Transoral Laser Microsurgery for Untreated Glottic Carcinoma

2007 ◽  
Vol 137 (3) ◽  
pp. 482-486 ◽  
Author(s):  
David G. Grant ◽  
John R. Salassa ◽  
Michael L. Hinni ◽  
Bruce W. Pearson ◽  
Richard E. Hayden ◽  
...  
Keyword(s):  
Therapeutic Option ◽  
Case Series ◽  
Glottic Carcinoma ◽  
Transoral Laser Microsurgery ◽  
Laser Microsurgery ◽  
Average Hospital ◽  
Kaplan Meier ◽  
Prospective Case Series ◽  
Preservation Rate

OBJECTIVES: To report the oncology and functional outcomes of transoral laser microsurgery (TLM) for untreated glottic carcinoma. STUDY DESIGN: A 2 center prospective case series analysis. SETTING: Academic, tertiary referral centers. RESULTS: Seventy-six patients underwent TLM. Pathologic T stages were: T1, 45 (59%); T2, 21 (28%); T3, 5 (7%); and T4, 5 (7%). Five (7%) patients had neck dissections. Five (7%) patients received adjuvant radiotherapy. Mean follow-up was 42 months. Respective T1 and T2 5-year Kaplan-Meier estimates were: local control, 90% and 93%; loco-regional control, 90% and 93%; disease specific survival, 90% and 93%; and overall survival, 94% and 93%. The average hospital stay was 2 days. Two (3%) patients experienced major complications. The overall laryngeal preservation rate was 95% (72 of 76). CONCLUSIONS: TLM is a safe and effective treatment in select carcinoma of the glottic larynx. Low morbidity and mortality and short periods of hospitalization make TLM an attractive therapeutic option. SIGNIFICANCE: TLM is an emerging strategy in the treatment of laryngeal cancer.

scholarly journals Clinical and radiological outcomes of acetabular revision surgery with trabecular titanium cups in Paprosky type II and III bone defects

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Loris Perticarini ◽  
Stefano Marco Paolo Rossi ◽  
Marta Medetti ◽  
Francesco Benazzo
Keyword(s):  
Revision Surgery ◽  
Case Series ◽  
Bone Defects ◽  
Harris Hip Score ◽  
Type Ii ◽  
Level Of Evidence ◽  
Kaplan Meier ◽  
Prospective Case Series ◽  
Acetabular Components

Abstract Background This prospective study aims to evaluate the mid-term clinical outcomes and radiographic stability of two different types of cementless trabecular titanium acetabular components in total hip revision surgery. Methods Between December 2008 and February 2017, 104 cup revisions were performed using trabecular titanium revision cups. Mean age of patients was 70 (range 29–90; SD 11) years. The majority of revisions were performed for aseptic loosening (86 cases, 82.69%), but in all the other diagnoses (18 cases), a significant bone loss (Paprosky type II or III) was registered preoperatively. Bone defects were classified according to Paprosky acetabular classification. We observed 53 type II defects and 42 type III defects. Cups were chosen according to the type of defect. Results Average follow-up was 91 (range 24–146) months. Mean Harris Hip Score (HHS) improved from 43.7 (range 25–70; SD 9) preoperatively to 84.4 (range 46–99; SD 7.56) at last follow-up. One (1.05%) cup showed radiographic radiolucent lines inferior to 2 mm and was clinically asymptomatic. One (1.05%) cup was loose and showed periacetabular allograft reabsorption. Kaplan–Meier survivorship was assessed to be 88.54% (95% CI 80.18–93.52%) at 71 months, with failure of the cup for any reason as the endpoint. Conclusion Trabecular titanium revision cups showed good clinical and radiographic results at mid-term follow-up in Paprosky type II and III bone defects. Level of evidence Level IV prospective case series

Longitudinal analysis of Voice Handicap Index in early glottic cancer patients treated with transoral laser microsurgery: age, gender, stage and time dependence

