Functional Outcomes after Salvage Transoral Laser Microsurgery for Laryngeal Squamous Cell Carcinoma.

Autor: Fink DS; Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA Our Lady of the Lake Voice Center, Baton Rouge, Louisiana, USA dfink1@lsuhsc.edu., Sibley H; Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA., Kunduk M; Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA Our Lady of the Lake Voice Center, Baton Rouge, Louisiana, USA Department of Communication Sciences and Disorders, Louisiana State University, Baton Rouge, Louisiana, USA., Schexnaildre M; Our Lady of the Lake Voice Center, Baton Rouge, Louisiana, USA., Sutton C; Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA., Kakade-Pawar A; Merial Limited, North Brunswick, New Jersey, USA., McWhorter AJ; Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA Our Lady of the Lake Voice Center, Baton Rouge, Louisiana, USA.
Jazyk: angličtina
Zdroj: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2016 Oct; Vol. 155 (4), pp. 606-11. Date of Electronic Publication: 2016 May 10.
DOI: 10.1177/0194599816648111
Abstrakt: Objectives: Transoral laser microsurgery (TLM) has been increasingly used in lieu of total laryngectomy to treat malignancy after definitive radiation. There are few data in the literature regarding functional outcomes. We retrospectively reviewed voice and swallowing outcomes in patients who underwent TLM for recurrent laryngeal carcinoma.
Study Design: Case series with chart review.
Setting: Tertiary care center.
Subjects and Methods: Forty-two patients were identified with recurrent squamous cell carcinoma of the larynx after definitive radiation therapy from 2001 to 2013: 28 patients with glottic recurrence and 14 with supraglottic recurrence. Swallowing outcomes were evaluated by gastrostomy tube dependence, the MD Anderson Dysphagia Inventory, and the Functional Oral Intake Scale. Voice outcomes were evaluated by the Voice Handicap Index and observer-rated perceptual analysis.
Results: No significant difference was noted between mean pre- and postoperative MD Anderson Dysphagia Inventory scores: 78.25 and 74.9, respectively (P = .118, t = 1.6955). Mean Functional Oral Intake Scale scores after TLM for supraglottic and glottic recurrences were 6.4 and 6.6, respectively. Of 42 patients, 17 (40.5%) required a gastrostomy tube either during radiation or in conjunction with the salvage procedure. Of 17 patients, 15 resumed sufficient oral diet for tube removal. Patients' mean Voice Handicap Index score did increase from 34.3 to 51.5 (P = .047), and their mean perceptual score did decrease from 60.0 to 45.3 (P = .005). However, at 1-year follow-up, there was no significant difference in perceptual score: 61.1 to 57.1 (P = .722).
Conclusions: TLM is a successful surgical option for recurrent laryngeal cancer with acceptable functional outcomes.
(© American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.)
Databáze: MEDLINE
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