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Contemporary Indications and Technical Limits of Transoral Laser Microsurgery for Laryngeal Squamous Cell Carcinoma.
Transoral laser microsurgery (TOLMS) is an established organ-preserving treatment for early-stage and selected intermediate-stage laryngeal squamous cell carcinoma (SCC). Initially indicated for Tis-T1 lesions, its use has progressively exp…
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Exoscopic Transoral Supraglottic Laryngectomy.
This article, accompanied by technical notes and video, presents a case of an 85-year-old patient with a cT2N0 laryngeal squamous cell carcinoma treated using CO transoral laser exoscopic surgery (TOLES). The procedure achieved en bloc tumo…
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Refining prognostic subcategories in intermediate-advanced glottic cancer: A multicentric study on 637 patients treated by transoral laser microsurgery.
[BACKGROUND] The current TNM staging system does not fully address the variations in glottic squamous cell carcinoma (SCC) extension and subsites involvement, especially if treated with transoral laser microsurgery (TOLMS). This study aims …
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Preventing and managing pharyngocutaneous fistula after total laryngectomy - A narrative review.
Pharyngocutaneous fistula (PCF) remains one of the most frequent and serious complications following total laryngectomy (TL). PCF can lead to severe health issues such as infections and thromboembolic events prolonging hospitalization, as w…
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Optimising oncologic outcomes in pT3 glottic cancers treated by transoral laser microsurgery: the impact of adjuvant treatment.
[OBJECTIVE] The treatment strategy for cT3 glottic squamous cell carcinoma (SCC) is far from being standardised, and the role of adjuvant treatment(s) is not clearly defined. This study assessed the impact of adjuvant (chemo-)radiotherapy (…
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Transoral laser exoscopic surgery of the larynx: state of the art and comparison with traditional transoral laser microsurgery.
[OBJECTIVE] To evaluate the efficacy of transoral laser exoscopic surgery (TOLES) in a unicentric series of patients affected by benign and malignant glottic and supraglottic lesions, and compare outcomes with those of transoral laser micro…
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Voice Outcome After Carbon Dioxide Transoral Laser Microsurgery for Glottic Cancer According to the European Laryngological Society Classification of Cordectomy Types - A Systematic Review.
[BACKGROUND] Voice outcome after carbon dioxide transoral laser microsurgery (COTOLMS) for glottic cancer is of prime importance. However, a comprehensive overview according to the European Laryngological Society (ELS) classification of cor…
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Lateral hypopharyngectomy with laryngeal preservation reconstructed with inlay fascio-cutaneous free flaps: clinical and functional outcomes.
[OBJECTIVE] Lateral hypopharyngectomy (LH) is one of the organ-preservation surgical strategies available for treatment of selected naïve early squamous cell carcinoma (SCC), as well as for rarer non-SCC tumours and persistent/recurrent/sec…
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Complications related to the Cook-Swartz implantable Doppler probe use in head and neck microvascular reconstruction: a systematic review.
[PURPOSE] Vascular perfusion research has been dedicated to identify inexpensive, effective, and easy to use methods to assess free flap perfusion for both buried and non-buried flaps. [METHODS] Systematic review of complications in patien…
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Magnetic resonance diagnosis of laryngeal chondritis after transoral laser microsurgery for laryngeal cancer.
[OBJECTIVE] Laryngeal chondritis (LC) is a rare complication of carbon dioxide transoral laser microsurgery (CO TOLMS) for laryngeal tumours and can pose a diagnostic challenge. Its magnetic resonance (MR) features have not been previously …
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Guided Zygomatic Implantology for Oral Cancer Rehabilitation: A Case Report.
Oral rehabilitation after maxillary oncological resection is challenging. This case report presents the rehabilitation of a 65-year-old Caucasian male adenoid cystic carcinoma patient using a myo-cutaneous thigh flap, zygomatic implant plac…
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Transoral Laser Microsurgery for Glottic Cancer in Patients Over 75 Years Old.
[OBJECTIVES/HYPOTHESIS] Laryngeal squamous cell carcinoma (LSCC) has a non-negligible incidence in elderly patients. However, there is still no clear indication on the ideal treatment for early-intermediate glottic LSCC in this specific age…
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Is the exoscope ready to replace the operative microscope in transoral surgery?