2019 ◽  
Vol 133 (4) ◽  
pp. 318-323 ◽  
Author(s):  
C Lane ◽  
M Rigby ◽  
R Hart ◽  
J Trites ◽  
E Levi ◽  
...  
Keyword(s):  
Voice Handicap Index ◽  
Glottic Cancer ◽  
Glottic Carcinoma ◽  
Transoral Laser Microsurgery ◽  
Laser Microsurgery ◽  
Early Glottic Cancer ◽  
Related Quality ◽  
The Voice

AbstractObjectivesTransoral laser microsurgery is an increasingly common treatment modality for glottic carcinoma. This study aimed to determine the effect of age, gender, stage and time on voice-related quality of life using the Voice Handicap Index-10.MethodsPrimary early glottic carcinoma patients treated with transoral laser microsurgery were included in the study. Self-reported Voice Handicap Index testing was completed pre-operatively, three months post-operatively, and yearly at follow-up appointments.ResultsVoice Handicap Index improvement was found to be dependent on age and tumour stage, while no significant differences were found in Voice Handicap Index for gender. Voice Handicap Index score was significantly improved at 12 months and 24 months. Time versus Voice Handicap Index modelling revealed a preference for non-linear over linear regression.ConclusionAge and stage are important factors, as younger patients with more advanced tumours show greater voice improvement post-operatively. Patient's Voice Handicap Index is predicted to have 95 per cent of maximal improvement by 5.5 months post-operatively.

Transoral laser microsurgery outcomes with early glottic cancer: the Dalhousie University experience

2011 ◽  
Vol 125 (5) ◽  
pp. 509-512 ◽  
Author(s):  
S E Lester ◽  
M H Rigby ◽  
S M Taylor
Keyword(s):  
Overall Survival ◽  
Disease Free Survival ◽  
Glottic Cancer ◽  
Transoral Laser Microsurgery ◽  
Laser Microsurgery ◽  
Free Survival ◽  
Early Glottic Cancer ◽  
Kaplan Meier ◽  
Disease Free

AbstractObjective:To report the results of transoral laser microsurgery for the treatment of early glottic cancer at our institution.Design:Cohort study. Retrospective review of charts of patients diagnosed with tumour stage 1 or 2 (early stage; no nodes or metastases), previously untreated, primary glottic cancer, treated with transoral laser microsurgery at the Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada. The minimum follow-up period was two years.Setting:Tertiary care head and neck cancer centre.Participants:Fifty-three patients treated between January 2002 and November 2007.Outcome measure:Kaplan–Meier survival analysis for disease-free survival, overall survival and laryngectomy-free survival, at five years.Results:The group comprised 46 men and seven women, with a mean age of 66 years (range 30–84 years). Mean follow up was 40 months (range 12–89 months). There were four cases of complications (7.5 per cent). Kaplan–Meier survival analysis revealed a five-year disease-free survival (including salvage) of 96.2 per cent, a five-year overall survival (all causes) of 88.8 per cent and a five-year laryngectomy-free survival of 98.1 per cent.Conclusion:Transoral laser microsurgery is a safe and effective initial treatment for early laryngeal cancer, and has high rates of laryngeal preservation and disease-free survival.

OCTA-guided navigated laser therapy for advanced macula neovascularization secondary to age related macular degeneration

2020 ◽  
pp. 112067212098319
Author(s):  
Francesca Amoroso ◽  
Eric H Souied ◽  
Salomon Yves Cohen ◽  
Alexandre Pedinielli ◽  
Polina Astroz ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Degeneration ◽  
Optical Coherence Tomography Angiography ◽  
Therapeutic Option ◽  
Case Series ◽  
Age Related Macular Degeneration ◽  
Optical Coherence ◽  
Age Related ◽  
Prospective Case Series

