Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “LARYNGECTOMY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 217 records · Page 12Linked to original sources
PubMed2003

[Study of the causes of recurrence of patients with glottic cancer after partial laryngectomy].

OBJECTIVE: To study the causes of recurrence of patients with glottic cancer after partial laryngectomy and to propose some possible measures for the prevention of glottic cancer postoperative recurrence. METHOD: A retrospective review of consecutive 46 patients with recurrent glottic cancer after partial laryngectomy was conducted. The sites of primary tumors, the ways of operations and the sites of tumor recurrence were investigated. RESULT: Among 46 patients diagnosed with glottic cancer recurrence after partial laryngectomy, 32 cases were local recurrences and 14 were regional metastasis or local-regional recurrences. 13 cases of the second primary lesions in larynx were the cause of the failure and occupied 40.6% of all cases of local recurrences (13/32). In the regional metastasis, the commonest recurrent site was encountered in the upper neck. The upper neck metastasis or local recurrences were common in local recurrent cases treated by salvage surgery. CONCLUSION: It is very important for the prevention of glottic cancer recurrence after partial laryngectomy to properly manage the upper cervical lymph node in the advanced glottic cancers and the local recurrences in larynx and to know the relation of the postoperative recurrence of glottic cancer and the second primary lesions in larynx and carry out corresponding management.

Adult↗
PubMed2003

[Adjuvant radiotherapy of the neck lymph modes in patients after partial laryngectomies].

Adjuvant radiotherapy after partial laryngectomy is still controversial mainly due to high level morbidities which may occur in the irradiated larynx. The aim of this study was to evaluate the results (locoregional control) and toxicities (acute and late) of combined treatment. Between 1996 and 2001 the group of 14 patients (12 men, 2 women), aged less than 60 years, Karnofsky scale > 70, were investigated retrospectively. The following surgical procedures were carried out: cricohyoidopexy (CHP) and cricohyoidoepiglottopexy (CHEP) in 9 out of 14 patients, horizontal laryngectomy in 1 patient, fronto-lateral laryngectomy in 4 patients. In all cases diagnosis of squamous cell carcinoma was confirmed. According to pathological classification the stage of disease in the neck was as follows: N1 = 8 patients and N2 = 6 patients. Indications for adjuvant radiotherapy were a high risk of microscopic spread of disease and expectation of regular follow-up problems in treated patients. The main rule of radiotherapy technique was avoiding the irradiation of the preserved larynx. All patients were irradiated postoperatively in conventional way to the elective dose of 50 Gy to the neck with additional dose of 16 Gy to the area of high risk of local recurrence. During follow-up no patients had locoregional failure. The toxicities (early and late) concerned the skin and mucosa of pharynx. These toxicities, evaluated according to the RTOG scale, in all cases were less than III grade. We conclude that combination of partial laryngectomy and postoperative radiotherapy with protection of the larynx during irradiation in the group of patients with high risk of regional recurrence plays an important role in decrease of treatment failures and permits preservation of laryngeal function without any significant side effects. Therefore the described method is an effective treatment for selected patients with the carcinoma of the larynx.

Adult↗
PubMed1977

[Course of intraluminal esophageal pressure after laryngectomy (author's transl)].

A new electronic equipment permits the measurement of the course of intraluminal esophageal pressures in patients before and after laryngectomy. The values obtained in all parts of the esophagus could be reproduced, thus proving the correctness of the measuring system. In patients with laryngectomy having a good compensatory esophageal voice the pressures in the lower esophageal sphincter doubled, when compared with those patients with laryngectomy which had little or no compensatory voice. The pressure in the area of the upper esophageal sphincter was reduced because of the laryngectomy, and the pressure in the area of the upper third of the esophagus was unchanged. There was no difference between the groups with good and with poor esophageal voice.

Aged↗
PubMed2003

[The clinical observation of early oral feeding following total laryngectomy].

OBJECTIVE: To demonstrate the feasibility of oral feeding 48-72 hours after total laryngectomy of carcinoma of the larynx or pyriform sinus. METHOD: Forty-two patients underwent total laryngectomy (included 34 patients of larynx carcinoma and 8 patients of pyriform sinus carcinoma) were random categorized into control group and experimental group. The experimental group of 21 patients who received oral feeding 48 to 72 h after total laryngectomy was compared with the control group of 21 patients who received oral feeding 10 to 12 days. RESULT: Pharyngocutaneous fistula occurred in one patient (4.8%) in the experimental group and in two patients (9.5%) in the control group. These differences were not statistically significant (P > 0.05). The length of hospital stay was significantly shorted. CONCLUSION: Our results indicate that in the patient population initiation of oral feeding 48 to 72 h after total laryngectomy of carcinoma of the larynx or pyriform sinus is a safe clinical practice.

