Vocal Fold Cyst Formation after Photoangiolytic KTP Laser Treatment of Early Glottic Cancer

2021 ◽  
pp. 000348942110222
Author(s):  
Kenneth Yan ◽  
Aaron D. Friedman
Keyword(s):  
Vocal Fold ◽  
Retrospective Chart Review ◽  
Cyst Formation ◽  
Glottic Cancer ◽  
Ktp Laser ◽  
Glottic Carcinoma ◽  
Early Glottic Cancer ◽  
Vocal Process ◽  
Tumor Distribution

Objective: The incidence of post-operative glottic cyst (POGC) formation in patients treated with transoral laser microsurgery with potassium-titanyl-phosphate laser (TLM-KTP) photoablation of early glottic carcinoma (EGC) has not previously been described. Methods: A retrospective chart review was performed to identify all patients with early glottic cancer who underwent with single-modality TLM-KTP at our institution. Each patient received regular follow up with videostroboscopy for tumor surveillance. New glottic cysts seen on surveillance examinations were noted and their management was documented. Results: A total of 33 patients met inclusion criteria. Eight patients (24%) developed POGC’s within the original geographic perimeter of the cancerous vocal fold(s): 6 in the infraglottic region and 2 near the vocal process, at an average of 8 months after their initial cancer surgery. Of these 8 POGC’s, 7 were at the periphery of the original tumor distribution and 1 was in the center of it. No POGC’s were associated with any change in voice. Four of the 8 POGC’s were phonosurgically excised, all without evidence of malignancy on pathology. The remaining 4 were monitored: 2 were stable for an average of 49 months of follow up; the remaining 2 resolved spontaneously by 7 and 31 months after first identification. Conclusions: POGC’s are a frequent sequela of TLM-KTP for EGC. While these results suggest that they are unlikely to represent submucosal recurrences, surgeons should have a low threshold to biopsy if there is clinical concern for such and should counsel patients pre-operatively about the potential for their formation.

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.

KTP Laser Treatment of Early Glottic Cancer: A Multi-Institutional Retrospective Study

2020 ◽  
Vol 130 (1) ◽  
pp. 47-55
Author(s):  
Noah P. Parker ◽  
Mark S. Weidenbecher ◽  
Aaron D. Friedman ◽  
Brian A. Walker ◽  
David G. Lott
Keyword(s):  
Overall Survival ◽  
Outcome Measures ◽  
Oncologic Outcomes ◽  
Glottic Cancer ◽  
Ktp Laser ◽  
Disease Specific Survival ◽  
Early Glottic Cancer ◽  
T2 Lesions ◽  
Disease Specific

Objectives: The primary objectives were to report oncologic outcomes of transoral laser microsurgery with potassium-titanyl-phosphate (KTP) laser (TLM-KTP) ablation of early glottic cancer (EGC). The secondary objectives were to report vocal outcomes and to analyze factors that might influence outcomes. Methods: A multi-institutional, retrospective analysis of consecutive patients treated for T1 or T2 glottic squamous cell carcinoma undergoing TLM-KTP ablation with at least 2 years of follow-up was performed. Patients with prior radiation or surgery for laryngeal disease were excluded. Primary outcome measures included: surgical failures requiring radiation or laryngectomy, disease-specific survival (DSS), and overall survival (OS). Secondary outcome measures included: pre- and postoperative Voice Handicap Index-10 (VHI-10) scores. The effects of smoking status, stage, and anterior commissure involvement on outcomes were analyzed. Results: Overall 88 patients met inclusion criteria (83% male, 79.5% current or former smokers). Mean age was 68 (standard deviation (SD): 12). Mean follow-up was 39.5 months (SD: 15.3). Staging included 50 T1a, 21 T1b, and 20 T2 tumors, including three metachronous second primaries. Radiation and/or laryngectomy avoidance was achieved in 87/88 (98.9%) of patients, inclusive of 24 patients requiring KTP re-treatments. Two patients had biopsy-proven recurrence (2.3%), but only 21 of 24 re-treated patients received a formal biopsy. No patients died from laryngeal cancer. DSS and OS were 100% and 92.3%, respectively. The mean VHI-10 scores were 19.3 preoperatively, 3.8 at 6-months postop, and 3.8 at 2-years postop. Smokers had a longer interval to re-treatment ( P = .03), patients with T2 lesions had a shorter interval to re-treatment (0.02), and patients with T2 lesions presented with worse initial VHI-10 scores (0.002). Conclusions: A multi-institutional, retrospective case series of TLM-KTP ablation of EGC demonstrated excellent oncologic outcomes when close surveillance and proactive re-treatments were utilized. Disease-specific survival, overall survival, and vocal function were excellent. Additional studies are necessary to further analyze the merits and risks of this treatment approach.

