly, indicating the death of cancer cells. Both the low percentage of QDs and the valence of Cr exclude the toxicity of QDs. The experimental results support to the moment that the most apparent mechanism for cancer death is the heat shock due to NIR resonance fluorescence property of QDs. Also, QDs have the ability to absorb the required energy for excitation from the surrounding environment.

Analiza pojave, mesta i tretmana recidiva karcinoma larinksa

Introduction: The efficacy of the applied model of laryngeal cancer treatment is measured by recurrence. Recurrence significantly reduces survival and determines the type of subsequent treatment. Objective: To determine the incidence of laryngeal cancer recurrence, the location of recurrence, and the definitive treatment of laryngeal cancer recurrence concerning different types of surgical treatments applied. Results: In the period from 2002 to 2017, 844 subjects with primary operated laryngeal squamous cell carcinoma were analyzed. Recurrence developed in 191/844 (22.6%) subjects. The mean recurrence time is 12.6 months. Supraglottic carcinoma is more likely to recur than glottic carcinoma 35.93% / 17.46%, p = 0.000. In N0 necks the recurrence rate is 14.42% and in N + necks it is 45.91, p = 0.000. In more advanced stages of the disease, the number of recurrence increases, p = 0.000. The most common area of recurrence is the neck with 45%, followed by local recurrence with 25.1%. Recurrence most often occurs in subjects with total laryngectomy and partial pharyngectomy, 50%. The most common development of regional recurrence is in the N3 category and extracapsular spread, 72.7%. The definitive treatment of recurrence usually involves radical neck dissection and total laryngectomy. Subjects with recurrence have a significantly lower three-year overall survival compared to those without recurrence, 47.6% / 92.3%, p = 0.000. Conclusion: Recurrence is expected in every fourth patient in the first 36 months following any type of surgical treatment of laryngeal carcinoma. The efficacy of treatment is directly related to recurrence. Recurrence is more common in more advanced stages of disease, extracapsular spread, and present metastases in the neck. Recurrence significantly reduces the overall survival of patients with laryngeal cancer.

Expression levels and clinical significance of miR-203 and miR-133b in laryngeal carcinoma.

The present study aimed to investigate the expression levels and clinical significance of microRNA (miR)-203 and miR-133b in laryngeal carcinoma. A total of 154 patients with laryngeal carcinoma (research group) along with 100 healthy individuals (control group) were enrolled in the study. The patients were admitted to Yidu Central Hospital of Weifang (Weifang, China) from February 2016 to October 2018. Fasting venous blood (5 ml) was extracted from all subjects to determine the expression levels of serum miR-203 and miR-133b by reverse transcription-quantitative polymerase chain reaction (PCR) and to compare them among patients with different pathological characteristics. Receiver operating characteristic (ROC) curves were plotted to analyze the diagnostic values of miR-203 and miR-133b for laryngeal carcinoma. The research group showed significantly lower expression levels of miR-203 and miR-133b than the control group (P<0.05). According to ROC curve analysis, when the cut-off value was 0.659, the sensitivity and specificity of miR-203 in diagnosing laryngeal carcinoma were 60.00 and 90.26%, respectively, whereas when the cut-off value was 1.398, the sensitivity and specificity of miR-133b were 55.00 and 87.66%, respectively. The sensitivity and specificity of the joint detection were 70.00 and 83.77%, respectively, when the cut-off value was 0.416. In the research group, miR-203 was expressed significantly different in patients with different pathological stages and tumor types (P<0.050). The expression of miR-133b varied significantly in patients with different pathological stages, differentiation degrees and lymph node metastasis (P<0.050). In conclusion, miR-203 and miR-133b were expressed at low levels in patients with laryngeal carcinoma. The expression of miR-203 was related to tumor-node-metastasis (TNM) stage and tumor type, whereas the expression of miR-133b was related to TNM stage, differentiation degree, as well as lymph node metastasis. Joint detection of miR-203 and miR-133b is expected to be an excellent marker for the diagnosis and treatment of laryngeal carcinoma.

Involvement of microRNA-124 in biological behaviors of laryngeal carcinoma via PLOD2 signaling pathway.

The purpose of this study was to investigate the role of microRNA-124 (miR-124) in laryngeal carcinoma (LC) and to explore the underlying mechanisms. LC tissues were collected from 98 patients diagnosed with LC in our hospital. Quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) analysis was used to detect the expression levels of miR-124 and procollagen-lysine, 2-oxoglutarate 5-dioxygenase 2 (PLOD2) in LC tissues and cell lines. Bioinformatics (TargetScan and miRDB) and double Luciferase assay were performed to predict and confirm the relationship between PLOD2 and miR-124 in LC, respectively. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) assay and the colony formation assay were designed to measure the proliferation ability of the cells. Additionally, transwell and wound healing assays were used to explore cell migration and invasion. MiR-124 was found significantly downregulated both in LC tissues and cells. PLOD2 was predicted and confirmed as the target gene of miR-124 in LC. By regulating the protein expression of PLOD2, miR-124 could significantly suppress the proliferation, migration, and invasion of cells. However, the transfection of PLOD2 could partially offset the effects of miR-124 on LC cells. MiR-124 was involved in regulating the malignant behaviors of LC cells. Furthermore, the miR-124/PLOD2 axis might become a potential target for the treatment of LC.