Adult↗
PubMed2004

Impact of tracheostomy or laryngectomy on spousal and caregiver relationships.

Caregiving is an important component in the management of patients with a tracheostomy or laryngectomy. The purpose of this integrative research literature review was to gain a better understanding of the impact of caregiving for adults and children with laryngectomy or tracheostomy on the patient, the family, and the caregiver. Patients who had undergone laryngectomy or tracheostomy included those with and without cancer. This integrated review of the literature on caregiving in this population demonstrates the dearth of studies on this subject. Despite the significance of the caregiving role, few studies have addressed caregiving, and those that have are primarily descriptive. Studies are needed that develop and test interventions to assist caregivers in adaptation to their role, identification of methods of decreasing caregiver burden and strain, and coordination of resources to support patients and caregivers of patients with tracheostomies and laryngectomies.

Activities of Daily Living↗
PubMed2003

[The clinical analysis of cervical lymph node metastases from squamous cell carcinoma of the larynx and hypopharynx treated with total laryngectomy].

OBJECTIVE: To detect the distribution and characteristics of lymph nodes metastasis in patients of laryngeal and hypopharyngeal cancer. METHOD: A retrospective review of 129 patients who had radical neck dissection, including first recurrence in cervical lymph nodes after laryngectomy, was performed to analyze the cervical lymph node metastases of different types of laryngeal and hypopharyngeal cancer treated by total laryngectomy. RESULT: The patients of the hypopharyngeal and supraglottic cancer had a tendency of cervical lymph nodes metastasis in their early stage. The rate of the fusional lymph nodes was high in hypopharyngeal cancer, and so as to the rate of the positive lymph nodes in their level IV. In our study the percentage of the poor-differentiated squamous cell carcinoma was relatively high in hypopharyngeal and supraglottic cancer than in glottic cancer. And there was no statistical difference in stages of the primary tumour between groups of neck dissection with laryngectomy simultaneously and of first recurrence in lymph nodes after laryngectomy. CONCLUSION: The latent lymph nodes metastasis and preventive neck dissection should be considered in patients of hypopharyngeal and supraglottic cancer in or above stages of T2, especially in patients with poor-differentiated squamous cell carcinoma, though the sign of positive lymph nodes was not evident.

Adult↗
PubMed2003

[Voice prosthesis in patients after total laryngectomy].

The aim of the study is to present the role of voice prostheses in the voice rehabilitation in patients who underwent total laryngectomy. 7 patients with laryngeal cancer were included in the study. All patients are males aged 41-72 years (mean age 58) treated in the Department of Otolaryngology Medical Academy of Bialystok from November 2001 to March 2002. The voice prostheses were placed during the total laryngectomy in 5 patients. In 2 patients the voice prosthesis was placed in the period of 1.5 to 2 years after laryngectomy. The voice prostheses type Provox 2 were used in all cases. In 2 cases the prosthesis was in size of 8 mm, in 5 cases--10 mm. The control group included 7 patients after total laryngectomy without placing the voice prostheses. These patients developed oesophageal speech. All patients underwent phoniatric measurements during 12 to 30 days after the surgical procedure. The data indicate that patients who developed oesophageal speech, their voice in the range of subjective measurements is understandable but it is necessary to emphasize that the voice is harsh, low without fluency of the speech result from the intervals essential to accumulate the air in the oesophagus. The patients with voice prostheses have dull voice but more fluent and louder. The clarity of the voice of the patients with voice prostheses is significantly higher. According to the objective measurements all parameters are better in the oesophageal speech.

Adult↗
PubMedDate not supplied

[Thyroidectomy associated with laryngectomy in laryngeal cancer treatment. Is it routinely necessary?].

