Introduction: The impact of advanced laryngeal cancer and its extensive surgical treatments cause significant morbidity for these patients. Total laryngectomy impacts essential functions such as breathing, communication and swallowing, and may influence the quality of life as well as affecting the social life of laryngeal cancer patients. Objective: Describe the quality of life and analyze the factors associated with the reduced quality of life in patients who have undergone total laryngectomy. Method: Observational cross-sectional study was carried out to evaluate the quality of life of patients who had undergone total laryngectomy due to laryngeal cancer. The fourth version of the UW-QOL Quality of Life Assessment Questionnaire from Washington University, validated for Portuguese, was used. Results: The study population was 95 patients, and the mean composite score of the QOL was 80.4. In the subjective domains the majority of the patients (38.9%) reported they felt much better at present compared to the month before being diagnosed with cancer. When questioned about how they evaluated their health-related quality of life, there was a predominance of those who considered it good (43.2%), and most considered they had a good quality of life (46.3%) considering personal well-being. The overall quality of life was considered good to excellent by 83.2% of the patients. Patients with tracheoesophageal prosthesis reported a better quality of life, compared to patients using an electrolarynx or esophageal voice. Conclusion: The high mean value of the composite score for quality of life revealed that the patients assessed their quality of life positively. The absence of vocal emission was the only variable associated with a lower quality of life within the composite score according to the UW-QOL questionnaire.

Introdução: A laringectomia parcial supratraqueal (LPST) é uma alternativa atual de intervenção cirúrgica, indicada para o tratamento de tumor laríngeo intermediário / avançado. Quando sua ressecção é mais ampla do que previsto, acrescentamos à nomenclatura o termo “extendida”. Sua reconstrução é feita por uma traqueohioidoepiglotopexia (THEP). As principais complicações conhecidas deste procedimento estão relacionadas à deglutição e respiração. Objetivo: Caracterizar a população selecionada e avaliar aspectos funcionais da deglutição na LPST extendida em reconstrução THEP. Método: Estudo observacional de corte transversal de pacientes de ambos os sexos com neoplasia de laringe submetidos à LPST extendida THEP de um hospital oncológico entre 1995 a 2017. Realizou-se estudo de prontuário, consulta ao sistema cirúrgico, videofluoroscopia da deglutição e aplicação da escala National Outcomes Measurement System da American Speech-Language Hearing Association (ASHA NOMS). Resultados: 10 homens, idade entre 52 e 83 anos (mediana 69), 80% tabagistas e etilistas ao diagnóstico; T2 [70%], T3 [30%]. Resultados da videofluoroscopia da deglutição: 100% de estase em base da língua, 80% em valécula, aritenóide(s) e recessos piriformes, 40% em esfíncter esofágico superior e 30% em parede posterior da faringe; 30% apresentou aspiração. Todos apresentaram alimentação e hidratação exclusiva por via oral. Conclusão: Indivíduos homens, majoritariamente idosos, etilistas e tabagistas com estadiamentos intermediários e avançados. Todos possuíam capacidade de nutrição e hidratação sem vias alternativas de alimentação. A função de deglutição foi satisfatoriamente restaurada com atendimento fonoaudiológico especializado em todos os momentos do tratamento. Os pacientes com mais de nove meses de cirurgia apresentaram melhores resultados funcionais.

Pizzorni N, Schindler A, Castellari M, Fantini M, Crosetti E, Succo G. Swallowing safety and efficiency after open partial horizontal laryngectomy: a videofluoroscopic study. Cancers. 2019;11(4):549.

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In this study, we have analyzed the specific contribution of the cortical radial glia (RG) for gap junctional communication (GJC) within the postnatal subventricular zone (SVZ). To specifically target RG as source of dye-coupling in situ, we have developed a new technique that involves direct cell loading through the processes that reach the pial surface, with a mix of gap junction permeant (Lucifer yellow, LY) and nonpermeant (rhodamine-conjugated dextran 3 KDa, RD) fluorochromes, the latter used as a marker for direct loaded cells. Tissue sections were analyzed for identification of directly loaded (LY+RD+) and coupled cells (LY+RD-) in the SVZ. Directly loaded cells were restricted to the region underlying the pial loading surface area. Coupled cells were distributed in a bistratified manner, along the outer dorsal surface of the SVZ and aligning the ventricle, leaving the SVZ core relatively free. Blocking GJC prior to pial loading greatly reduced dye coupling. Phenotypic analysis indicated that coupling by RG excludes neuroblasts and is mostly restricted to cells of glial lineage. Notwithstanding, no corresponding restriction to specific cell phenotype was found for two connexin isotypes, Cx43 and Cx45, in the postnatal SVZ. The extensive homocellular cell coupling by RG suggests an important role in the regulation of neurogenesis and functional compartmentalization of the postnatal SVZ.