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Med Pregl 2013 Sep-Oct;66(9-10):349-56

The strategy of organ preservation by applying chemoradiotherapy in the treatment of laryngeal carcinoma, which has been extensively used since 1990s, is now being reviewed regarding its further justification. Despite good results in other localization of head and neck cancer, it has not met the expectations in case of laryngeal cancer. One explanation is the lower participation of human papillomavirus type 16 in the etiology of laryngeal cancer. Read More

Acta Otolaryngol 2009 Dec;129(12):1480-5

Division of Surgical Oncology, Regional Cancer Centre, Trivandrum, India.

Conclusions: Compared with larynx cancers salvage rates are poorer for hypopharyngeal cancers and the role of primary surgery seems to be significantly higher and more decisive in overall survival (OS). Hypopharyngeal cancers therefore warrant a closer follow-up after an organ preservation protocol, to detect recurrence at the earliest stage and plan for an effective salvage surgery.

Objective: To evaluate the survival and morbidity of patients treated by surgery for carcinoma of the larynx and hypopharynx according to site. Read More

Asian J Surg 2002 Jan;25(1):27-34

Head and Neck Services, Tata Memorial Hospital, Parel, Mumbai, India.

Objective: To demonstrate the oncological and physiological safety of near-total laryngectomy (NTL), its versatility for use following extensive resections that necessitate pharyngoplasty, in post radiation recurrences and its success in voice conservation. To highlight the importance of a "maintenance free biological shunt" for voice production in patients of advanced laryngeal and pharyngeal cancers and compare the merits of the same to an artificial shunt created with a tracheo-esophageal puncture and prosthesis.

Study: In this study of 150 cases of NTL for cancers of the larynx (52 cases) and the pyriform fossa (98 cases), 130 pts (86. Read More

Otolaryngol Clin North Am 2004 Jun;37(3):655-77

Mayo Clinic College of Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.

Near-total laryngectomy provides oncologic control of hypopharyngeal and laryngeal cancers that are not amenable to conservation procedures. The resulting myomucosal shunt provides a prosthesis-free method of voice rehabilitation. This review presents indications, technique, and speech rehabilitation for a near-total laryngectomy. Read More

Laryngoscope 2002 Feb;112(2):375-80

Head and Neck Services, Tata Memorial Hospital, Parel, Mumbai, India.

Objective: To demonstrate the oncologic and physiological safety of near-total laryngectomy (NTL), its success in voice conservation, and its versatility for use in extensive resections that necessitate pharyngoplasty, and even in post-radiation recurrences.

Study: In this study of 137 cases of NTL for cancer of the larynx (45 cases) and pyriform (92 cases), 86.9% were stage T3/T4 and 60. Read More

Otolaryngol Head Neck Surg 1995 Dec;113(6):689-94

Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.

Limited acoustic data are available describing vocal characteristics of individuals after near-total laryngectomy. Computer-based acoustic analyses (FO, jitter, shimmer, signal-to-noise ratio) were performed on vowel samples produced by 20 speakers who underwent near-total laryngectomy. On the basis of data obtained, the subjects who had undergone near-total laryngectomy demonstrated (1) higher than normal and more variable modal fundamental frequency values for sustained vowels; (2) increased frequency (jitter) and amplitude (shimmer) perturbation; and (3) decreased spectral noise (signal-to-noise) components. Read More

Ann Otol Rhinol Laryngol 1995 Oct;104(10 Pt 1):763-9

Department of Otolaryngology/Head and Neck Surgery/Audiology, Mayo Clinic Scottsdale, Arizona, USA.

The purpose of the study was to assess the quality of life of patients after surgical treatment for cancer of the larynx. Three groups of patients were identified according to surgical treatment: total laryngectomy, 111 patients; near-total laryngectomy, 38 patients; and partial laryngectomy, 23 patients. The impact of successful surgical treatment on their life roles was analyzed in terms of work, activities, familial and spousal relationships, sexuality, and psychologic features such as stress and anxiety. Read More

Indian J Cancer 1994 Dec;31(4):244-9

Department of Head & Neck Surgery, Kidwai Memorial Institute of Oncology, Bangalore, India.

The practice of Pearson's (1981) technique of near total laryngectomy with speech shunt is evaluated acoustically in 11 subjects using matched esophageal speakers. Not only do these patients vocalize earlier with effortless cease, analysis of their speech both subjectively & by acoustic analysis of the parameters seems definitely to be of superior quality. The functional utility of this technique is addressed in this study justifying its more frequent practice in unilateral lesions of larynx and hypopharynx which defy satisfactory control by conventional conservation laryngeal surgery or radiation therapy. Read More

Ann Otol Rhinol Laryngol 1989 Jan;98(1 Pt 1):2-7

Department of Otorhinolaryngology, Mayo Clinic Scottsdale, Arizona 85259.

This report emphasizes the utility of the near-total laryngectomy for those patients in whom conventional conservation surgery is an option but may be oncologically or physiologically unsafe. The near-total operation can be offered for supraglottic cancer, pharyngeal cancer, and, more commonly, primary glottic cancer with cord fixation. Its application is described for patients who are candidates for conventional conservation surgery but are compromised physiologically by age or poor general health and for patients in whom tumor extent would not permit safe conventional conservation surgery. Read More

Arch Otolaryngol 1985 Jun;111(6):356-60

Subtotal (near-total) laryngectomy has recently been advocated to eradicate large laryngeal tumors. The operation, which preserves the cricoarytenoid joint and adjacent vocal fold, is based on the premise that many T3 and T4 tumors can be resected without complete sacrifice of the phonatory mechanism. The purpose of this study was to verify or disprove the assumption by examining sections of whole-organ laryngeal specimens. Read More

Arch Otolaryngol 1984 Oct;110(10):664-9

The surgical specimens from total laryngectomy and partial pharyngectomy in 20 consecutive cases of piriform sinus carcinoma were studied by whole-organ serial sectioning in the horizontal plane. There had been gross clinical involvement or fixation of the vocal cord in 19 of these cases. Histopathologic evidence of cartilage invasion or piriform apex involvement was found in 17 specimens. Read More