INTRODUCTION: In patients with laryngeal invasive epidermoid carcinoma who are candidates for total laryngectomy, it is recommended to resect en bloc at least half of the thyroid gland on the same side as the laryngeal tumor with the objective of decreasing local recurrence associated with thyroid infiltration. Nevertheless, in the histopathologic analysis of the specimen, a minority of thyroid glands show tumor infiltration. The fact that in these patients even partial thyroid resection is associated with hypothyroidism increased by postoperative radiotherapy is well known. The study was undertaken to determine the frequency of thyroid gland invasion in patients who have undergone total laryngectomy due to laryngeal cancer and its associated factors. MATERIAL AND METHODS: We evaluated the histological results of glands resected en bloc with laryngectomy in patients who underwent total laryngectomy due to laryngeal cancer; the clinical stage was compared to the laryngeal subsite tumor origin. The glandular histological condition was compared to the local recurrence presence (peristomal). RESULTS: Ninety two patients were included, 11 (12%) showed glandular infiltration due to epidermoid carcinoma, all with tumors clinically typified as T3 and T4, 8/11 were transglottic and only 3 (27%) showed subglottic invasion. During follow-up (5-year mean) 17/92 showed peristomal recurrence (18%), only 3 (3%) showed thyroid invasion. Among patients with glandular invasion the peristoma recurrence rate was 27% (3/11). DISCUSSION: The best laryngeal cancer thyroid tumor invasion predictor is the evidence of extralaryngeal extension. Thyroid resection en bloc should not be routinely advised due to the low frequency of glandular infiltration.

Carcinoma, Squamous Cell↗
PubMed2004

Supracricoid laryngectomy: oncological and functional outcome.

OBJECTIVES: The aim of this study was to evaluate the oncological outcome and postoperative course, mortality, morbidity, and functional results of supracricoid laryngectomy (SCL). PATIENTS AND METHODS: The study included 15 consecutive patients who underwent SCL for primary laryngeal squamous cell carcinoma and had a follow-up period of more than two years. Unilateral arytenoidectomy was required in seven of the SCLs. All of the patients with supraglottic tumors and the patients with glottic T2-3 tumors underwent neck dissection in the same session with SCL. Adjuvant radiotherapy was applied in two patients with pN2 and pN3, respectively. RESULTS: The mean time for starting oral feeding was 6 days (range 3-10 days) and the time for adequate oral taking was 12.5 days (range 7-25 days). Nasogastric tube was removed between the seventh and 49th postoperative days (mean 15.7 days). All the patients were decannulated successfully in 10 to 38 days (mean 18 days) and had a satisfactory swallowing, a well-understood speech, and an intelligible voice quality. The hospitalization period was 12 to 46 days (mean 23.4 days). The durations of adequate oral feeding, nasogastric tube removal, decannulation, and hospitalization were longer in patients with one arytenoid preserved than those with bilateral arytenoids preserved, but the difference was not statistically significant. Postoperative complications were observed in three patients. Wound infection was found in two patients in the early postoperative period. One patient with a T3 supraglottic tumor that involved the medial wall of the pyriform sinus developed aspiration pneumonia twice in six months after the first operation. This patient underwent total laryngectomy seven months after the first operation. Recurrences and mortality did not occur in the follow-up period. The mean follow-up of the patients was 50.3 months (range 26-80 months). CONCLUSION: Supracricoid laryngectomy has obvious functional advantages over total laryngectomy with similar local control rates.

Aged↗
PubMed2005

[Supracricoid partial laryngectomy for the treatment of laryngeal cancer].

OBJECTIVE: To evaluate the oncological and functional outcomes in patients undergoing supracricoid partial laryngectomy (SCPL). METHODS: Forty-three cases underwent supracricoid partial laryngectomy with functional reconstruction in stage T1b-T4. In these cases, 16 were supraglottic cancers, 21 were glottic cancers, and 2 were subglottic cancers. Three types of supracricoid partial laryngectomy (cricohyoidopexy CHP, cricohyoidoepiglottopexy CHEP and tracheocricohyoidoepiglottopexy TCHEP) were employed accordingly. RESULTS: The 3- and 5-year accumulative survival rates were 90.7% and 83.7% respectively (Kaplan-Meier method). Median follow-up time was 57 months. Decannulation rate was 95.3% (41/43) in those. The mean time of decannulation was 14 days in patients preserved both cricoarytenoid units and 43 days in those only preserved one cricoarytenoid unit. The removal of epiglottis increased the risk of aspiration and prolonged time of decannulation (P < 0.05). CONCLUSIONS: Supracricoid partial laryngectomy for selected laryngeal cancer is feasible. The patients can gain satisfied survival rate and quality of life.

