Total Laryngectomy with Tracheopharyngeal Fistula (Neoglottis)

Our experience with the so-called “neoglottis” (according to Staffieri) after total laryngectomy is presented. The technique, described in detail, aims at giving the patient good speech by creating a tracheoesophageal fistula through which air passes. In the period from 1973–1979, 63 patients underwent the procedure. The functional results were satisfactory in 68% of the cases. The patient's voice is much more agreeable than the esophageal voice and sounds louder and less monotonous than a laryngophone voice. The spectrographic analyses confirm its resemblance to natural voice. An occasional passage of liquids into the trachea may occur, but is not prejudicial to either speech or swallowing. Some dysfunctional problems may arise early or late after the operation: they are continuous aspiration during swallowing and lack of phonatory function. In most cases, these problems are due to incorrect surgical technique; the possibilities and procedures of correction are described. In conclusion, we maintain that the “neoglottis,” which may be applied to nearly all cases of total laryngectomy, represents a worthwhile “phonatory” innovation in the field of mutilating surgery of laryngeal cancer.

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Surgical Closure of Tracheoesophageal Puncture Without a Flap Interposition

Otolaryngology ◽

10.1177/0194599820931077 ◽

2020 ◽

Vol 163 (3) ◽

pp. 618-620

Author(s):

João Fonseca Neves ◽

Ana Rita Nobre ◽

Edite Portugal ◽

Francisco Branquinho

Keyword(s):

Surgical Technique ◽

Total Laryngectomy ◽

Tracheoesophageal Fistula ◽

Skin Flap ◽

Anterior Segment ◽

Continuous Suture ◽

Vocal Rehabilitation ◽

Surgical Closure ◽

Tracheoesophageal Puncture ◽

Suture Closure

Tracheoesophageal puncture for voice prosthesis placement is often used in vocal rehabilitation of patients undergoing total laryngectomy. Although its closure can occur spontaneously, some patients require a surgical procedure. We propose a surgical technique, without flap interposition, that begins with careful separation of the esophagus and trachea and identification of the site of tracheoesophageal fistula. After continuous suture closure of the esophagus, the anterior segment of the first tracheal rings is vertically incised to facilitate tracheal closure in a suture without tension. Finally, a small pectoral skin flap is made and mobilized to suture to the free edges of the sectioned tracheal rings, thus reducing the risk of tracheal stenosis. Four patients underwent this procedure with uneventful postoperative evolution and permanent closure of the fistula.

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Tracheoesophageal Fistula by Chemoradiotherapy after a Total Laryngectomy in a Laryngeal Cancer Patient: A Case Report

Journal of the Korean Dysphagia Society ◽

10.34160/jkds.2020.10.1.016 ◽

2020 ◽

Vol 10 (1) ◽

pp. 130-133

Author(s):

Ji Hye Kang ◽

Min-Wook Kim ◽

Inn-Chul Nam

Keyword(s):

Case Report ◽

Cancer Patient ◽

Laryngeal Cancer ◽

Total Laryngectomy ◽

Tracheoesophageal Fistula ◽

Laryngeal Cancer Patient

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Faculty Opinions recommendation of Comparison of quality of life in advanced laryngeal cancer patients after concurrent chemoradiotherapy vs total laryngectomy.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1126894.584003 ◽

2008 ◽

Author(s):

Giulio Cantu ◽

Stefano Riccio

Keyword(s):

Quality Of Life ◽

Cancer Patients ◽

Laryngeal Cancer ◽

Total Laryngectomy ◽

Concurrent Chemoradiotherapy

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Long-Term Histologic Changes in Nasal Mucosa after Total Laryngectomy

International Journal of Otolaryngology ◽

10.1155/2010/137128 ◽

2010 ◽

Vol 2010 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

Çiğdem Tepe Karaca ◽

Erdoğan Gültekin ◽

M. Kürşat Yelken ◽

Ayşenur Akyıldız İğdem ◽

Mehmet Külekçi

Keyword(s):

Cancer Patients ◽

Nasal Mucosa ◽

Laryngeal Cancer ◽

Total Laryngectomy ◽

Group 3 ◽

Histopathologic Changes ◽

Group 2 ◽

The Relationship ◽

Histopathologic Findings

Objective. To determine the long-term histopathologic changes in nasal mucosa and the relationship between progression of the histopathologic changes and the duration without air current stimulation.Material and Method. Biopsies were taken from the inferior turbinates of 11 laryngeal cancer patients after total laryngectomy. Specimens were stained with hematoksilen-eosin and several histopathologic parameters were examined under light microscopy.Results. All of the patients demonstrated at least one histopathologic abnormality (100%,n=11). Goblet destruction and stromal fibrosis were the most common findings (81%,n=9), followed by focal epithelial atrophy and subepithelial seromusinous gland destruction (45%,n=5), neovascularization and congestion (36%,n=4), complete epithelial atrophy and mixoid degeneration (27%,n=3). According to the duration between laryngectomy and biopsy, patients were grouped in to three: group 1; less than 12 months (36%,n=4), group 2; 12–36 months (18%,n=2), and group 3; more than 36 months (45%,n=5). Only congestion was found to be decreased as the duration increased (P<.005).Conclusion. In laryngeal cancer patients histopathologic changes occur in nasal mucosa eventuate due to the cessation of air current stimulation, however there was no relation between progression of the histopathologic findings and the duration of cessation.

