Phonatory results after laser surgery for glottic carcinoma

Sittel, Christian; Eckel, H. E.; Eschenburg, Claudia

doi:10.1016/s0194-5998(98)70093-2

Cited by 62 publications

(50 citation statements)

References 17 publications

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“…Sittel et al [27] assessed phonatory results after laser surgery for glottic carcinoma in a group who had speech therapy after surgery (n = 33) and another group who did not have such therapy (n = 47). None of the parameters (phonetogram, rating of the communication ability by 2 speech therapists and a trained otolaryngologist) differed significantly between both groups.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Functional Outcome after Unilateral Cordectomy

Keilmann¹,

Napiontek²,

Engel³

et al. 2010

ORL

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Purpose of the Study: Our aim was to longitudinally analyze the vocal outcome after endoscopic CO₂ laser resection of early glottic carcinoma. Procedures: Sixteen patients treated with laser surgery for T1 or T2 tumors of the vocal cords received voice therapy and were examined 1, 2, 3, 4.5, 6 and 12 months postoperatively. Besides videolaryngostroboscopy, each examination included history, phonetogram of the speaking and the singing voice, language-specific hoarseness diagram and a questionnaire (Voice Handicap Index 12 in German). Results: Objective parameters demonstrated a broad variability with a slight tendency of improvement over time. For the maximal phonation time a nearly constant improvement was seen. After an initial improvement deterioration for subjective assessment in the Voice Handicap Index was noted in most patients 3–6 months postoperatively. Conclusions: The functional outcome after cordectomy is variable. Message of the Paper: Discrepancies between objective findings and patient satisfaction over time have to be considered after cordectomy.

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Section: Discussionmentioning

confidence: 99%

Long-Term Functional Outcome after Unilateral Cordectomy

Keilmann¹,

Napiontek²,

Engel³

et al. 2010

ORL

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“…9 Isso permite um aumento das indicações para a realização de cirurgias de lesões benignas de pregas vocais com laser de CO 2 . 16,17,19,20 CONCLUSÃO O laser de CO 2 é o laser mais utilizado em cirurgias de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço. As novas tecnologias do laser, como a diminuição do "microspot" e o uso de superpulso, têm aumentado as indicações de seu uso para serem usadas também em lesões benignas de pregas vocais, respeitando as técnicas microcirúrgicas.…”

Section: Discussionunclassified

“…[13][14][15][16] O uso do laser de CO 2 para tratamento de lesões benignas de pregas vocais depende de casos devidamente selecionados e da experiência do cirurgião com a moderna tecnologia. [17][18][19][20] O laser de CO 2 com o microspot é efetivo e seguro, quando usado apropriadamente em níveis intermitentes baixos, para remover lesões laríngeas benignas. Instrumentos microlaríngeos refinados podem prover resultados equivalentes quando usados em lesões pedunculadas pequenas, tais como nódulos.…”

Section: Introductionunclassified

Estudo comparativo histológico na prega vocal após incisão com instrumental a frio e com laser de CO2 em modelo animal

Santos¹,

Grellet

Aguilar

et al. 2003

Rev. Bras. Otorrinolaringol.

