Could laser‐assisted dissection of the pre‐epiglottic space affect functional outcome after ESL?

Bertolin, Andy; Lionello, Marco; Russo, Simone; Rizzotto, Giuseppe; Lucioni, Marco

doi:10.1002/lary.26961

Cited by 6 publications

(3 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…21,22 Regarding functional outcomes, Bertolin et al, found worse results in patients undergoing endoscopic epiglottis and PES resection compared to patients undergoing the same resection by open approach reported to the increase in the sphincter capacity potentially obtained by a compensatory effect of the laryngopexy performed in open surgery, advocating for the authors for open surgery in every case requiring resection of the epiglottis and the PES. 23 In elderly patients over 65 years old specifically, Chiesa Estomba et al reported postoperative rates of aspiration pneumonia of 20% after open surgery and of 41.2% after TLM in supraglottic carcinoma, albeit difference was not statistically significant and the rates of dysphagia were similar, 30% versus 29.4%, respectively. 9 Together with our results, these findings argue for considering a transoral procedure rather than an open procedure for a tumor smaller than thirty millimeters when local exposition is favorable and no local extension associated with a risk of decreased local control after a transoral is suspected.…”

Section: Discussionmentioning

confidence: 97%

“…Although TLM has been reported to be associated with similar survival in intermediate‐size tumors, our local preferences for OPHL type I were based on the goals of optimizing local control and laryngeal preservation 21,22 . Regarding functional outcomes, Bertolin et al, found worse results in patients undergoing endoscopic epiglottis and PES resection compared to patients undergoing the same resection by open approach reported to the increase in the sphincter capacity potentially obtained by a compensatory effect of the laryngopexy performed in open surgery, advocating for the authors for open surgery in every case requiring resection of the epiglottis and the PES 23 . In elderly patients over 65 years old specifically, Chiesa Estomba et al reported postoperative rates of aspiration pneumonia of 20% after open surgery and of 41.2% after TLM in supraglottic carcinoma, albeit difference was not statistically significant and the rates of dysphagia were similar, 30% versus 29.4%, respectively 9 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic Features in Intermediate‐Size Supraglottic Tumors Treated With Open Supraglottic Laryngectomy

et al. 2021

View full text Add to dashboard Cite

Objectives/Hypothesis: We investigated growth patterns and pathological features in intermediate-size laryngeal carcinoma amenable to supraglottic laryngectomy.Study design: Retrospective cohort study. Methods: We reviewed patients who underwent an open partial horizontal laryngectomy (OPHL) type I. We analyzed pathological data, tumor sizes, overall survival, disease-specific survival, local control, and laryngeal preservation. Results were stratified between three groups: group I comprised patients with endolaryngeal carcinoma, group II comprised patients with anterior epilaryngeal carcinoma who underwent an OPHL type I + base of tongue (BOT), group III comprised patients with lateral epilaryngeal carcinoma who underwent an OPHL type I + pyriform sinus (PIR).Results: Sixty-eight patients were analyzed. The 5-year rates of overall survival, disease-specific survival, local control, and laryngeal preservation were 68.4%, 83.7%, 91.6%, and 98.3%, respectively. The tumor sizes at pathological examination were similar between the three groups (mean 27 mm, P = .80) and were associated with pathological features, notably preepiglottic space (PES) invasion (24.9 mm vs. 32.2 mm, P = .01), occult invaded lymph nodes (22.6 mm vs. 29.9 mm, P = .03), and trends for margins status (26.5 mm vs. 29.3 mm, P = .45). The risks of PES invasion, occult lymph nodes, and positive margins, respectively, predominated in group I (41.7%), group II (56.3%), and group III (23.3%). Conclusion:In intermediate-size tumors amenable to supraglottic laryngectomy, pathological features are associated with tumor size according to group stratification based on tumor location.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Prognostic Features in Intermediate‐Size Supraglottic Tumors Treated With Open Supraglottic Laryngectomy

et al. 2021

View full text Add to dashboard Cite

show abstract

“…ESL generally allows for shorter time for swallowing recovery, reduced tracheostomy maintenance, and lower incidence of aspiration pneumonia ( 18 ) because of the complete preservation of the sensation of the vestibule and hypopharynx by sparing the superior laryngeal nerve in the majority of the cases, of the accessory muscles that normally contribute to the craniocaudal movements of the larynx, and of an effective cough reflex that may prevent severe problems ( 4 , 23 , 24 ). However, major dysfunction after ESL, such as permanent tracheostomy and/or PEG, have been reported in the literature (Table 7 ) ( 1 , 5 , 6 , 14 , 25 , 26 ). In the present series, we did not perform any PEG, and all tracheostomies were removed within 1 month from surgery.…”

