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 379 records · Page 21Linked to original sources
PubMed2000

[Supracricoid partial laryngectomy in laryngeal cancer].

OBJECTIVE: To assess the effectiveness of supracricoid partial laryngectomy in the treatment of laryngeal cancer and the reconstructed laryngeal functions. METHODS: This study involved 29 patients operated on from 1978 to 1998 using this surgical procedure. In these cases, 18 were male and 11 were female with a mean age of 55.4 years (range, 38 to 70 years). The disease was classified according to the 1987 UICC system. There were 10 supraglottic cancers (3 T2N0, 1 T2N1, 3 T3N0, 2 T3N1, 1 T3N2), and 19 glottic cancers (12T2N0, 1T2N1, 4T3N0, 2T3N1). Two subtypes of supracricoid partial laryngectomy were performed, one with epiglottis preserved and reconstructed with cricohyoidepiglottopexy (CHEP), the other involved epiglottic resection and reconstructed with cricohyoidopexy (CHP). RESULTS: The voice was good in all cases. Twenty-seven cases were decannulated (93.1%). All cases had overcome the aspiration by practice. The overall 3-year and 5-year survival rates were 89.7% and 75.9%. CONCLUSION: Supracricoid partial laryngectomy was appropriate for selected supraglottic and glottic cancers.

Adult↗
PubMed2000

[Supracricoid subtotal laryngectomy for the treatment of advanced laryngeal cancers].

OBJECTIVE: This procedure was designed to eradicate the advanced laryngeal carcinomas while preserving the laryngeal physiologic function. The indications and contraindications for the operation were also discussed and evaluated in this paper. METHODS: Twenty-one patients with advanced laryngeal cancers underwent this procedure during the period from 1988 through 1996 in our department. All of the patients were not amenable to conventional partial horizontal and vertical laryngectomies. In those patients, there were 9 supraglottic cancers, 10 glottic cancers and 2 transglottic cancers. Among them, 16 cases had stage T2 lesions and 5 cases had stage T3 lesions. In this procedure, the hyoid and thyroid cartilages were excised in toto, along with both true and false vocal cords, paraglottic space as well as the partial or total epiglottis and the whole preepiglottic space. The cricoid cartilage and at least one arytenoid cartilage were spared. The new larynx was reconstructed by suturing the cricoid and/or epiglottis to the base of the tongue. RESULTS: Of 21 patients, 95% were able to eat normally without aspiration, 90% were decannulated with near normal speech function. In two patients, the tracheotomy tube was reserved, one developed a stenosis, and another had recurrent aspiration pneumonia. No patients experienced local recurrence. Nineteen patients were followed up for at least 3 years, 13 patients achieved 5 years tumor-free survival. CONCLUSION: The term supracricoid subtotal laryngectomy best describes the surgical approach and the reconstruction model of the new larynx. As a useful alternative to total laryngectomy in selected advanced laryngeal cancers, this procedure may greatly improve the quality of life and prolong the life without recurrence.

Adult↗
PubMed2003

[Treatment of hypopharyngeal stricture after total laryngectomy by interventional therapy with inner-cavity cradle].

OBJECTIVE: To investigate the main factors in the treatment of hypopharyngeal stricture after total laryngectomy by interventional therapy with inner-cavity cradle. METHOD: Nine patients of hypopharyngeal stricture after total laryngectomy accepted the interventional therapy with inner-cavity cradle. RESULT: The interventional therapy with inner-cavity cradle succeeded in 8 patients, the difficulty of swallowing was obviously improved immediately after the therapy. The therapy failed in 1 patient. The follow-up period lasted from 5 months to 36 months. For the 8 patients, the inner-cavity cradle helped them to overcome the difficulty of swallowing, gained more time for further treatment. CONCLUSION: A suitable inner-cavity cradle can extend the hypopharyngeal stricture after total laryngectomy, help the patient to overcome the difficulty of swallowing. The therapy is easy to perform, the effect is reliable. It can be a utility treatment for the hypopharyngeal stricture.

Aged↗
PubMedDate not supplied

[The stapler in total laryngectomy with closed technique].

UNLABELLED: AIMS AND BACKGROUNDS: The use of the stapler in total laryngectomy with closed technique is described by the authors. MATERIALS AND METHODS: From October 1999 to December 2002, 27 total laryngectomy were performed, 15 with a stapler and 5 cases had a primary tracheoesophageal puncture. RESULTS: Only one patient developed a pharyngocutaneous fistula, no other patients experienced post-operative complications. All cases in this study had negative surgical margins. CONCLUSION: The correct indication for the use of the stapler is a tumor that needs a total laryngectomy, but completely endolaryngeal. The technique allows to remove the nso-gastric tube at the end of the first week after the operation, to avoid soiling the surgical field, to reduce the time in theatre. This technique seems to be safe as the traditional suture.

