Vertical partial frontolateral laryngectomy with simultaneous pedunculated sternothyroid muscle flap reconstruction of the vocal fold – surgical procedure and treatment outcomes

2018 ◽  
Vol 72 (1) ◽  
pp. 23-29
Author(s):  
Olga Jurek-Matusiak ◽  
Piotr Wójtowicz ◽  
Tomasz Szafarowski ◽  
Antoni Krzeski
Keyword(s):  
Treatment Outcomes ◽  
Vocal Fold ◽  
Muscle Flap ◽  
Good Method ◽  
Intermediate Stage ◽  
Glottic Cancer ◽  
Partial Laryngectomy ◽  
Flap Reconstruction ◽  
Tumor Spread ◽  
Male Patients

Purpose of the study: The aim of the study was to present the treatment outcomes after vertical partial laryngectomy with or without pedunculated sternothyroid muscle flap reconstruction following the resection of neoplasm-infiltrated vocal fold. The procedure was used in a patient with glottic cancer. Oncological outcomes, morphology of neo-vocal fold and the act of swallowing were evaluated. Material and methods: 45 patients with T1-T2 glottic cancer were subjected to vertical partial laryngectomy with 26 patients undergoing a procedure with pedunculated sternothyroid muscle flap reconstruction and the remaining 19 patients undergoing a procedure without such a reconstruction. Two female and 43 male patients aged 35-82 years (mean age of 62.5 years) were enrolled in the study. Local tumor spread and the condition of reconstructed vocal fold were assessed in sequential videofiberoscopy examination conducted each month after surgery whereas the regional spread was assessed in ultrasound scans. Postoperative aspiration was graded according to the Pearson’s scale. Results: Six patients experienced local recurrence while 2 patients experienced regional recurrence of the tumor. The pedunculated sternothyroid muscle flap neo-fold was structurally resemblant of the non-affected vocal fold. Episodic, daily dysphagia was observed in 1 patient while normal act of swallowing with no Pearson’s scale symptoms was observed in the remaining 44 patients. No necrosis of pedunculated flap was observed. Conclusions: Vertical partial laryngectomy with or without pedunculated sternothyroid muscle flap reconstruction is a good method for the treatment of low- or intermediate-stage glottic cancer, especially when endoscopic access to the tumor is limited and when CO2 laser cannot be used. No significant functional disorders were observed in operated larynges.

Pectoralis Muscle Flap Reconstruction of Pediatric Sternal Wound Infections

2003 ◽  
Vol 14 (4) ◽  
pp. 512-516 ◽  
Author(s):  
David Zabel ◽  
Benjamin D. Eskra ◽  
Dimitri Laddis ◽  
Negin Noorchashm ◽  
Ralph Siewers ◽  
...  
Keyword(s):  
Muscle Flap ◽  
Wound Infections ◽  
Pectoralis Muscle ◽  
Flap Reconstruction ◽  
Sternal Wound Infections

A view of partial laryngectomy in the treatment of laryngeal cancer

1987 ◽  
Vol 101 (2) ◽  
pp. 143-154 ◽  
Author(s):  
H. J. Shaw
Keyword(s):  
Laryngeal Cancer ◽  
Glottic Cancer ◽  
Partial Laryngectomy ◽  
Therapeutic Dosage ◽  
Reasonable Expectation ◽  
Functional Conservation ◽  
Supraglottic Cancer ◽  
Results Of Treatment ◽  
The United Kingdom ◽  
Conservation Surgery

AbstractAttention is drawn to the problems of surgical resection by partial laryngectomy after full therapeutic dosage of telecobalt irradiation. Material is presented from two treatment centres to indicate trends in surgical treatment and the complications experienced. Results will be given which confirm a reasonable expectation of cure and functional conservation by vertical partial laryngectomy for recurrence of glottic cancer after irradiation. The results of treatment of recurrent supraglottic cancer by horizontal partial laryngectomy gave more cause for concern in terms of complications and survival. In conclusion an attempt is made, based on the quoted experience, to define the position of conservation surgery in two centres for laryngeal cancer in the United Kingdom.