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Dent re os vários tipos de laser usados em Medicina, o laser de CO 2 é o mais usado na Otorrinolaringologia e Cirurgia de Cabeça e Pescoço. As vantagens de seu uso são a diminuição do sangramento, a diminuição do edema no pós-operatório e a facilidade de acesso ao campo operatório, entre outras. Desde os trabalhos de Jako e Strong em 1972 1,2 , quando o laser de CO 2 passou a ser usado no tratamento de papilomatose laríngea e de lesões malignas glóticas iniciais, suas indicações têm aumetado, principalmente em lesões benignas, a partir da alta tecnologia desenvolvida dos últimos anos como, por exemplo, a diminuição do microspot e o uso do superpulso, reduzindo conseqüentemente seu efeito térmico sobre os tecidos. Métodos: Neste trabalho foram realizadas incisões com instrumental a frio e com laser de CO 2 1 watt de modo contínuo e superpulso, em pregas vocais caninas e observado, através de cortes histológicos corados pelo método de Sirius Red, a quantidade de colágeno depositada sobre as mesmas. Resultados: A quantidade de colágeno das pregas vocais foi maior do que no grupo controle, e estatisticamente maior no grupo de animais submetidos a procedimentos com instrumental a frio do que com laser de CO 2 . Não houve diferença estatística entre o grupo controle e o grupo submetido a incisões com instrumentos a frio. Conclusão: A microcirurgia de laringe com o laser de CO 2 , quando este é usado em baixa potência, com pequeno "microspot" e com superpulso, é um método seguro em relação à deposição de colágeno, quando comparado com instrumentos com lâmina a frio, obedecendo os princípios da fonomicrocirurgia. Among the several types of lasers employed in medicine today, the CO 2 is the most widely used in otorhinolaryngology and head and neck surgeries. The advantages of its use are: the reduction in bleeding, reduction in post-operative edema and the easy access to the operation site, among others. Ever since Jako and Strong's works in 1972 1,2 , when CO 2 was first applied in the treatment of papilomatosis and early glottic malign lesions, its indications have risen, most especially in benign lesions, due to new technology developed over the last years as, for example, the reduction of microspot and the superpulse, reducing the thermal effects on the tissues. Methods: In this work, incisions with cold steel instruments and 1watt continuous mode and super-pulse CO 2 laser were conducted on canine vocal folds. The amount of collagen deposited over the vocal folds was observed through histological exams using the Sirius Red method. Results: The amount of collagen on the vocal folds was greater than the control group and statistically greater in the group of animals submitted to surgical procedures using cold instruments than procedures involving CO 2 . There was no statistical difference between the control group and the group submitted to incisions with cold steel instruments. Conclusions:The larynx surgery with CO 2 laser, when employed in low potency, with small microspot and superpulse, is a safe method in relati...

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“…Deglutition seems to be less disturbed than after horizontal partial laryngectomy, and vocal function is usually satisfactory or good [7,8,19,20]. As compared with radiation therapy, TLS is faster accomplished for the patient and is obviously more cost effective.…”

Section: Discussionmentioning

confidence: 99%

Current Status of Endoscopic Laser Surgery in Head and Neck Surgical Oncology

Eckel¹

2002

Otorhinolaryngol Nova

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This review of the Cologne University Medical School experience with oncological laser surgery evaluates the potential role of transoral laser surgery for oral, oropharyngeal, laryngeal and hypopharyngeal carcinoma by reporting the treatment modalities and results in large, unselected cohorts of consecutive patients from a university-based referral center that prefers transoral laser surgery over open surgical approaches for all head and neck cancer cases if such an approach is considered feasible and oncologically sound by the contributing surgeons at our department. It seeks to determine the proportion of all oncological cases that can be managed using a transoral approach and to describe survival, local control and organ preservation rates with endoscopic CO₂ laser surgery. The data presented in this study suggest that transoral laser surgery is no longer a treatment modality that should be restricted to highly selected patients, but may well become a major treatment option for most infiltrating laryngeal and oral carcinomas, for important subgroups of pharyngeal cancer, and for practically all carcinomas in situ and verrucous carcinoma. Additional treatment options are required for the neck if suspect lymph nodes are detectable at the time of primary treatment or if the neck is considered to be at risk for regional metastases. In light of the recent literature on treatment modalities for head and neck carcinoma, the future may bring new roles for surgery and radiotherapy: organ-sparing surgery, including transoral laser surgery, may become a more widespread approach to early-stage disease, while organ preservation programs based on sequential or concomitant chemotherapy and radiotherapy may replace surgery as the most important treatment modality in advanced but resectables stages.

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Phonatory results after laser surgery for glottic carcinoma

Cited by 62 publications

References 17 publications

Long-Term Functional Outcome after Unilateral Cordectomy

Long-Term Functional Outcome after Unilateral Cordectomy

Estudo comparativo histológico na prega vocal após incisão com instrumental a frio e com laser de CO2 em modelo animal

Current Status of Endoscopic Laser Surgery in Head and Neck Surgical Oncology

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