Predictive Factors of Carcinological Outcomes for Glottic Cancer Treated With Transoral Laser Cordectomy

2020 ◽  
Vol 2 (1) ◽  
pp. 01-04
Author(s):  
ALJ zineb
Keyword(s):  
Predictive Factors ◽  
Laser Surgery ◽  
Local Control Rate ◽  
Glottic Cancer ◽  
Glottic Carcinoma ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Early Glottic Cancer ◽  
Transoral Laser Surgery ◽  
Preservation Rate

Tran’s oral laser surgery is at the forefront of the therapeutic arsenal of epidermoid glottic cancer, but its indications for certain local extensions are controversial. We have analyzed through a retrospective study of 37 patients with T1 or T2 epidermoid glottic carcinoma, treated with transoral laser surgery, the post-surgical outcomes regarding the relapse-free survival, local control rate, laryngeal preservation rate and overall survival, correlated to the initial local extension. This study aimed at clarifying further the clinical behavior of early glottic cancer following transoral laser surgery and to determine, using retrospective analysis, and the predictive factors of carcinological outcomes.

Voice Outcomes for Photoangiolytic KTP Laser Treatment of Early Glottic Cancer

2013 ◽  
Vol 122 (3) ◽  
pp. 151-158 ◽  
Author(s):  
Aaron D. Friedman ◽  
Robert E. Hillman ◽  
Tali Landau-Zemer ◽  
James A. Burns ◽  
Steven M. Zeitels
Keyword(s):  
Laser Treatment ◽  
Glottic Cancer ◽  
Ktp Laser ◽  
Early Glottic Cancer

Voice outcomes following transoral laser microsurgery for early glottic squamous cell carcinoma

2007 ◽  
Vol 121 (12) ◽  
pp. 1184-1188 ◽  
Author(s):  
J T Kennedy ◽  
P M Paddle ◽  
B J Cook ◽  
P Chapman ◽  
T A Iseli
Keyword(s):  
Glottic Cancer ◽  
Transoral Laser Microsurgery ◽  
Laser Microsurgery ◽  
Early Glottic Cancer ◽  
Primary Radiotherapy ◽  
Second Procedure ◽  
European Laryngological Society ◽  
Choice Of Therapy ◽  
Salvage Laryngectomy

AbstractIntroduction:Early glottic cancer may be treated with primary radiotherapy or transoral laser microsurgery with comparable survival. The choice of therapy therefore depends on patient preference after discussion of risks, benefits and alternatives.Materials and methods:All previously untreated patients undergoing transoral laser microsurgery for T1 or T2 glottic cancer at St Vincent's Hospital between July 1997 and December 2004 had their staging and demographics recorded. Surgery was categorised according to the European Laryngological Society. A voice recording was made pre-operatively then at 12 weeks post-operatively and scored by two independent speech therapists on the Oates Russell Voice Profile – a scale of zero (normal) to five (severe dysphonia). Follow up was for a minimum of two years.Results and analysis:Fifty-three patients with a mean age of 56 were included. The observed survival was T1 89.4 per cent and T2 85.3 per cent after a mean follow up of 47 months. Nineteen patients staged T1 underwent cordectomy. A second procedure was required in 22.2 per cent, however, none required a laryngectomy. Thirty-four patients staged T2 underwent hemilaryngectomy. A second procedure was required in 41.2 per cent including 8.8 per cent requiring salvage laryngectomy. One patient died with unresectable nodal disease. The mean Oates Russell Voice Profile for T1 disease was 2.37 and for T2 2.68 (range 1 to 4) indicating a mild (2) to moderate (3) degree of voice impairment.Conclusions:Survival outcomes following transoral laser microsurgery are comparable to treatment with radiotherapy. Voice impairment is usually mild to moderate following transoral laser microsurgery for early glottic cancer but overall may be greater than in radiotherapy patients. The repeatability of transoral laser microsurgery may result in a lower laryngectomy rate compared with published series using radiotherapy.