[PURPOSE OF REVIEW] Exoscopes are external digital devices that provide enhanced and magnified visualization of the surgical field. They usually have dedicated digital controls and a more compact mechanical structure than operative microsco…
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Gracilis free flap in head and neck reconstruction beyond facial palsy reanimation.
[INTRODUCTION] The gracilis muscle free flap has gained popularity in head and neck reconstruction due to minimal donor-site morbidity, reliable vascular pedicle, strong muscular component, and possibility to perform nerve coaptation. Howev…
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Magnetic resonance imaging to assess cartilage invasion in recurrent laryngeal carcinoma after transoral laser microsurgery.
[OBJECTIVE] To evaluate the diagnostic performance of magnetic resonance (MR) with surface coils in assessing cartilage invasion in recurrent laryngeal carcinoma after carbon dioxide transoral laser microsurgery (CO TOLMS). [METHODS] Two e…
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Compartmental Surgery for Oral Tongue Cancer: Objective and Subjective Functional Evaluation.
[OBJECTIVE] To assess functional outcomes in patients treated by compartmental tongue surgery (CTS) and reconstruction for advanced oral tongue/floor-of-mouth cancer. [STUDY DESIGN] Retrospective case series. [METHODS] A retrospective coh…
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Fascio-cutaneous-free flaps as primary reconstruction in salvage total laryngectomy.
[INTRODUCTION] Salvage total laryngectomy (STL) is the most common treatment for recurrent laryngeal cancer after (chemo)-radiotherapy [(C)RT]. In this scenario, a higher rate of local wound complications, such as pharyngo-cutaneous fistula…
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European Laryngological Society position paper on laryngeal dysplasia Part II: diagnosis, treatment, and follow-up.
To give an overview of the current knowledge regarding the diagnosis, treatment, and follow-up of laryngeal dysplasia (LD) and to highlight the contributions of recent literature. The diagnosis of LD largely relies on endoscopic procedures …
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Validation of the European Laryngological Society classification of glottic vascular changes as seen by narrow band imaging in the optical biopsy setting.
[PURPOSE] In 2016, the European Laryngological Society (ELS) proposed a classification for vascular changes occurring in glottic lesions as visible by narrow band imaging (NBI), based on the dichotomic distinction between longitudinal vesse…
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Long-term Oncologic Outcomes of 1188 Tis-T2 Glottic Cancers Treated by Transoral Laser Microsurgery.
[OBJECTIVE] To evaluate long-term disease-specific survival (DSS) and organ preservation (OP) rates in patients affected by Tis-T2 glottic squamous cell carcinoma (SCC) treated by carbon dioxide transoral laser microsurgery (CO TOLMS). [ST…
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Salvage surgery for residual or recurrent laryngeal squamous cell carcinoma after (Chemo)radiotherapy: Oncological outcomes and prognostic factors.
Nonsurgical primary treatment of early and advanced laryngeal squamous cell carcinoma, employing radiotherapy with or without chemotherapy, is considered a standard of care in many centers throughout the world. When patients have persistent…
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Salvage carbon dioxide transoral laser microsurgery for laryngeal cancer after (chemo)radiotherapy: a European Laryngological Society consensus statement.
[PURPOSE] To provide expert opinion and consensus on salvage carbon dioxide transoral laser microsurgery (CO TOLMS) for recurrent laryngeal squamous cell carcinoma (LSCC) after (chemo)radiotherapy [(C)RT]. [METHODS] Expert members of the E…
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Imaging checklist for preoperative evaluation of laryngeal tumors to be treated by transoral microsurgery: guidelines from the European Laryngological Society.
[INTRODUCTION] The modern availability in daily practice of different DICOM viewers allows physicians to routinely evaluate computed tomography (CT) and magnetic resonance (MR) scans of patients in the pre-, intra-, and postoperative settin…
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T1 Glottic Cancer: Does Anterior Commissure Involvement Worsen Prognosis?
Radiotherapy (RT) and transoral laser microsurgery (TLM) represent the main treatment modalities for early glottic carcinoma. Local failure is notoriously more frequent in T1b glottic cancer in comparison to T1a and T2 tumors. In this scena…
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Metastatic Squamous Cell Carcinoma to the Cervical Lymph Nodes From an Unknown Primary Cancer: Management in the HPV Era.
[BACKGROUND] Patients with metastases in the lymph nodes of the neck and no obvious primary tumor, neck cancer with unknown primary (NCUP), represent a management challenge. A majority of patients have metastatic squamous cell carcinoma (SC…