Combined Modality Therapy↗
PubMed1992

Partial laryngectomy in transglottic carcinoma.

At the ENT Department of Zagreb University from 1973 to 1982 119 cases of transglottic carcinoma were treated. In the first group of 20 cases total laryngectomy was done. Five years later, ten of the patients treated had survived. Primary and secondary neck metastases were present in 6 cases, i.e. 30%. In the second group of 99 cases partial laryngectomy (vertical and combined) was done. Five years later 70 cases had survived, i.e. 70%. Primary and secondary neck metastases were present in 19 cases, i.e. 19%. In the partial laryngectomy the reconstruction was done by fascia sternohyoidea and partial resection of the cricoid and totally of the arythenoid in the cases where there was the indication. Postoperative irradiation was given in cases with neck metastases and where resection margin was inadequate.

Glottis↗
PubMed2003

[The reparation of tissular defect and reconstruction of laryngeal function in subtotal laryngectomy with pedicled cutaneous and musculocutaneous flaps].

OBJECTIVE: To explore the recovery of wounded surface and reconstruction of laryngeal function after subtotal laryngectomy. METHOD: Thirty-three cases of subtotal laryngectomy were reviewed for analysis. The hyoid bone, most part of thyroid cartilage and the gap before epiglottis exsected while arytenoids cartilage of one side, 1/3 thyroid cartilage and 1/3 true vocal cord were reserved in the subtotal laryngectomy operation. And pedicled cutaneous flap of one side and pedicled musculocutaneous flap of the other side were used to rehabilitate the wounded surface and reconstruct the laryngeal function. RESULT: The function of respiration and swallowing resumed in all cases, 93.9% patients got normal pronunciation function after windpipe casing pulled out. Three-year survival rate was 89.3% and five-year survival rate was 78.6%. CONCLUSION: The results demonstrated our method has such advantages as follows: being easy to get material, having good vascular circle, laryngeal narrow seldom happened, shortening the time with windpipe casing and improving the quality of life.

Adult↗
PubMed2003

[The management of pharyngocutaneous fistulas after total laryngectomy and the factors affecting their incidence].

OBJECTIVES: This study sought to determine the incidence and etiologic factors of pharyngocutaneous fistulas occurring after total laryngectomy. PATIENTS AND METHODS: A total of 138 patients (136 males, 2 females; mean age 59.5 years; range 36 to 83 years) underwent total laryngectomy for squamous cell carcinoma. Risk factors and the management of pharyngocutaneous fistulas were assessed together with durations in relation to fistula occurrence, oral feeding, hospitalization, and healing. RESULTS: Pharyngocutaneous fistulas were seen in 37 patients (26.8%). Significantly high rates of fistula occurrence were detected in patients with alcohol consumption (p=0.032), and in those who underwent partial pharyngectomy (p=0.058) or bilateral neck dissection (p=0.049) along with total laryngectomy. The occurrence of fistulas was significantly associated with prolonged lengths of time for oral feeding and hospital stay (p<0.001). Fistulas were repaired surgically in 24.3% of patients, in whom the time to oral feeding was significantly shorter than that of patients who received local wound care (p=0.03). CONCLUSION: Our data show that early surgical intervention is more beneficial in preventing further morbidity associated with pharyngocutaneous fistulas.

Adult↗
PubMed2003

[Estimation of motor ranges and muscle strength in cervical spine after total laryngectomy].

After total laryngectomy and after complementary treatment (radiotherapy) there are many functional disorders in the range of head and neck. It was observed, that muscles of this area became weakened with simultaneous increase of their rest tension. These changes affect reduction of physiological motor range of the cervical spine. Comparison of function of cervical muscle between patients after total laryngectomy and healthy people allows to characterize defects of neck movements. Detailed estimation of muscle strength and move range in cervical spine after total laryngectomy will enable application of effective physiotherapy program.

Adult↗
PubMed2003

[Factors influencing pharynx' and pharyngoesophageal sphincter's morphology and their function after total laryngectomy].

