Conservation Laryngeal Surgery: A Critical Analysis

Maceri, Dennis R.; Lampe, H. B.; Makielski, Kathleen H.; Passamani, Peter P.; Krause, Charles J.

doi:10.1001/archotol.1985.00800080047003

Cited by 41 publications

(14 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Conversely, removal of false vocal folds (as is done in some supraglottic laryengectomies) would lead to a reduced ability to phonate. This is inline with the observations of Maceri et al25. Although we have not conducted a study of the onset of phonation, the current results would seem to suggest that the presence of the false vocal folds could also reduce the threshold phonation pressure and removal of false vocal folds could lead to increased required effort for phonation.…”

Section: Resultssupporting

confidence: 92%

“…This implies that for a given pressure across the larynx, the presence of the FVF will result in a larger sound pressure. This observation is in line with the in-vitro study of Alipour et al4, and also confirms the clinical observation that the removal of FVF results in a reduced ability to phonate 25…”

Section: Resultssupporting

confidence: 91%

“…Finally, the effect that FVF have on the flow induced vibration of the true-vocal folds have not been addressed in any of the past studied except for that of Alipour et al4 An understanding of this role is important for a number of reasons. First, a better understanding of FVF function would provide clinicians with useful insights on surgical interventions or other pathologies associated with the false vocal folds25. Second, an understanding of FVF function in phonation can lead to improvements in biomechanical models of the human larynx.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Computational Study of the Effect of False Vocal Folds on Glottal Flow and Vocal Fold Vibration During Phonation

et al. 2009

View full text Add to dashboard Cite

The false vocal folds are believed to be components of the acoustic filter that is responsible for shaping the voice. However, the effects of false vocal folds on the vocal fold vibration and the glottal aerodynamic during phonation remain unclear. This effect has implications for computational modeling of phonation as well as for understanding laryngeal pathologies such as glottal incompetence resulting from unilateral vocal fold paralysis. In this study, a high fidelity, two-dimensional computational model, which combines an immersed boundary method for the airflow and a continuum, finite-element method for the vocal folds, is used to examine the effect of the false vocal folds on flow-induced vibration (FIV) of the true vocal folds and the dynamics of the glottal jet. The model is notionally based on a laryngeal CT scan and employs realistic flow conditions and tissue properties. Results show that the false vocal folds potentially have a significant impact on phonation. The false vocal folds reduce the glottal flow impedance and increase the amplitude as well as the mean glottal jet velocity. The false vocal folds also enhance the intensity of the monopole acoustic sources in the glottis. A mechanism for reduction in flow impedance due to the false vocal folds is proposed.

show abstract

Section: Resultssupporting

confidence: 92%

Section: Resultssupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Computational Study of the Effect of False Vocal Folds on Glottal Flow and Vocal Fold Vibration During Phonation

et al. 2009

View full text Add to dashboard Cite

show abstract

“…3). In summary, 6 studies7, 25, 27, 32, 33, 36 reported a 100% local control rate, and 3 studies9, 19, 30 reported local control rates <60%. The latter studies included a significant proportion of patients who underwent SGL.…”

Section: Resultsmentioning

confidence: 95%

Oncologic outcomes of open conservation laryngectomy for radiorecurrent laryngeal carcinoma

Paleri

Thomas

Basavaiah

et al. 2011

Cancer

View full text Add to dashboard Cite

BACKGROUND:The role of open conservation (partial) laryngeal surgery in radiorecurrent laryngeal cancers is unclear, and the procedure is not widely accepted or practiced. The objective of this review was to assess the oncologic and functional outcomes of partial laryngectomy in radiorecurrent tumors of the larynx reported in the literature. METHODS: The systematic review was performed using independently developed search strategies and included Medline, Embase, Zetoc, conference proceedings, and, when appropriate, a manual search. Inclusion criteria for the articles were set a priori. All included articles were subjected to quality assessment. Pooled estimates of local control at 24 months and of disease-free and overall survival rates were calculated using both a fixed-effects model (inverse square) and a random-effects model (DerSimonian-Laird). RESULTS: The search identified 401 publications, of which 26 studies satisfied all inclusion criteria. Ten studies had a quality score 6 (good), and 16 had a score of 4 or 5 (fair). The pooled estimates of oncologic outcomes using the random-effects model were as follows: The local control rate at 24 months for 560 patients was 86.9% (95% CI, 84%-89.5%), the disease-free survival rate for 352 patients was 91.2% (95% CI, 88.2%-93.9%), and the overall survival rate for 360 patients was 83.1% (95% CI, 79.1%-86.7%). Decannulation of tracheostomy occurred in 95.1% (95% CI, 92.6%-97.2%) of the patients who were analyzed (n ¼ 315), whereas the pooled mean larynx preservation rate was 83.9% (95% CI, 80.7%-87%; n ¼ 502) CONCLUSIONS: The current results indicated that open partial laryngectomies are oncologically sound procedures in the salvage setting and have a high larynx preservation rate. Cancer 2011;117:2668-76. V C 2011 American Cancer Society.KEYWORDS: radiorecurrent cancer, laryngeal cancer, partial laryngectomy, local control, disease-free survival.Residual or recurrent laryngeal cancer is a difficult clinical problem. Although several treatment options exist for patients with laryngeal cancer at first presentation, options for those with recurrent cancer will be limited based on the initial treatment received. For many early cancers, radiation therapy is a widely used treatment that produces good results. Cancers that recur after radiation therapy often demonstrate aggressive behavior, arise in a field where lymphatic drainage is unpredictable, and are associated with poor control rates. Total laryngectomy is an often recommended option, even for early radiorecurrent cancers, because it is technically easy, and the outcomes are predictable. However, total laryngectomy has far-reaching consequences for the patient in terms of function and quality of life.Other less often practiced options include open conservation laryngectomy and transoral laser microsurgical resection. The latter is a relatively recent procedure, and its wide use can be limited by the availability of specialized equipment,