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.

Modern diagnostics of early glottic cancer

2020 ◽  
Vol 9 (4) ◽  
pp. 1-5
Author(s):  
Anna Rzepakowska
Keyword(s):  
Vocal Folds ◽  
Post Treatment ◽  
Initial Diagnosis ◽  
Glottic Cancer ◽  
Review Of Literature ◽  
Careful Evaluation ◽  
Early Glottic Cancer ◽  
Current Guidelines

This article is a review of literature and a summary of the current guidelines in the diagnosis of hypertrophic vocal folds suspected of malignancy. It gives a detailed overview both of initial diagnosis, as well as the methods of in-depth intraoperative diagnostics and proposals for careful evaluation during post-treatment follow-up examinations.

Salvage Endoscopic Angiolytic KTP Laser Treatment of Early Glottic Cancer after Failed Radiotherapy

2013 ◽  
Vol 122 (4) ◽  
pp. 235-239 ◽  
Author(s):  
Anca M. Barbu ◽  
James A. Burns ◽  
Gerardo Lopez-Guerra ◽  
Tali Landau-Zemer ◽  
Aaron D. Friedman ◽  
...  
Keyword(s):  
Laser Treatment ◽  
Glottic Cancer ◽  
Ktp Laser ◽  
Early Glottic Cancer

Multimodal Evaluation of Voice Outcome in Early Glottic Cancers Treated With Definitive Radiotherapy

2021 ◽  
Vol 1 (3) ◽  
pp. 143-149
Author(s):  
MARIANNA TRIGNANI ◽  
ANGELO DI PILLA ◽  
CONSUELO ROSA ◽  
MARZIA BORGIA ◽  
DAVID FASCIOLO ◽  
...  
Keyword(s):  
Glottic Cancer ◽  
Early Glottic Cancer ◽  
Vocal Cord Motion ◽  
Voice Outcome ◽  
Speech Pathologist ◽  
Primary Radiotherapy ◽  
Evaluation Of Parameters ◽  
Speech Therapist

Background/Aim: We employed a multimodal evaluation of voice outcome (MEVO) model to assess long-term voice outcome in early glottic cancer (EGC) patients treated with primary radiotherapy (RT). The model consisted of objective and subjective vocal evaluation during follow-up, by a dedicated Speech Pathologist and Speech Therapist. Patients and Methods: MEVO methodology includes Self-perception Voice Handicap Index (VHI-30), evaluation of parameters Grade (G), Roughness (R), Breathiness (B), Asthenia (A) and Strain (S) according to GRBAS scale, objective analysis and aerodynamics using the PRAAT software and laryngeal evaluation with videostroboscope (VS). Results: The MEVO methodology was described and tested on a sample of 10 EGCs submitted to definitive RT (total dose 66-70 Gy). Mean follow-up was 48.9 months (range=9-115). VHI was mild-moderate in 90% of patients; overall voice function (GRBAS) was normal-mildly impaired in 70% of patients; VS evaluation showed normal vocal cord motion in 90% of patients, but complete glottic closure in 60%. PRAAT scores confirmed these findings. Conclusion: A multidimensional voice evaluation is time consuming, but useful to objectify vocal impact of radiotherapy. The MEVO model allowed to quantify vocal dysfunction, showing a good objective vocal outcome.

Sign in / Sign up

Export Citation Format

Share Document