Section: Discussionmentioning

confidence: 99%

CO2 Transoral Microsurgery for Supraglottic Squamous Cell Carcinoma

et al. 2018

View full text Add to dashboard Cite

The present study analyzed the results of the endoscopic approach to T1, T2 and selected T3 supraglottic carcinoma with the aim of reviewing functional and oncologic outcomes after different types of endoscopic supraglottic laryngectomies. This is a retrospective clinical study of 42 consecutive patients (mean age of 61.8 years, 33 males, 9 females) treated by the senior author for supraglottic squamous cell carcinoma with a transoral CO2 laser approach and reviewed from November 2010 to September 2017. Surgical procedures were classified according to the European Laryngological Society. In addition to the standardized transoral supraglottic laryngectomies, we introduced a modified type IVb by sparing the inferior third of the arytenoid if not directly involved in the tumor. Swallowing was evaluated with the Swallowing Performance Status Scale reported by the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology. Survival probabilities were estimated using Kaplan-Meier curves. Two type I, 2 type IIa, 2 type IIb, 3 type IIIa, 12 type IIIb, 13 type IVa, 3 type modified IVb, and 5 type IVb supraglottic laryngectomies were performed. Twenty-one patients (50%) underwent primary neck dissection. The pathologic TNM classification according to the 8th edition of the American Joint Committee on Cancer system was as follows: 9 pT1cN0, 2 pT1N0, 1 pT1N1, 7 pT2cN0, 1 rypT2cN0, 9 pT2N0, 4 pT2N1, 2 ypT2N1, 2 pT3cN0, 2 rypT3cN0, 1 pT3N1, and 2 pT3N2b. Mean follow-up was 3.4 years (range of 9 months to 6 years). According to the Kaplan–Meier analysis, 5-year disease-specific survival, local-relapse-free survival, nodal-relapse-free survival, overall laryngeal preservation and overall survival of patients without previous head and neck radiotherapy/open surgery were 100%, 95.2%, 87.8%, 100%, and 64.6%, respectively. Patients who underwent type I, IIa, and IIb resections (n = 6) started oral feeding the day after surgery, patients who underwent type III-IVb modified resections (n = 31) started oral feeding 3–4 days after surgery, and patients who underwent standard type 4b resections (n = 5) started oral feeding 7 days after surgery. Three months after surgery, patients without a clinical history of previous head and neck radiotherapy/open surgery who underwent type III, IVa, and modified IVb resections showed significantly better swallowing compared to patients who underwent standard type IVb resection: grade 4–6 impairment of swallowing in 8 and 66.7% of cases, respectively (p = 0.006072); patients with a clinical history of previous head and neck radiotherapy/open surgery who underwent type III, IVa, and modified IVb resections showed not statistically significant better swallowing compared to patients who underwent standard type IVb resection: grade 4–6 impairment of swallowing at 3 months in 16.7% and 50% of cases, respectively (p = 0.23568). Transoral CO2 laser supraglottic laryngectomy is an oncologic sound alternative to traditional open neck surgery and chemo-radiotherapy. Recovery o...

show abstract

Relationship between dysphagia and surgical treatment for supraglottic laryngeal carcinoma: A meta-analysis

Yin

Guo

et al. 2023

American Journal of Otolaryngology

View full text Add to dashboard Cite

Could laser‐assisted dissection of the pre‐epiglottic space affect functional outcome after ESL?

Abstract: 4. Laryngoscope, 128:1371-1378, 2018.

Cited by 6 publications

References 19 publications

Prognostic Features in Intermediate‐Size Supraglottic Tumors Treated With Open Supraglottic Laryngectomy

Prognostic Features in Intermediate‐Size Supraglottic Tumors Treated With Open Supraglottic Laryngectomy

CO2 Transoral Microsurgery for Supraglottic Squamous Cell Carcinoma

Relationship between dysphagia and surgical treatment for supraglottic laryngeal carcinoma: A meta-analysis

Contact Info

Product

Resources

About