OBJECTIVE: Pharyngoesophageal stricture formation and dysphagia following total laryngectomy negatively affect quality of life and result in nutritional compromise that can be successfully managed with various techniques. This study was conducted to describe our experiences of office-based balloon dilatation by transnasal endoscopy, which can be performed by an otolaryngologist. METHOD: The present study investigated three patients who underwent transnasal endoscopy guided balloon dilatation of pharyngoesophageal stricture. The assessment was performed based on the number of procedures and recurrences, final subjective outcomes, and complications. RESULT: There were no post-procedural complications. In one patient, a scarric band was found after the procedure; therefore, steroids were injected into the stricture site. There were 2–3 balloon dilatations and the interval between dilatations was 3–6 months. All patients were able to tolerate solid diet after 2 or 3 sessions. CONCLUSION: Transnasal endoscopic balloon dilatation, which can be easily performed by an otolaryngologist in an office setting without sedation or general anesthesia, can be a useful modality for treating pharyngoesophageal stricture after total laryngectomy.
Anesthesia, General ; Constriction, Pathologic ; Deglutition Disorders ; Diet ; Dilatation ; Endoscopy ; Humans ; Laryngectomy ; Methods ; Quality of Life ; Recurrence ; Steroids

Total laryngectomy remains as an important treatment option in selected patients with laryngopharyngeal cancers, which inevitably sacrifices naturally produced voice. Much effort has been devoted to voice restoration for these laryngectomized patients. Several ways of voice rehabilitation after total laryngectomy have been developed and utilized thus far, including tracheoesophageal shunt speech, esophageal speech, pneumatic speech aid, and electrolarynx. Of these, tracheoesophageal shunt speech appears to be the most effective voice restoration method, while other trials might also be useful in special situations. Nevertheless, each method has its own unique mechanisms of voice production, thus has its advantages and drawbacks in clinical setting. In this review, we discuss the currently available management options for the rehabilitation of laryngectomized voice.
Humans ; Laryngectomy* ; Methods ; Rehabilitation* ; Speech, Esophageal ; Voice*

PURPOSE: Decision to perform concurrent ipsilateral thyroidectomy on patients with hypopharyngeal cancer is important, and unnecessary thyroidectomy should be avoided if oncologically feasible. We hypothesized that concurrent ipsilateral thyroidectomy is not routinely required to prevent occult metastasis. This study aimed to determine the prevalence of histological thyroid invasion in patients with hypopharyngeal cancer, and to refine the indications for prophylactic ipsilateral thyroidectomy in patients with hypopharyngeal cancer. MATERIALS AND METHODS: A retrospective review of the medical records from the Department of Otolaryngology at Yonsei University College of Medicine was conducted from January 1994 to December 2009. A total of 49 patients underwent laryngopharyngectomy with thyroidectomy as a primary treatment of hypopharyngeal cancer. RESULTS: The incidence of thyroid gland involvement was 10.2%. The most common route of invasion was direct extension through the thyroid cartilage. Thyroid cartilage invasion (p=0.034) was the most significant factor associated with thyroid invasion. Disease-specific survival at 5 years was lower in patients with than without thyroid gland invasion (26.7% vs. 55.2%, respectively; p=0.032). Disease-free survival at 5 years was also lower in patients with than without thyroid gland invasion (20.0% vs. 52.1%, respectively; p=0.024). CONCLUSION: Ipsilateral thyroidectomy in combination with total laryngopharyngectomy is indicated when invasion of the thyroid cartilage is suspected in patients with hypopharyngeal cancer.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell/epidemiology/pathology/*surgery ; Disease-Free Survival ; Female ; Humans ; Hypopharyngeal Neoplasms/epidemiology/pathology/*surgery ; Incidence ; *Laryngectomy ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasms, Second Primary/epidemiology/pathology/surgery ; *Pharyngectomy ; Predictive Value of Tests ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies ; Thyroid Gland/*pathology/surgery ; Thyroid Neoplasms/epidemiology/*secondary ; Thyroidectomy/*methods

