ABSTRACT
BACKGROUND: Laryngeal cancer accounts for 1% of all cancers in men and 0.3% of all cancers in women. Pharyngolaryngectomy (TPL) and total laryngectomy (TL) are central surgical techniques in the management of advanced laryngeal malignancies but are associated with significant morbidity. In addition, optimal reconstruction following TPL remains an area of active research. METHODS: Here, we compared speech and swallowing outcomes following circumferential and partial pharyngeal resection alongside total laryngectomy in patients with laryngeal and hypolaryngeal tumors. We performed a systemic analysis of patient demographics, tumor characteristics, treatment modality, and pharyngeal reconstruction technique following TPL and TL, leveraging data collected over a 20-year period at a large tertiary referral center. RESULTS: Analyzing 155 patients the results show circumferential pharyngeal defects and prior radiotherapy have a significant impact on surgical complications. CONCLUSION: Pharyngeal resection carries a substantial risk of incurring impaired speech and swallowing in patients. Moreover, our results support poorer functional outcomes with more radical pharyngeal resections and show a clear trend toward worse swallowing outcomes in salvage surgery.
Subject(s)
Laryngeal Neoplasms , Laryngectomy , Female , Humans , Laryngeal Neoplasms/pathology , Laryngectomy/methods , Male , Pharyngectomy , Retrospective Studies , Salvage TherapyABSTRACT
Primary intraorbital ectopic meningiomas are rare and their existence remains controversial. We present a 30-year-old female with painless, non-axial proptosis and a palpable superomedial mass. The MRI demonstrated that the mass had no optic nerve sheath or sphenoid wing involvement and was initially reported to have no intracranial extension. The patient was initially thought to have an ectopic orbital meningioma. Subsequent multidisciplinary team (MDT) consultation and further specialist review of the MRI revealed a subtle dural tail connecting to an enhancing mass in the olfactory groove. Biopsy revealed a WHO Grade 1 transitional meningioma with an infiltrative pattern. We argue that some previously reported cases of ectopic meningioma may lack the requisite imaging to discover the primary disease. Our report highlights the importance of MRI in this group of patients and the role of a skull-base MDT with specialist neuroradiology input to determine the true origin and extent of these extradural orbital meningiomas.
Subject(s)
Choristoma/diagnostic imaging , Meningeal Neoplasms , Meningioma/diagnostic imaging , Orbital Neoplasms/diagnostic imaging , Adult , Choristoma/pathology , Choristoma/therapy , Exophthalmos/diagnosis , Female , Humans , Lacrimal Apparatus Diseases/diagnosis , Magnetic Resonance Imaging , Meningioma/pathology , Meningioma/therapy , Nasolacrimal Duct/diagnostic imaging , Orbital Neoplasms/pathology , Orbital Neoplasms/therapyABSTRACT
A 74-year-old woman presented with a history of prolonged dysphonia, a red flag symptom for laryngeal cancer. Flexible nasal endoscopy revealed a lesion which looked suspicious for malignancy and therefore she went onto have a microlaryngoscopy and an attempt at biopsy. It was during this procedure that a foreign body was removed whole from a dilated laryngeal ventricle. We believe that some subtle anatomical changes caused by a pre-existing unilateral vocal cord palsy contributed to the impaction of this foreign body.