Aged↗
PubMedDate not supplied

[Histopathologic study of the frontolateral laryngectomy specimen: topics of clinical interest].

Frontolateral laryngectomy is a surgical procedure that allows removal of a vocal cord, anterior commissure, one third of the healthy vocal cord and the thyroid cartilage keel. It is indicated in patients with T1a and T1b glottic-located carcinomas with adverse prognosis factors and selected T2 cases. The success relies on appropriate tumor excision. In order to make an assessment, we need to know the critical topics of clinic interest in the histopathologic study of the specimen. The objective is to analyze which are the significant factors to histologically assess in frontolateral laryngectomy and to report the histological study technique conducted at the Oncology Hospital of the National Medical Center of the Mexican Social Security Institute. According to the critical sites in the surgical technique and significant for local tumor recurrence, we report the histological study technique followed for the frontolateral laryngectomy specimens. The factors to assess in the frontolateral laryngectomy specimen are the anterior third part of the healthy cord, the paraglottic space and the crico-vocal ligament. The pathologic study technique reported herein allows us to satisfactorily assess these risk factors. Macroscopic tumor excision is not sufficient, and a satisfactory histological analysis is required that will allow us to assess the critical sites where there may be residual tumor. These may translate into a higher possibility of tumor recurrence for the patient. Communication between pathologists and surgeons is essential to achieve success in this procedure.

Humans↗
PubMed2005

Speech results with tracheoesophageal voice prosthesis after total laryngectomy.

OBJECTIVE: To assess the success rate of tracheoesophageal voice prosthesis as the primary mode of voice rehabilitation in patients after total laryngectomy. METHODS: Medical record files of 35 patients subjected to total laryngectomy were reviewed for determining success or failure of the voice prosthesis. The indicators used were quality of speech and utility of the device. Subsequent complications that developed were also assessed. In addition other factors taken into consideration were pharyngeal myotomy, use of radiation, and timing of replacement. All thirty five patients (n=35) had prosthesis placed at the time of laryngectomy. RESULTS: The success rate at one month and four months follow up was 85.18%. Of note, 3 patients were lost to follow-up, 3 patients died of disease and 2 had recurrence of disease. CONCLUSION: Our results confirm the effectiveness, longevity and safety of the tracheoesophageal voice prosthesis for speech rehabilitation following total laryngectomy.

Adult↗
PubMed2006

Supracricoid partial laryngectomy as a primary treatment for carcinosarcoma of the larynx.

Carcinosarcoma of the larynx is uncommon. When it does occur; its clinical features resemble those of sarcomatoid carcinoma, and its biologic behavior is similar to that of malignant mesenchymal neoplasms. We describe 2 cases of carcinosarcoma of the glottis. The tumors were staged as T3N0M0 and T2N0M0. Both patients were treated with supracricoid partial laryngectomy with cricohyoidoepiglottopexy. Eight months postoperatively, 1 of the 2 patients experienced a recurrence of the sarcomatous component of the tumor, and he underwent a total laryngectomy. The other patient remained free of disease at 12 months of follow-up. We conclude that supracricoid partial laryngectomy may be offered as an organ-preserving measure even in patients with sarcomatous disease; total laryngectomy can be held in reserve as a rescue measure. Patients must be closely monitored for early detection of recurrence. The role of adjuvant therapy for sarcomatous neoplasms in this area has not yet been clearly established.

Carcinosarcoma↗
PubMed2006

[Estimation of smell sense rehabilitation in patients after total laryngectomy].

The loss of sense of smell significantly decreases a quality of life after total laryngectomy. That is why this problem should be considered within a complex rehabilitation of laryngectomized patients. The smell exercises ought to start parallely to the speech rehabilitation. The aim of our study was to estimate the efficacy of smell rehabilitation after total laryngectomy. 59 persons after total laryngectomy attending the fourteen days long rehabilitation camp were examined. All the patients had the examination of three smells identification (lemon, mint and anise) made before the beginning of exercises. All the persons had also the efficacy of air aspiration through the nose measured. The control examination of those parameters was conducted after fourteen days of exercises of making the negative pressure in the throat and nasopharynx directing the air flow into the olfactory area of the nose. We confirmed a statistically significant differences between the smell identification and the force of aspiration before and after rehabilitation. We confirmed that patient's age and the time from laryngectomy have the influence into the efficacy of smell rehabilitation.