Introduction: To evaluate the effects of the Navilas system guided by optical coherence tomography angiography for advanced macular neovascularization (MNV) secondary to age-related macular degeneration (AMD). Methods: Prospective case-series including nine eyes presenting with advanced MNV with persistence of exudative signs, no longer responding to anti-VEGF therapy, best-corrected visual acuity at least of 1.3 logMar. All patients were treated with Navilas guided by overlaid optical coherence tomography angiography (OCTA) images at the site of branching large neovascular trunks. Results: Occlusion of large neovascular trunks successfully occurred in all nine included patients. OCTA analysis revealed, at 1 month follow up, MNV total area decreasing from 6.2 ± 3.1 to 2.6 ± 3.4 mm2. At 6 months follow up, mean MNV area was 3.3 ± 3.4 mm2 ( p = 0.008). Conclusion: This preliminary study showed that Navilas treatment guided by OCTA may represent an attractive therapeutic option in advanced neovascular lesions secondary to AMD.

scholarly journals Functional and Oncologic Outcomes of Octogenarians Undergoing Transoral Laser Microsurgery for Laryngeal Cancer

OTO Open ◽  
2021 ◽  
Vol 5 (3) ◽  
pp. 2473974X2110469
Author(s):  
Changseok Lee ◽  
David Forner ◽  
Christopher W. Noel ◽  
Victoria Taylor ◽  
Colin MacKay ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Functional Outcomes ◽  
Case Series ◽  
Length Of Hospital Stay ◽  
Glottic Cancer ◽  
Transoral Laser Microsurgery ◽  
Laser Microsurgery ◽  
Kaplan Meier ◽  
Disease Free ◽  
Disease Specific

Objective To evaluate the oncologic and functional outcomes of transoral laser microsurgery (TLM) for glottic cancers in patients ≥80 years. Study Design Prospectively collected case series. Setting QEII Health Sciences Centre, Halifax, Canada. Methods This case series used a prospectively collected glottic cancer database to examine consecutive elderly patients (≥80 years old) undergoing TLM. Kaplan-Meier analysis was used to evaluate rates of disease-free, disease-specific, and overall survival as the primary end points of oncologic control. Secondary functional outcomes included voice function, length of hospital stay, and time to readmission. Results From 2005 to 2017, 17 octogenarian patients underwent TLM for glottic cancer. Median follow-up was 4.19 years (interquartile range, 0.71-6.95). Kaplan-Meier estimates of 5-year survival were 78.4% (disease free), 92.9% (disease specific), and 81.9% (overall). The median length of hospital stay was 1 day (range, 0-8). There was only 1 readmission within 30 days of surgery. No patients in this study developed significant surgical or postoperative complications requiring unplanned readmissions. Patient-perceived voice function improved to normal after treatment in 62.5% of patients. Conclusion The results of this study suggest that TLM is a safe and effective treatment modality for glottic cancer in patients aged ≥80 years, providing good oncologic control and satisfactory functional outcomes.

Simple limbal epithelial transplantation (SLET) in failed cultivated limbal epithelial transplantation (CLET) for unilateral chronic ocular burns

2018 ◽  
Vol 102 (12) ◽  
pp. 1640-1645 ◽  
Author(s):  
Sayan Basu ◽  
Sashwanthi Mohan ◽  
Swapnil Bhalekar ◽  
Vivek Singh ◽  
Virender Sangwan
Keyword(s):  
Case Series ◽  
Primary Outcome Measure ◽  
Successful Outcome ◽  
Kaplan Meier ◽  
Limbal Stem Cell ◽  
Prospective Case Series ◽  
Ocular Burns ◽  
Cultivated Limbal Epithelial Transplantation ◽  
Better Than