OBJECTIVE: To compare the clinical results between stapled and traditional suture closure total laryngectomy. METHOD: Fifty-three cases of laryngeal cancer with total laryngectomy were divided into 2 groups: 32 cases with traditional suture closure total laryngectomy (group A) and 21 cases with stapled total laryngectomy group (group B). Compare two groups in pharyngeal fistula, postoperative bleeding, dysphagia, and nasal regurgitation. RESULT: There was no difference of postoperative pharyngeal fistula between group A and B (P>0. 05). The incidence of dysphagia, nasal regurgitation, and postoperative bleeding in group B were 23. 8%, 14. 3% and 14. 3% respectively, which were obviously higher than that in group A (P<0. 05). CONCLUSION Stapled total laryngectomy has the advantages of reducing the operative time and simplifying the operation with some disadvantages such as higher standards of operation indications, higher incidence of dysphagia, higher nasal regurgitation, higher postoperative bleeding, and poor medical economic profit. Traditional suture closure total laryngectomy is recommended in clinical practice.
Deglutition Disorders ; Fistula ; pathology ; Humans ; Incidence ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Pharynx ; pathology ; Postoperative Complications ; Suture Techniques ; Sutures

OBJECTIVE: To discuss the function recovery and treatment effect of extended supraglottic orizontal-partial laryngectomy in the treatment of advanced laryngeal carcinoma and vallecula carcinoma. METHOD: Forty-four patients who received extended supraglottic orizontal partial laryngectomy were followed up on the survival, breath function, pronunciation and swallowing function. RESULT: The 2-year, 3-year survival rates of this group were 72.7% and 71.4%, respectively. There were no recurrence cases in this group. All cases of death were due to cervical lymph node metastasis or recurrent cervical lymph node metastasis after cervical lymph node dissection. The extractive rate of tracheostomy tube was 97.7%. Forty-two patients own good pronunciations. Two patients who received partial arytenoid cartilage resection own weaker pronunciations. After practising, all the patients can eat without the nasal feeding tube. CONCLUSION Extended supraglottic orizontalpartial laryngectomy give complete resection of the primary lesion. Patients who received extended supraglottic orizontalpartial laryngectomy have good breath, swallowing and pronunciation function.
Arytenoid Cartilage ; surgery ; Epiglottis ; pathology ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Neck Dissection ; Neoplasm Recurrence, Local ; Survival Rate ; Tracheostomy

OBJECTIVE: To investigate the surgery management of glottic carcinoma with high-frequency electrotome. METHOD: Twenty cases of patients with glottic carcinoma were treated by cordectomy under micro-laryngoscopy with high-frequency electrotome. RESULT: The 20 patients were followed up from 5 months to 6 years, retained good laryngeal function and structure: 1 case had local recurrences after 6 months, underwent total laryngectomy, and now no recurrence had been found: 19 cases (mild adhesions of vocal cords formed in 2 cases) had no local recurrence nor lymph node metastasis. CONCLUSION It is unnecessary to invest in expensive equipment in the cordectomy under micro-laryngoscopy with high frequency electrotome under general anesthesia and the result is satisfactory.
Aged ; Electrosurgery ; instrumentation ; Glottis ; pathology ; Humans ; Laryngeal Neoplasms ; pathology ; surgery ; Laryngectomy ; instrumentation ; methods ; Male ; Microsurgery ; Middle Aged ; Treatment Outcome

OBJECTIVE: To investigate the efficacy of CO2 laser treatment for patients with precancerous laryngeal lesions under phonomicrosurgery and to explore the points for attention in operation. METHOD: They were all treated with phonomicrosurgery techniques as mucosal epitheliumablation or mucosal stripping by using CO2 laser. Eight patients with laryngeal papilloma were excised by CO2 laser. RESULT: All patients were treated with CO2 laser surgery successfully. During follow-up of 6 to 39 months, all patients survived. Local recurrence or canceration were detected in 3 cases, of which 2 cases with laryngeal papilloma underwent CO2 laser treatment in one year post-operatively, while the other case with severe dysplasia underwent laryngeal vertical partial laryngectomy and post-operative radiotherapy one and half year postoperatively due to canceration. No local recurrence occurred until the last follow up. No severe complications such as dyspnea and hemorrhage occured. CONCLUSION CO2 laser surgery is an effective and minimally invasive treatment for precancerous laryngeal lesions. Through selecting the appropriate patient and paying attention to the operation during surgery, the adhesion of vocal cord can be reduced or even be avoided after CO2 laser surgery.
Adult ; Aged ; Carbon Dioxide ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Laser Therapy ; Lasers, Gas ; therapeutic use ; Male ; Microsurgery ; Middle Aged ; Precancerous Conditions ; surgery ; Treatment Outcome

