Factors responsible for the development of carbon granuloma post transoral laser cordectomy

Nerurkar, Nupur Kapoor; Shah, Ruchi

doi:10.1007/s10103-019-02726-3

Cited by 3 publications

(7 citation statements)

References 18 publications

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“…With the increase in the range of cordectomy, the incidence of TG is also significantly increased. Therefore, it is necessary to investigate ways to reduce the incidence and severity of postoperative TG [ 8 , 15 ]. Like TLM, the coblation-assisted endoscopic cordectomy or TCM used in our study is also based on thermal damage, whose working temperature is 40°C-70°C, much lower than laser's working temperature which is 800°C-1000°C, and as a result, its healing process and the mechanism of TG formation are also similar to those of TLM.…”

Section: Discussionmentioning

confidence: 99%

“…Like TLM, the coblation-assisted endoscopic cordectomy or TCM used in our study is also based on thermal damage, whose working temperature is 40°C-70°C, much lower than laser's working temperature which is 800°C-1000°C, and as a result, its healing process and the mechanism of TG formation are also similar to those of TLM. Current literature indicates that reflux may be an important factor in the occurrence of postoperative TG [ 8 , 13 – 15 ]. Therefore, we aimed to investigate whether antiacid therapy could reduce TG through an analysis of the effects of PPI treatment in patients who underwent type IV-VI cordectomy, which has rarely been reported.…”

Section: Discussionmentioning

confidence: 99%

“…Enlarged wounds and damage to the perichondrium or cartilage may lead to increased TG and chondronecrosis. Nerurkar and Shah reported that the incidence of TG in patients who have undergone type IV TLM was 100%, and the study by Wang et al showed that the incidences of TG in patients who have undergone type IV and type V TLM were 78.6% and 80.0%, respectively [ 12 , 15 ]. Meanwhile, the incidence of chondronecrosis was not rare (1.02%), especially on whom the surgeon had to expose the thyroid cartilage during tumor resection in TLM [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Reflux is an important factor that affects granuloma formation. Proton pump inhibitors (PPI) are often used empirically in the treatment of patients with postoperative granulomas [ 8 , 12 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…This can sometimes be very severe, even requiring temporary tracheotomy to alleviate dyspnea, which greatly and adversely impacts patients' quality of life. PPIs have been empirically used for the treatment of patients with postoperative granuloma, and evidence of its effectiveness has been published [ 15 ]. However, there has not been any research on the prevention of postoperative granuloma formation with PPIs.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Antiacid Therapy on Granuloma after Transoral Type IV-VI Cordectomy in Patients with Early-Stage Glottic Cancer

Jin

Wang

2020

BioMed Research International

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Objective. To investigate whether preventive administration of a proton pump inhibitor (PPI) can reduce the occurrence and development of traumatic granuloma (TG) following type IV-VI cordectomy. Methods. We retrospectively analyzed the status of postoperative granulomas in 37 patients who underwent type IV-VI cordectomy due to glottic cancer and determined whether postoperative administration of a PPI had any impact on granuloma formation and development. Results. The percentage and number of patients with granuloma in the PPI treatment group (experimental group) at the 1st, 2nd, 3rd, and 6th month following surgery were 81.25% (13/16), 25.00% (4/16), 18.75% (3/16), and 0.00% (0/16), respectively. The percentage and number of patients with granuloma in the no-PPI group (control group) were 95.24% (20/21), 71.43% (15/21), 52.38% (11/21), and 14.29% (3/21), respectively. The granuloma percentage of the PPI treatment group was lower than that of the control group at all postoperative time points assessed. The differences were not statistically significant at the 1st month (p=0.175) but were statistically significant at the 2nd and 3rd months after surgery (p=0.005, p=0.037). Conclusion. Preventive use of a PPI in patients after type IV-VI cordectomy can shorten the TG recovery duration and may reduce the severity of TG, but it cannot prevent TG from occurring. Our results should be confirmed by prospective randomized controlled trials with large sample sizes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of Antiacid Therapy on Granuloma after Transoral Type IV-VI Cordectomy in Patients with Early-Stage Glottic Cancer

Jin

Wang

2020

BioMed Research International

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Healing after transoral carbon dioxide laser surgery for early glottic cancer

Jabbour

Tracy

et al. 2022

J. Laryngol. Otol.

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Objective This study aimed to evaluate the clinical significance of granulation tissue after endoscopic carbon dioxide laser surgery for glottic cancer. Method This was a retrospective review of 36 patients who underwent endoscopic carbon dioxide laser surgery for T1 and T2 glottic cancer. Post-operative, endoscopic examinations were rated by three blinded otolaryngologists for time to heal and presence of granulation. Patient and surgical factors were compared with time to heal and granulation. Results A total of 16 of 36 wounds (44 per cent) developed granulation tissue, and 24 wounds (67 per cent) healed without requiring surgical intervention. A total of 7 of 8 wounds biopsied more than 3.5 months after surgery had persistent cancer versus 1 of 4 wounds biopsied at equal to or less than 3.5 months (85.7 per cent vs 25 per cent; p = 0.03). Biopsy at more than 3.5 months was associated with 28-fold increased odds of cancer in biopsy compared with biopsy at equal to or less than 3.5 months (odds ratio, 28.0; 95 per cent confidence interval, 1.088–373.3). Conclusion After carbon dioxide laser surgery for glottic cancer, development of granulation tissue is common. Granulation that persists for more than 3.5 months necessitates biopsy because of increased risk of persistent cancer.

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Can pepsin immunohistochemical staining of laryngeal lesions accurately diagnose non-acid laryngeal reflux?

Wang

Zhao

et al. 2023

Acta Oto-Laryngologica

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Factors responsible for the development of carbon granuloma post transoral laser cordectomy

Cited by 3 publications

References 18 publications

Effects of Antiacid Therapy on Granuloma after Transoral Type IV-VI Cordectomy in Patients with Early-Stage Glottic Cancer

Effects of Antiacid Therapy on Granuloma after Transoral Type IV-VI Cordectomy in Patients with Early-Stage Glottic Cancer

Healing after transoral carbon dioxide laser surgery for early glottic cancer

Can pepsin immunohistochemical staining of laryngeal lesions accurately diagnose non-acid laryngeal reflux?

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