AimsCultivated limbal epithelial transplantation (CLET) fails in around 20%–30% of cases. This study aimed to report the clinical outcomes of autologous simple limbal epithelial transplantation (SLET) in eyes with recurrent unilateral limbal stem cell deficiency (LSCD) due to failure of CLET.MethodsThis was a prospective case series which included 30 eyes of 30 patients who underwent SLET between 2010 and 2016 after failure of one (n=24) or two (n=6) previous CLET procedures for chronic unilateral ocular burns. The primary outcome measure was success of SLET defined on the basis of relative improvement in five objective criteria: best corrected visual acuity (BCVA), and grades of symblepharon, corneal conjunctivalisation, vascularisation and opacification.ResultsAt a mean follow-up of 2.3 years, 24 (80%) of the 30 eyes maintained a successful outcome. Kaplan-Meier analysis showed a 5-year survival probability of 77%±8%. At 1 year postoperatively statistically significant improvement was noted in BCVA (logarithm of the minimum angle of resolution of 3 to 1) and in the median grades of corneal conjunctivalisation (2 to 0), vascularisation (2 to 0) and opacification (2 to 1) (P≤0.0026). In 62.5% of successful cases, BCVA improved to 20/200 or better. The success rate of SLET in failed CLET was better than that of repeat CLET (53.5%, P=0.011). None of the donor eyes developed any complications.ConclusionSLET is an effective alternative to CLET in eyes with recurrence of LSCD after previously failed CLET procedures. Since SLET is single-staged and less expensive, it is probably preferable to repeating CLET.

Transoral laser microsurgery for Tis, T1, and T2 glottic carcinoma: 5-year follow-up

2020 ◽  
Author(s):  
D. De Seta ◽  
Flaminia Campo ◽  
V. D’Aguanno ◽  
M. Ralli ◽  
A. Greco ◽  
...  
Keyword(s):  
Glottic Carcinoma ◽  
Transoral Laser Microsurgery ◽  
Laser Microsurgery ◽  
T1 And T2

Punch Grafting for the Management of Hard-to-Heal Diabetic Foot Ulcers: A Prospective Case Series

2021 ◽  
pp. 153473462110310
Author(s):  
Marta García-Madrid ◽  
Irene Sanz-Corbalán ◽  
Aroa Tardáguila-García ◽  
Raúl J. Molines-Barroso ◽  
Mateo López-Moral ◽  
...  
Keyword(s):  
Wound Healing ◽  
Clinical Outcomes ◽  
Diabetic Foot ◽  
Donor Site ◽  
Case Series ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Wound Debridement ◽  
Prospective Case Series

Punch grafting is an alternative treatment to enhance wound healing which has been associated with promising clinical outcomes in various leg and foot wound types. We aimed to evaluate the clinical outcomes of punch grafting as a treatment for hard-to-heal diabetic foot ulcers (DFUs). Six patients with chronic neuropathic or neuroischemic DFUs with more than 6 months of evolution not responding to conventional treatment were included in a prospective case series between May 2017 and December 2020. All patients were previously debrided using an ultrasound-assisted wound debridement and then, grafted with 4 to 6 mm punch from the donor site that was in all cases the anterolateral aspect of the thigh. All patients were followed up weekly until wound healing. Four (66.7%) DFUs were located in the heel, 1 (16.7%) in the dorsal aspect of the foot and 1 (16.7%) in the Achilles tendon. The median evolution time was 172 (interquartile range [IQR], 25th-75th; 44-276) weeks with a median area of 5.9 (IQR; 1.87-37.12) cm2 before grafting. Complete epithelization was achieved in 3 (50%) patients at 12 weeks follow-up period with a mean time of 5.67 ± 2.88 weeks. Two of the remaining patients achieved wound healing at 32 and 24 weeks, respectively, and 1 patient showed punch graft unsuccessful in adhering. The median time of wound healing of all patients included in the study was 9.00 (IQR; 4.00-28.00) weeks. The wound area reduction (WAR) at 4 weeks was 38.66% and WAR at 12 weeks was 88.56%. No adverse effects related to the ulcer were registered through the follow-up period. Autologous punch graft is an easy procedure that promotes healing, achieving wound closure in chronic DFUs representing an alternative of treatment for hard-to-heal DFUs in which conservative treatment has been unsuccessful.

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