The usefulness of the videolaryngoscopy in patients after total laryngectomy/laryngopharyngectomy was discussed. They serve for: a) evaluation of the pharynx and of the pharyngoesophageal sphincter (pes) morphology, b) prognosis of the esophageal speech developing. In the study videolaryngoscopy was done in 82 patients (7 female and 75 male). In 62 of them total laryngectomy was done (among them in 50/62--with standard pharynx suture, in 9/62--with the pes plasty, and 3/62--with simple pes myotomy). In 20 case of laryngopharyngectomies--4/20 standard pharynx suture was done, 12/20 were reconstructed with tongue flap, 3/20--with pes plasty, and in 1/20 simple myotomy was performed. The investigations were carried out between 1 to 36 months after total laryngectomy and 24 month after laryngopharyngectomy. The analysis of the videolaryngoscopy imagings revealed that the pharynx and pes morphology after laryngectomy/laryngopharyngectomy (shape, thickness of the mucose, weakened wall peristalsis, secretion retention, lack or presence of the pes relaxation at the time of examination) correlates with the rest pressure in the pes area, measured by Seeman's method and with the occurrence of the esophageal speech mastering. The most significant changes in morphology and function of the pharynx (irregular shape, weakened wall peristalsis, retention of secretion) as well as the highest pressure in the area (5.1 +/- 3.33 kPa-38 +/- 25 mm Hg) was found after pharyngolaryngectomy. The shape of the pharynx in all the patients after laryngectomy with plasty or simple myotomy of the pes was regular, with thin and smooth mucosa while the rest pressure was low (3.0 +/- 1.18 kPa(-)+/- 22.5 +/- 8.8 mm Hg). In the analyzed material at the rest pressure in the sphincter area from 0.7 to 4kPa (from 5 to 30 mm Hg), 93% (41/44) of the patients have mastered the esophageal speech. It was stressed that videolaryngoscopy is entirely sufficient for the approximate assessment of the rest pressure in the pes area and prognosis of the esophageal speech development process.

Adult↗
PubMed2003

[Long-term follow-up result of near-total laryngectomy in senile patients with laryngeal carcinoma].

OBJECTIVE: To study the long-term follow-up result of near-total laryngectomy in senile patients with laryngeal carcinoma. METHOD: Twelve patients who were above 65 years old and underwent near-total laryngectomy from 1990 to 1996 were summarized. Twelve patients with quamous cell carcinoma of larynx were conformed. We adopted and improved Parson's operation, remained normal side cricoid cartilage plate, cricoarytenoid joint and recurrent laryngeal nerve. RESULT: Three year and five year survival rates were 75.0% and 66.7% respectively. All patients had good swallowing founction in two weeks after operation. Ten patients obtained good speech function. CONCLUSION: The authors believed that near total laryngectomy was safe and beneficial to senile patients with laryngeal cancers who suffered from foundermental disease in heart, lung or brain.

Aged↗
PubMed2004

[The supracricoid laryngectomy with cricohyoidopexy. Carcinological and functional results. 23 cases report of the Centre A. Lacassagne (Nice)].

OBJECTIVE: This study is to estimate the survival results, the morbidity and the functional consequences of the supracricoid laryngectomy with cricohyoïdopexy (SL-CHP). PATIENTS AND METHODS: Between 1990 and 2001, 23 patients had a SL-CHP in Centre Antoine Lacassagne of Nice. The average age was of 59 years. Patients were classified as follow: 1 T1, 11 T2, 10 T3 and 1 T4 (invasion of the thyroid cartilage without involving of anterior soft tissues). 17 patients were NO (73.9%). A bilateral radical neck dissection was performed in 10 cases, a radical neck dissection was associated to a functional neck dissection (1 case) and a homolateral functional neck dissection (10 cases). RESULTS: The limits were insufficient for a patient. Six patients were N+ (28.5%) of which 4 N+R+. The average delay was 21 days and 32.7 days to remove respectively the tracheotomy and the nasogastric tube. A functional total laryngectomy was done in two cases. We noted two cases of local recurrence. Survivals according to the method of Kaplan-Meier are 81% in 3 years and 75% in 5 years. CONCLUSION: The SL-CHP represents an alternative to the total laryngectomy for the supraglottic and transglottic carcinomas.

Adult↗
PubMed2002

[Long-term results of one stage tracheoesophageal end-side anastomosis voice restoration after total laryngectomy].