Efficacy of non-surgical larynx-preservation comprehensive treatment in advanced laryngeal carcinoma.

Efficacy of non-surgical larynx-preservation comprehensive treatment in advanced laryngeal carcinoma.

Fluorescence imaging-guided multifunctional liposomes for tumor-specific phototherapy for laryngeal carcinoma.

Reliable diagnosis and efficient targeted therapy are important and may lead to the effective treatment of laryngeal carcinoma. Multifunctional nano-theranostic agents demonstrate great potential in tumor theranostic applications. Thus, herein, we report novel targeting multifunctional theranostic nanoparticles, internalized RGD (iRGD)-modified indocyanine green (ICG) encapsulated liposomes (iLIPICG), for imaging-guided photothermal therapy (PTT) and photodynamic therapy (PDT) for the treatment of laryngeal carcinoma. The iRGD-PEG-DSPE lipid endowed iLIPICG with high affinity for tumor vascular targeting, tumor-penetration and tumor cell targeting. The in vivo results showed that iLIPICG exhibited excellent blood circulation and tumor accumulation. iLIPICG could be spatially and temporally controlled, simultaneously producing hyperthermia and reactive oxygen species as well as a fluorescence-guided effect through ICG to ablate laryngeal carcinoma cells under irradiation from an 808 nm laser. iLIPICG generated synergistic photodynamic-photothermal cytotoxicity against Hep-2 cells, resulting in the efficient ablation of laryngeal carcinoma. Thus, the iLIPICG system provides a promising strategy to improve the precision imaging and effective phototherapy for the treatment of laryngeal carcinoma.

Laryngeal Surgery - Malignant Lesions

This article is intended to give an overview of the surgery for laryngeal malignancies and the current state of transoral endoscopic laryngeal surgery. The current therapy concepts in transoral endoscopic laryngeal surgery are presented in combination with the various possibilities of reconstruction. The adequate oncological treatment under functional aspects described plays the decisive role here: treatment goals beyond the cure of the tumor disease are the functional maintenance of the larynx with simultaneous preservation of the voice. In general, the diagnosis and treatment of (pre-) cancerous lesions of the laryngeal mucosa is demanding and requires a great deal of experience of the attending laryngologist. Updated classification systems support level-based categorization. In transoral endoscopic laryngeal surgery, resection using cold instruments and the CO2 laser are currently among the traditional methods, although newer methods such as the angiolytic laser can be used to ablate these lesions. Transoral endoscopic laryngeal surgery is a highly endoscopic-microscopic procedure in (pre-) cancerous lesions, which may presumably continue to evolve from the microlaryngoscopic approach over the next few years due to the introduction of new instruments and high-resolution imaging techniques. Robot-assisted surgery has also found its way into the transoral endoscopic treatment of laryngeal carcinoma. Only in the next few years, however, will it become clear to what extent this technique can supplement, replace or clarify surgical methods, since the individualized surgical strategy currently has a priority position for every single patient.

Comparison of Swallowing Act Videofluoroscopy after Open and Laser Partial Supraglottic Laryngectomy.

The aim of this study was to compare the functional outcomes of swallowing act detected by videofluoroscopy of two different techniques in the treatment of laryngeal carcinoma. This study was conducted on 41 patients undergoing two supraglottic laryngectomy techniques. The research population was assigned into two groups of open and laser supraglottic laryngectomy, including 21 and 20 patients, respectively. Food residue was present in most of the patients in the open laryngectomy group. Aspiration of the liquid and solid contrasts was observed in 16 and 4 patients, respectively. In the laser laryngectomy group undergoing a partial supraglottic laryngectomy via carbon dioxide (CO2) laser, aspiration was recorded in only six patients. There was a statistically significant difference between these two groups regarding the presence of aspiration as a marker of a bad functional outcome. Techniques that include the endoscopic removal of the tumor via CO2 laser result in good oncologic and functional outcomes, along with reduced postoperative morbidity and mortality.

Surgical Treatment of Laryngeal Carcinoma

Theoretical basis: The treatment of laryngeal carcinoma is associated with various operative interventions depending on the distribution of the tumor process. The Aim of the study is to characterize the advantages and disadvantages of various surgical techniques used in the treatment of laryngeal carcinoma. Results: Any surgical procedure that preserves physiological speech and swallowing function without the need for a permanent tracheostomy is defined as organ preservative laryngeal surgery. Open techniques in early laryngeal carcinoma are divided into: vertical partial laryngectomy (frontal-lateral resection) – classically it includes a vertical incision of the thyroid cartilage. The aim is to resect the tumor at the glottic level with part of the thyroid cartilage; supraglottic laryngectomy – is best applied in T1 and T2 supraglottic lesions; supracricoid laryngectomy – is based on the concept that the main functional unit of the larynx is the cricoarytenoid complex, preservation of which is essential for the success of the operation; laser excision of early laryngeal carcinoma. Treatment of advanced carcinoma of the larynx is total laryngectomy with or without dissection cervical lymph nodes. Conclusion: The selection of the appropriate type of surgical intervention that correlates with the spread of the carcinoma is of extreme importance for the outcome of the treatment.