Treatment Outcomes and Prognostic Factors in Male Patients With Stage IV Breast Cancer: A Population-based Study

2018 ◽  
Vol 18 (1) ◽  
pp. e97-e105 ◽  
Author(s):  
Wei Chen ◽  
Ying Huang ◽  
Gary D. Lewis ◽  
Sean S. Szeja ◽  
Sandra S. Hatch ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Treatment Outcomes ◽  
Stage Iv ◽  
Population Based ◽  
Population Based Study ◽  
Stage Iv Breast Cancer ◽  
Male Patients

scholarly journals Reconstruction of the larynx with unipedicled sternohyoid myofascial flap following open extended vertical partial laryngectomy

2018 ◽  
Vol 5 (1) ◽  
pp. 231
Author(s):  
Ramil K. Yagudin ◽  
Kamil F. Yagudin
Keyword(s):  
Significant Risk ◽  
Extent Of Resection ◽  
Glottic Cancer ◽  
Partial Laryngectomy ◽  
Laryngeal Function ◽  
Protective Function ◽  
Simple Modification ◽  
Mucosal Defect ◽  
Laryngeal Mucosa ◽  
Ideal Technique

<p class="abstract">The extent of resection during open vertical partial laryngectomy may vary considerably and even an experienced surgeon may encounter difficulties in reconstructing the larynx to preserve laryngeal function and to prevent stenosis. Different local flaps were proposed for reconstruction; however, the ideal technique is still under development. A simple modification to the technique originally described by Calcaterra (1983) is presented. The unipedicled sternohyoid myofascial flap consists of the unsplit sternohyoid muscle with all three overlying fasciae harvested as a whole. The flap is rotated 90° and horizontally sutured in position to supply the necessary bulk to the entire neocord to produce a functional voice. Completely filling the mucosal defect USMF-flap allows laryngeal structures to maintain their native position and retain protective function of the larynx. The thick multilayered fascia covering facilitates rapid epithelization and prevents excessive granulation and secondary stenosis. The technique is indicated in glottic cancer patients treated by open extended vertical partial laryngectomy when the laryngeal mucosa defect is too extensive for primary closure and poses significant risk of developing postoperative stenosis.</p>

Laryngeal framework reconstruction using titanium mesh in glottic cancer after frontolateral vertical partial laryngectomy

2010 ◽  
Vol 120 (11) ◽  
pp. 2197-2202 ◽  
Author(s):  
Xue-Kui Liu ◽  
Quan Zhang ◽  
Quan Li ◽  
Wei-Wei Liu ◽  
Hao Li ◽  
...  
Keyword(s):  
Glottic Cancer ◽  
Partial Laryngectomy ◽  
Titanium Mesh

Pelvic Reconstruction following Abdominoperineal Resection and Pelvic Exenteration: Management Practices among Plastic and Colorectal Surgeons

2021 ◽  
Author(s):  
Michael J. Stein ◽  
Aneesh Karir ◽  
Melissa N. Hanson ◽  
Naveen Cavale ◽  
Alex M. Almoudaris ◽  
...  
Keyword(s):  
Abdominoperineal Resection ◽  
Dead Space ◽  
Management Practices ◽  
Pelvic Exenteration ◽  
Muscle Flap ◽  
The United States ◽  
Pelvic Reconstruction ◽  
Flap Reconstruction ◽  
Colorectal Surgeons ◽  
Perineal Defect

Abstract Background Pelvic reconstruction with a muscle flap significantly improves postoperative outcomes following abdominoperineal resection (APR). Despite it being the gold standard, significant surgeon-selection bias remains with respect to the necessity of pelvic obliteration, flap choice, and ostomy placement. The objective of the study was to characterize management practices among colorectal surgeons (CSs) and plastic surgeons (PSs). Methods Specialty-specific surveys were distributed electronically to CSs and PSs via surgical societies. Surveys were designed to illustrate geographic and specialty-specific differences in management. Results Of 106 (54 CSs and 52 PSs) respondents (58% Canada, 21% Europe, 14% the United States, and 6% Asia/Africa), significant interdisciplinary differences in practices were observed. Most respondents indicated that multidisciplinary meetings were not performed (74% of CSs and 78% of PSs). For a nonradiated pelvic dead space with small perineal defect, 91% of CSs and 56% of PSs indicated that flap reconstruction was not required. For a radiated pelvic dead space with small perineal defect, only 54% of CSs and 6% of PSs indicated that there was no need for flap reconstruction. With respect to ostomy placement, 87% of CSs and 21% of PSs indicated that stoma placement through the rectus was superior. When two ostomies were required, most CSs preferred exteriorizing ostomies through bilateral recti and requesting thigh-based reconstruction. PSs favored the vertical rectus abdominis muscle (VRAM; 52%) over the gracilis (23%) and inferior gluteal artery perforator (IGAP; 23%) flaps. Among PSs, North Americans favor abdominally based flaps (VRAM 60%), while Europeans favor gluteal-based flaps (IGAP 78%). Conclusion A lack of standardization continues to exist with respect to the reconstruction of pelvic defects following APR and pelvic exenteration. Geographic and interdisciplinary biases with respect to ostomy placement, flap choice, and role for pelvic obliteration continues to influence reconstructive practices. These cases should continue to be approached on a case by case basis, driven by pathology, presence of radiation, comorbidities, and the size of the pelvic and perineal defect.

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