OBJECTIVE: The purpose of this study is to discuss long-term results of one different kind of voice restoration after total laryngectomy with 10 years experience. METHOD: One stage tracheoesophageal end-side anastomosis after total laryngectomy was performed in 36 patients from 1991-1996. The key technique of this operation is to make a tongue-ship flap(1.5 cm x 1.5 cm-1.8 cm x 1.5 cm) with tracheal membranous part and dissect it from the esophagus to 1 cm below the upper incisal margin of trachea. Then a 0.8 cm middle vertical incision was made on the lowest anterior wall of the separated esophagus. Folding the tongue-ship flap posteriorly to approximate the esophagus incision and make an end-side anastomosis. Close the upper incisal margin of trachea with left to right direction suture. The follow up time is 5 - 10 year. One lost follow 2.5 years later and was judged as dead. RESULT: The short-term and long-term success rate were 69% (25/36) and 83% (30/36) respectively. The 3-, 5- and 10 year survival rate are 72%, 69%, 69%, respectively. CONCLUSION: This technique does not change the pattern of total laryngectomy and various neck dissections do not affect voice rehabilitation. Advantages of the operation: easy to operate and learn; the special form of tracheoesophageal shunt (high in the tracheal side and low in esophageal side) prevents the aspiration; high successful rate, excellent speech, fluent language, good acceptability and lower aspiration.

Adult↗
PubMed2004

[Phonation reconstruction and function assessment after total and near-total laryngectomy].

BACKGROUND & OBJECTIVE: Total laryngectomy is a common surgery pattern for treating laryngeal and hypopharyngeal cancer, but patients will lost phonation function after operation. This study was to retrospectively analyze usage of modified Amatsu, and modified Pearson operation in treating laryngeal and hypopharyngeal cancers, and to analyze phonation function by subjective and objective assessment. METHODS: Clinical data of 69 patients with laryngeal or hypopharyngeal cancer treated by total or near-total laryngectomy (modified Amatsu or modified Pearson operation) in our department from 1996 to 2003 were retrospectively analyzed. Phonation function of 69 patients was evaluated by acoustic analysis and Jiyan classification method, and compared with phonation quality of patients received vertical hemilaryngectomy (VHL) and healthy people. RESULTS: No patient appeared obvious aspiration. Four cases with post-operative radiotherapy all regained phonation function. The 3-year survival rate was 88% (22/25); 5-year survival rate was 80% (4/5). Results of acoustic assessment, and Jiyan classification method indicated that phonation function of patients received modified Amatsu or modified Pearson operation could meet daily requirements. CONCLUSIONS: Modified Amatsu and modified Pearson operations can be learnt and applied easily for phonation reconstruction after laryngectomy. They may be optional surgery patterns, especially modified Pearson operation.

Adult↗
PubMed1992

A comparative acoustic analysis of voice production by near-total laryngectomy and normal laryngeal speakers.

Limited objective data are available on voice characteristics of patients following near-total laryngectomy. Acoustic characteristics of near-total voice were quantified and compared to laryngeal voice production. High quality audio recordings were obtained from 11 subjects who had undergone near-total laryngectomy and 11 age-matched laryngeal speakers. Subjects performed vocal tasks which provided frequency, intensity and duration measures. These data were computer analyzed and indicated that substantial inter and intrasubject variability existed in the acoustic measures for near-total laryngectomy patients. These patients demonstrated a general restriction in fundamental frequency, reduced intensity and a limitation in duration of phonation when compared to laryngeal speakers.

Adult↗
PubMedDate not supplied

Delphian lymph node in glottic carcinoma subjected to supracricoid partial laryngectomy with cricohyoidoepiglottopexy.

INTRODUCTION: Metastases to Delphian lymph node is rarely present in laryngeal malignancy. This report describes its frequency in patients with glottic cancer undergoing supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP). MATERIAL AND METHODS: Fourteen patients (13 male and 1 female) with a mean age of 58 years underwent a SCPL with CHEP and functional bilateral neck dissection (levels II-V) searching for the Delphian lymph node. Four patients were in stage I, five in stage II, four in stage III, and one in stage IV. Surgical margins and Delphian lymph nodes were searched for in each partial laryngectomy sample. RESULTS: The mean follow-up was 9 months. The right-side dissection yielded an average of 18 lymph nodes and the left-side dissection yielded an average of 22 lymph nodes, with no metastatic disease on the ultimate examination. Only one patient (7%) revealed a carcinoma-positive Delphian lymph node, and 6 months later a metastatic lymph node was found on the same side as the primary tumor. The patient underwent standard radiation therapy (66 Gy) targeted to larynx and lymph node areas, as well as to the supraclavicular region (20 Gy). DISCUSSION: Bilateral functional dissection is indicated in the presence of Delphian lymph node metastatic spread. Post-operative radiation therapy may occasionally be used as an adjuvant treatment in cases with positive Delphian lymph node in spite of a negative functional dissection in partial laryngectomies due to other possible node spread routes. Bilateral functional dissection should be chosen based on tumor site and size.

Adult↗
PubMed2005

[An observation on long-term results of subtotal laryngectomy with preservation of an arytenoid cartilage].