show abstract

“…Parsiyel larenjektomi tekniği ilk oarak 1837 yılında Billroth tarafından uygulanmış ve zaman içinde seçilmiş olgularda larenksi korumanın sağkalımı azaltmadığı gösterilmiştir. Bu bulgular ışı-ğında da uygulama alanı genişlemiştir (3,4). Parsiyel larenjektomide kanserli bölgenin onkolojik kurallara uygun olarak çıkarıl-ması ve geçici bir stoma oluşturulmasını takiben uzun dönemde hastaların ağız yoluyla solunumunu gerçekleştirebilmesi akla gelmektedir ve fonasyon çoğu zaman iyi düzeylere ulaşabilmek-tedir (5)(6)(7)(8).…”

Section: Introductionunclassified

Cost Analysis in Patients Treated with Partial Laryngectomy

Sözen¹,

Uçal²,

Talayhan³

et al. 2013

Turk Arch Otolaryngol

View full text Add to dashboard Cite

Objective: The aim of this study was to conduct a cost analysis in patients treated with partial laryngectomy surgery due to laryngeal carcinoma. Methods:The length of stay, complication rates, decannulation time, time to initiate oral nutrition, costs of examination, medication costs and total cost were assessed by investigating the records and bills of 26 patients with larynx squamous-cell carcinoma treated with frontolateral, supraglottic and supracricoid laryngectomy surgery in the Ear-Nose-Throat Clinic of the Şişli Etfal Research and Training Hospital between January 2007 and December 2011. Results:Frontolateral laryngectomy was performed in 11 of 26 patients, supraglottic laryngectomy was performed in 8 of these patients and supracricoid laryngectomy was performed in 7 of these patients. Complications were observed in one of these 26 patients. When the costs of diagnostic tests/treatments of these three surgical methods were compared, supracricoid laryngectomy was found to be the most expensive method (p<0.05). Drug costs in this set of patients were significantly higher than in the frontolateral and supraglottic laryngectomy group (p<0.05). The total cost of the supracricoid laryngectomy group was significantly higher than that of the supraglottic and frontolateral laryngectomy group (p<0.05). Length of stay in the supracricoid laryngectomy group was significantly higher than that of the frontolateral and supraglottic laryngectomy group (p<0.05). In terms of decannulation times, although there was no significant difference between the supracricoid and supraglottic laryngectomy groups, the decannulation time was significantly lower in the frontolateral laryngectomy group (p<0.05). While the initiation time of oral nutrition was longest in the supracricoid and supraglottic laryngectomy groups, there was no significant difference between them. The initiation time of oral nutrition was significantly lower in the frontolateral laryngectomy group (p<0.05). Conclusion:The length of stay following partial laryngectomy due to squamous-cell carcinoma of the larynx can be prolonged due to the longer decannulation time and the longer initiation time of oral nutrition. To overcome these problems, particularly in supracricoid laryngectomy, action to prevent complications and precautions that can be taken during surgery will seriously reduce costs.Key Words: Laryngeal carcinoma, partial laryngectomy, cost analysis, functional results Amaç:Larenks karsinomu nedeniyle parsiyel larenjektomi operasyonu uygulanan hastalar değerlendirerek maliyet analizinin ve maliyete etken olan faktörlerin karşılaştırılması amaçlandı.Yöntemler: Ocak 2007 ile Aralık 2011 tarihleri arasında larenks skuamoz hücreli karsinomu tanısı konan ve frontolateral, supraglottik ve suprakrikoid larenjektomi operasyonu uygulanan 26 hastanın dosya kayıtları ve faturaları incelenerek hastanede yatış süreleri, komplikasyon oranları, dekanülasyon ve oral beslenmeye geçiş süreleri ile tetkik-tedavi, ilaç ve toplam maliyetleri değerlendirildi. Bulgular: Yirmi ...

show abstract

Conservation Laryngeal Surgery: A Critical Analysis

Cited by 41 publications

References 13 publications

A Computational Study of the Effect of False Vocal Folds on Glottal Flow and Vocal Fold Vibration During Phonation

A Computational Study of the Effect of False Vocal Folds on Glottal Flow and Vocal Fold Vibration During Phonation

Oncologic outcomes of open conservation laryngectomy for radiorecurrent laryngeal carcinoma

Cost Analysis in Patients Treated with Partial Laryngectomy

Contact Info

Product

Resources

About