OBJECTIVE: To investigate the feasibility and clinical characteristics of small partial laryngectomy without tracheotomy for T1-2 stage glottic carcinoma. METHOD: Forty-five patients with laryngeal squamaous cell carcinoma in T1-2 stage received small partial laryngectomy without tracheotomy. RESULT: All patients were primarily healed and were hospitalized for an average of 11.5 days post-operatively. In all patients, the function of respiration and the reflection of cough were normal, and laryngeal obstruction did not happen. The only postoperative complication was subcutaneous emphysema noted in 29 patients. Among them, subcutaneous emphysema extincted after 4-6 days in 26 patiens, only 3 patiens suffered from delayed healing because the subcutaneous emphysema extincted after 2 weeks. Mild subcutaneous emphysema did not affect the function of respiration and deglutition, healing of wound, and psychology of patients. All patients had been followed-up for 1-13 years. Only 2 patients died of tumor recurrence or metastasis. The function of respiration and deglutition were normal in the living patients, and no implanting metastasis on surface of trachea were found. CONCLUSION The theoretical foundation of small partial laryngectomy without tracheotomy for T1-2 stage glottic carcinoma has been well established. This surgical technique is feasible, safe and effective. It can significantly improve clinical outcome of T1-2 stage glottic carcinoma with minimal invasiveness. Furthermore, it can obviously abate the surgical, physiological and psychological trauma on patients.
Adult ; Aged ; Aged, 80 and over ; Glottis ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Male ; Middle Aged ; Tracheotomy

OBJECTIVETo discuss the clinical relevant factors causing recurrence and failure of laryngeal cancer after partial laryngectomy.

METHODSThe clinical data of 183 patients with laryngeal cancer who underwent partial laryngectomy from January 2005 to July 2009 in our hospital were analyzed retrospectively. 12 selected factors which might cause recurrence including sex, age, smoking condition, drinking condition, laryngeal cancer type, T stage, N stage, clinical stage, pathological grade, mode of operation, radiotherapy and margin status were analyzed.

RESULTSIn the 183 patients, 37 cases were recurrence, the recurrence rate was 20.2%, 3-year survival rate was 83.1%, and 5-year-expected survival rate was 71.8%. Seven factors, i.e. T stage, N stage, pathological grades, surgical margins, radiotherapy, drinking and smoking condition were associated with recurrence after partial laryngectomy. Multivariate analysis showed that drinking condition, surgical margins, adjuvant radiotherapy and pN stage were the main factors affecting the prognosis of patients with partial laryngectomy, and they all were risk factors.

CONCLUSIONSSimple surgical treatment of early laryngeal cancer alone can achieve satisfactory therapeutic effect. However, multidisciplinary treatment mode of the operation combined with radiotherapy should be considered for patients with advanced laryngeal carcinoma and positive surgical margins.

Adult ; Aged ; Aged, 80 and over ; Alcohol Drinking ; Carcinoma, Squamous Cell ; pathology ; radiotherapy ; surgery ; Female ; Follow-Up Studies ; Humans ; Laryngeal Neoplasms ; pathology ; radiotherapy ; surgery ; Laryngectomy ; methods ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Recurrence, Local ; radiotherapy ; surgery ; Neoplasm Staging ; Proportional Hazards Models ; Radiotherapy, Adjuvant ; Retrospective Studies ; Smoking ; Survival Rate ; Young Adult

OBJECTIVE: To compare the postoperative survival rate of laryngeal carcinoma patient at stage III or IV whom accepted partial laryngectomy and total laryngectomy. METHOD: We performed a retrospective cohort follow-up study of 126 patients of stage III or IV who underwent operation for laryngeal carcinoma in Chinese PLA General Hospital between January, 2005 and December, 2009. Survival rates were calculated by product-limit method. RESULT: There were 80 patients at stage III and 46 patient at stage IV. Sixty five patients underwent partial laryngectomy and 61 patients underwent total laryngectomy. There were 24 patients in whole group died in the 5 years, 15 of them underwent partial and 9 accepted total laryngectomy. The 5-years survival rate of partial and total group were 62.58% and 68.74% respectively. The survival curve of both groups had no significant difference (P < 0.05). CONCLUSION For laryngeal carcinoma patients at later stage, with suitable operative indication, the partial laryngectomy could achieve an acceptable effect as well as total laryngectomy.
Carcinoma, Squamous Cell ; mortality ; Humans ; Laryngeal Neoplasms ; mortality ; Laryngectomy ; methods ; mortality ; Neoplasm Staging ; Postoperative Period ; Retrospective Studies ; Survival Rate ; Treatment Outcome