OBJECTIVE: To discuss the long-term results of the subtotal laryngectomy with preservation of an arytenoids cartilage. METHODS: The long-term results of the subtotal laryngectomy with preservation of an arytenoids cartilage were analysed in 82 patients with squamous cell carcinoma of larynx (stage III 73 cases, IV 9 cases; supraglottic type 71 cases, glottic 6, transglottic 5). RESULTS: The functions of speech and deglutition were recovered in 82 patients, and the respirations were normal in 69 of 82 cases (84.2%). Pharyngeal fistula appeared in 2 cases, and the infection of incision wound in 6, but all of them were cured by conservative treatment. All of 82 cases were followed-up for more than 5 years, 5 cases were lost follow-up, so the follow-up rate was 93.3%. 26 patients died of various causes during 5 years after operation. 5 of 26 cases died of local recurrence of laryngeal carcinoma, neck metastasis in 4, others in 4 (cardiac insufficiency, myocardiac infarction, lungs metastasis, rectal carcinoma 1 case, respectively) unknown in 4, lost follow-up in 5.68 patients were followed-up for more than 10 years, 30 cases were dead (26 cases who died of various causes included during 5 years after operation; died of local recurrence in larynx was 1 case, unknown 2, lost follow-up 1, during 5 approximately 10 years after surgery). 5, 10 years survival rates were 68.3% (56/82) and 55.9% (38/68), respectively. CONCLUSIONS: Subtotal laryngectomy with preservation of an arytenoids cartilage is recommended for T3 and some elective T4 laryngeal carcinoma.

Adult↗
PubMed2005

[Reconstruction of laryngeal defect in vertical partial laryngectomy with resection of arytenoid cartilage].

OBJECTIVE: To discuss the method to reconstruct laryngeal defect after vertical partial laryngectomy with resection of arytenoid cartilage. METHODS: Laryngeal defect was reconstructed with local tissues after vertical partial laryngectomy with resection of arytenoid cartilage on 87 patients with laryngeal carcinoma of glottic type (T1 7 cases, T2 54 cases, T3 26 cases). All the lesions invaded arytenoid area or vocal process. No filling tissues were used to increase the height of affected arytenoid area and no skin flap or other tissues were used to reconstruct the vocal cord in all the patients. RESULTS: All the patients recovered normal swallow in 8 to 19 days postoperation and restored phonation. The decannulation rate was 98.9% (86/87). There were no pharyngeal fistula and pulmonary complications after operation. Local infection occurred in 3 patients and was cured in 7 days. The rate of local recurrence and cervical lymph node metastasis were 8.0% (7/87), 6.9% (6/87) respectively. Lost patients were assumed to death and direct method was used to calculate survival rate. In 87 patients postoperative period was above 3 years, 5 died in 3 years and 3 were lost 3- year survival rate was 90.8% (79/87). In 63 patients postoperative period was above 5 years, 10 died in 5 years and 2 were lost. 5- year survival rate was 81.0% (51/63). CONCLUSIONS: Utilizing local tissues to reconstruct laryngeal defect after vertical partial laryngectomy with resection of arytenoid cartilage will not lead to severe dysphagia. Phonation is acceptable. It not only saves the operation time but also avoids the negative effects of immoderate reparation.

Adult↗
PubMed2005

[Partial vertical laryngectomy with epiglottis reconstruction--Tucker technique].

OBJECTIVE: To evaluate the results of partial supracricoid laryngectomy with Tucker's reconstruction in T1b and T2 stages of glottic laryngocarcinoma. METHOD: One hundred and thirty-nine patients received partial supracricoid laryngectomy with Tucker's reconstruction were analyzed, among them, 127 patients (T1b-48, T2-79) had never been treated, 12 patients with glottic cancer (Tr) recurred after radiotherapy or cordectomy. We calculate survival rate and evaluate the function of larynx according to the stage. RESULT: For carcinology: 5-years survival rate for T1, T2 and Tr stages was 91%, 86% and 64% respectively; 5-years local control rate for T1, T2 and Tr stages was 100%, 94% and 82% respectively. With respect to the laryngeal function, the rate of decannulation is 100%, the average duration of decannulation is 10 days. The rate of the oblation of the naso-gastric tube is 99.3%. Six patients had accepted gastrotomy with difficulty during the deglutition of liquids; 1 patient had to have total laryngectomy because of incurable disorder of the deglutition. The time of the ablation of the naso-gastric tube is 15 days on average. One hundred and twenty-one patients (87%) presentented a satisfactory voice and only 18 patients have a medium voice quality. CONCLUSION: Tucker technique is a reliable intervention on the carcinology and laryngeal function for the glottic lesions of T1b and T2.

Adult↗