Objective:The aim of the presented study was to evaluate the outcomes of open partial laryngectomy (OPL) versus transoral laser surgery (TLS) in patients operated on for supraglottic laryngeal carcinoma based on functional parameters (duration of hospitalization, oral nutritional status and duration of transition to oral feeding, weaning status and duration after tracheotomy, and postoperative voice results) and oncological results (overall survival rate, disease-specific survival rate, recurrence, and presence of second primary tumors) in both groups. Methods: All laryngeal carcinoma patients who had undergone either OPL or TLS in the period from January 2012 to March 2017 in our center and were followed-up at least for 36 months were included in the study. Statistical analyses were carried out using the t-test and the Mann-Whitney U test to compare the means, and the Kaplan-Meier test for survival analysis. Results: Fifty patients (44 males and 6 females) met the study criteria, of whom 31 had undergone OPL and 19 TLS. Patients that underwent TLS had less tracheotomy needs, needed shorter hospitalization periods, and transitioned to oral feeding earlier, compared to those that underwent OPL. There were no significant differences between the two groups based on oral feeding rates and voice outcomes. The impact of TLS and OPL on organ preservation in supraglottic laryngeal cancer were comparable. For local recurrences, repeated endolaryngeal laser surgeries and adjuvant treatments could be used in the TLS patient group. There were no significant differences between the two groups based on overall survival rate and disease specific survival rate.
Conclusion:Although no significant differences were found in our study between the two surgical procedures in terms of oncological outcomes, TLS appeared to produce better functional outcomes in supraglottic laryngeal carcinoma than OPL.
Tonsil cancers account for 0,3% of all cancers and 6,7% of head and neck cancers. However, metastasis to tonsil is extremely rare. The kidney, skin, lung and breast are most common sites of primary tumor. Different histological types of lung cancer can metastase to tonsil. We present a case with left tonsil metastasis of lung adenocarcinoma. The most important point with our case is that the patient had his complaints for 1 year and received irrelevant treatments. As in our case, tonsil neoplasms may present with peritonsillar abscess. However, patients with history of cancer and prolonged complaints need a thorough evaluation of suspicious tonsil enlargement. Metastases may be synchronous with the lung tumor or may be observed before or after the treatment of primary tumor. Careful examination and radiological evaluation are very important in cancer patients; and biopsy must be performed in all cases with clinical suspicion.
Objectives: To assess the feasibility of using Image1 S™ endoscopic
enhancement system for discrimination of the vascular patterns in
laryngeal lesions. Design: Forty patients presenting with benign,
dysplastic and malign laryngeal lesions were examined with Image1 S
system. The vascular patterns were classified by a group of the authors/
according to the ELS guideline, as perpendicular or longitudinal, in all
lesions. Endoscopic images of the vascular patterns are evaluated
through an online survey by a group of otolaryngologists with different
levels of clinical expertise. The qualitative evaluation of the vascular
patterns in two groups were compared to investigate the consistency. The
relationship between the vascular patterns and the pathological results
was statistically analyzed. Results: Eleven patient presented with
benign, 13 patients with dysplastic and 16 patients with malignant
pathology. The vascular patterns were longitudinal in 9 lesions,
perpendicular in 28 lesions and undetectable in 3 lesions. The relevance
between the vascularization pattern and the pathological diagnosis was
found to be significant (χ2= 20.30, p < 0,001). The
qualitative evaluation of the vascular patterns by the two groups of
observers was significantly close to each other (=0.63). The survey also
showed that spectral modes producing high contrast images were preferred
by 81,9% of the participants over white light images. Conclusion: This
study demonstrated the usefulness and feasibility of Image1 S endoscopic
enhancement system to predict the diagnosis from vascular changes in
laryngeal lesions.
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