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Letter to Editor: Stapler closure versus manual closure in total laryngectomy for laryngeal cancer: A systematic review and meta‐analysis

Clinical Otolaryngology ◽

10.1111/coa.13757 ◽

2021 ◽

Author(s):

George Garas ◽

Ara Darzi ◽

Thanos Athanasiou ◽

Jeffrey Lancaster

Keyword(s):

Systematic Review ◽

Laryngeal Cancer ◽

Total Laryngectomy ◽

Meta Analysis

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Minimally invasive repair of ruptured Achilles tendon

Acta chirurgica iugoslavica ◽

10.2298/aci1501085b ◽

2015 ◽

Vol 62 (1) ◽

pp. 85-88

Author(s):

Nikola Bulatovic ◽

Miroslav Kezunovic ◽

Zarko Dasic ◽

Nikola Fatic

Keyword(s):

Surgical Technique ◽

Achilles Tendon ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Functional Results ◽

Recreational Athletes ◽

Acute Injuries ◽

Clinical Center ◽

Immobility Time ◽

Heel Bone

INTRODUCTION: Achilles tendon rupture usually occurs in recreational athletes of middle age 30-50godina and typical place of the rupture of 3-5 cm above the insertion of the heel bone. Most common in recreational athletes. OBJECTIVE: To view the surgical technique suture the tendon with a guide ?Achillon? the functional outcome of acute injuries. MATERIAL AND METHODS: retrospective analysis included a total of 20 patients treated at the Clinic of Orthopedics and Traumatology, Clinical Center of Montenegro in Podgorica in the 2009-14. They were monitored for 12 months. Diagnosis is based on history, clinical examination Thompson?s Simmond O?Brien test, ECHO and NMR. RESULTS: The average age was 38.8 ?2.79 years 21-52 years. Right in 14 respondents 70%, the left side in 6 30%. There were no complications as: infection, thrombosis, rerupture and embolism. Functional results tables we have shown through specific scores. CONCLUSION: It can be concluded that this procedure provides a simple and quick surgical technique, a small percentage of complications, shorter immobility time and good functional results.

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Application of fascia of the temporal muscle and cartilage of the auricular tragus in myringoplasty in children

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1208408b ◽

2012 ◽

Vol 140 (7-8) ◽

pp. 408-411 ◽

Cited By ~ 1

Author(s):

Ivan Baljosevic ◽

Jovica Milovanovic ◽

Vladan Subarevic ◽

Mladen Novkovic ◽

Katarina Stankovic

Keyword(s):

Surgical Technique ◽

Tympanic Membrane ◽

Statistical Significance ◽

Functional Results ◽

Young Age ◽

Temporal Muscle ◽

Temporal Fascia ◽

Middle Ear Infection ◽

Number Of Patients ◽

And Cartilage

Introduction. Perforation of the tympanic membrane in children may be the cause of recurrent middle ear infection and loss of hearing. Objective. The aim of this study was to analyze the application of different reconstructive materials in surgical technique myringoplasty. Methods. We performed 88 myringoplasties due to auricular tragus perforation in 76 children (aged 4 to 16 years, mean 11.9 years) from July 2001 to July 2009. Age, gender, size and the site of perforation, status of the contra lateral ear, underlying cause of the perforations, surgical technique, preoperative and postoperative hearing levels and postoperative complications were recorded and analyzed. In performing myringoplasty we used fascia of the temporal muscle and cartilage of the auricular tragus. Results. In 43 (48%) patients we used fascia of the temporal muscle and in 45 (52%) cartilage of the auricular tragus. Graft success was defined as an intact eardrum at 12 months postoperatively and improvement in the perception of air-bone gap of 10 dB, which we recorded in 73 (83%) cases. Re-perforations were recorded in 12 (13%) patients, of whom in 8 (18.6%) cases we used the temporal fascia and in 4 (9.3%) cases a tragal cartilage. Retraction of the tympanic membrane was recorded in 3 (4%) cases with the temporal fascia. Conclusion. Myringoplasty is a reasonably successful method with good functional results in pediatric patients. Risk factors of surgical failure are young age, the size of auricular tragus perforation and pathological conditions of the contra lateral ear. The tragal cartilage gives better results in cases with bilateral perforations because the possibility of retractions and re-perforations is lower. Relatively small number of patients is probably the reason that, except for young age, differences between the two groups did not reach the level of statistical significance.

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Radiomics and Texture Analysis in Laryngeal Cancer. Looking for New Frontiers in Precision Medicine through Imaging Analysis

Cancers ◽

10.3390/cancers11101409 ◽

2019 ◽

Vol 11 (10) ◽

pp. 1409 ◽

Cited By ~ 5

Author(s):

Chiesa-Estomba ◽

Echaniz ◽

Larruscain ◽

Gonzalez-Garcia ◽

Sistiaga-Suarez ◽

...

Keyword(s):

Decision Making ◽

Precision Medicine ◽

Texture Analysis ◽

Laryngeal Cancer ◽

Clinical Decision Making ◽

Functional Anatomy ◽

Functional Results ◽

Predictive Biomarker ◽

Diagnostic Tools ◽

Imaging Data

Radiomics and texture analysis represent a new option in our biomarkers arsenal. These techniques extract a large number of quantitative features, analyzing their properties to incorporate them in clinical decision-making. Laryngeal cancer represents one of the most frequent cancers in the head and neck area. We hypothesized that radiomics features can be included as a laryngeal cancer precision medicine tool, as it is able to non-invasively characterize the overall tumor accounting for heterogeneity, being a prognostic and/or predictive biomarker derived from routine, standard of care, imaging data, and providing support during the follow up of the patient, in some cases avoiding the need for biopsies. The larynx represents a unique diagnostic and therapeutic challenge for clinicians due to its complex tridimensional anatomical structure. Its complex regional and functional anatomy makes it necessary to enhance our diagnostic tools in order to improve decision-making protocols, aimed at better survival and functional results. For this reason, this technique can be an option for monitoring the evolution of the disease, especially in surgical and non-surgical organ preservation treatments. This concise review article will explain basic concepts about radiomics and discuss recent progress and results related to laryngeal cancer.

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