Adult↗
PubMed2005

[Analysis of relevant factors causing laryngeal stenosis after partial laryngectomy].

OBJECTIVE: To investigate the clinical relevant factors causing laryngeal stenosis after partial laryngectomy. METHODS: A retrospective study was carried out to review the history clinical data from 138 patients of partial laryngectomy in the First Affiliated Hospital of Sun Yat-Sen University between January 1994 to October 2004. The clinical relevant factors causing laryngeal stenosis were included as follows: age, sex, TNM stage, tumor site, extension of thyroid cartilage defect, extension of larynx parenchyma defect, reconstruction method, laryngeal dilator, duration of using antibiotics, postoperative radiotherapy, lung infection, gastroesophageal reflux, diabetes. Multivariate stepwise logistic regression model was used for the analysis. RESULTS: Of 138 cases after partial laryngectomy, stenosis developed in 25 cases. The occurrence rate was 18.1%. In multivariate analysis, it was confirmed that the following factors correlated to laryngeal stenosis, i. e, extension of thyroid cartilage defect (chi2 = 4.323, P = 0.038), postoperative radiotherapy (chi2 = 6.002, P = 0.014), lung infection (chi2 = 4.220, P = 0.040), and gastroesophageal reflux (chi2 = 5.614, P = 0.018). CONCLUSIONS: The clinical relevant factors causing laryngeal stenosis after partial laryngectomy were multiple. Statistical analysis showed that extension of thyroid cartilage defect, postoperative radiotherapy, lung infection and gastroesophageal reflux were the risk factors which may cause laryngeal stenosis.

Adult↗
PubMed1990

[Personal experience with total and subtotal reconstructive laryngectomy].

Customary total laryngectomy is a severe mutilating intervention with understandable efforts to offer better solutions. The author has conducted 95 subtotal reconstructive laryngectomies in the period of 1976 to 1984, with the following effects: decannulation, with the mean time of 6 weeks in 82%; deglutition without difficulties, after the third postoperative month in 90% of operated patients; the restoration of phonetics with sonorous-understandable speech in 11%. An average of a five-year survival of all subtotal reconstructive laryngectomies amounts to 63%. The author is of the opinion that this intervention presents important progress in the treatment of laryngeal carcinoma in certain patients, because it avoids mutilations which occur after total radical laryngectomy. Better results can be expected with the further advancement of the operative technique.

Humans↗
PubMedDate not supplied

[Three-quarter laryngectomy. Our experience: indications, surgical technique, results].

Three-quarter laryngectomy is regarded as a supraglottic laryngectomy which has been extended on one side to the glottic plane. Indications are those for supraglottic laryngectomy at the vestibular level and of cordectomy extended to the arytenoid at the glottic level (undamaged lower paraglottic space, preserved motility). Surgical technique includes total removal of the laryngeal vestibule together with the hyoid bone, pre-epiglottic space and one supracricoid hemilarynx (vocal cord, arytenoid, medial wall of the entrance of the pyriform fossa) through an internal, subperichondrial approach. Reconstruction of a new cord on the hemilaryngectomy side is through a triangular strip of the exterior thyroid perichondrium. From 1975 to 1989 44 patients underwent a three-quarter laryngectomy in the authors' department. Functional results were positive in all cases. The oncological results were as follows: 6 recurrences (3 local, 2 locoregional lymph node recurrences and 1 distant metastasis) and 4 primary secondary tumors. 9 patients expired (6 of T, 2 of secondary tumor, 1 of other causes). The actuarial 5-year survival rate for the tumor was 79%.

Adult↗
PubMed1989

[Results following total laryngectomy at the Budapest Clinic of Head-Neck surgery].

The data on 356 laryngectomies during a 12-year period were analysed retrospectively. The operations were divided into three groups: group I, laryngectomy alone; group II, laryngectomy and secondary neck dissection; group III, one-stage laryngectomy and radical neck dissection. Most patients had advanced disease (stage III and IV: 54.5% and 23.9%, respectively). Supraglottic and glotto-supraglottic tumours were commonest (39.6% and 36.8%, respectively). The results of palpation, fine-needle biopsy and histology of the lymph nodes are compared. The mean survival time for the three groups was 53.4, 42.7 and 29.8 months, respectively, and the 5-year survival rates were 61.9%, 32.0% and 30.8%, respectively.

Carcinoma, Squamous Cell↗