Modified approach of the anterior commissure for transoral cordectomy in case of difficult exposure: a surgical innovation
| Autor: | Nicolas Fakhry, Alexia Mattei, Carole Boulze, Antoine Giovanni, Patrick Dessi, Matthieu Le Flem, Laure Santini |
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| Přispěvatelé: | Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Laboratoire Parole et Langage (LPL), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Normal diet Thyroid Gland Anterior commissure Laryngectomy [SDV.CAN]Life Sciences [q-bio]/Cancer Vocal Cords [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery Thyrotomy glottic cancer 03 medical and health sciences thyroplasty 0302 clinical medicine Cordectomy medicine Humans 030223 otorhinolaryngology Laryngeal Neoplasms Aged Laryngoscopy business.industry General Medicine Middle Aged 3. Good health Surgery laser medicine.anatomical_structure Otorhinolaryngology Glottic cancer 030220 oncology & carcinogenesis Vocal folds Carcinoma Squamous Cell Lasers Gas difficult exposure Neurosurgery Laser Therapy Larynx business glottoplasty |
| Zdroj: | European Archives of Oto-Rhino-Laryngology European Archives of Oto-Rhino-Laryngology, Springer Verlag, 2020, 277, pp.301-306. ⟨10.1007/s00405-019-05692-2⟩ European Archives of Oto-Rhino-Laryngology, 2020, 277, pp.301-306. ⟨10.1007/s00405-019-05692-2⟩ |
| ISSN: | 0937-4477 1434-4726 |
| DOI: | 10.1007/s00405-019-05692-2⟩ |
| Popis: | International audience; Purpose: To propose, in patients presenting a difficult laryngeal exposure, a surgical innovation allowing to perform a transoral laser cordectomy for cancers reaching the anterior commissure or the anterior third of vocal folds (according to the European Laryngological Society classification of laryngeal endoscopic cordectomies).Methods: Our surgical technique consisted of adding to conventional cordectomies a modified relaxation thyroplasty proposed by Isshiki (type III), also called relaxation thyroplasty by a medial approach in the European Laryngological Society classification system. The anterior commissure retrusion is usually employed in the management of high-pitched voice disorders, but can also allow a better exposure of the anterior commissure.Results: We described here this surgical innovation through the example of our first two patients. For both patients, the definitive histologic analysis showed negative microscopic margins and there was no post-operative complication. There was no need for a tracheostomy. They were allowed to take a normal diet after 2 days and were discharged after 4 days. The voice was breathy and hoarse as expected in case of extended cordectomy.Conclusions: This surgical innovation corresponding to the addition of an anterior commissure retrusion by a bilateral thyrotomy could be useful in the ELS classification of endoscopic cordectomies. It should allow surgeons to carry out a transoral CO2 laser cordectomy in patients with a T1 and sometimes T2 glottic carcinoma, even with a difficult laryngeal exposure. |
| Databáze: | OpenAIRE |
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