Our Summary

This research paper presents a new technique for a specific type of throat surgery called supracricoid partial laryngectomy with cricohyoidoepiglottopexy (SCPL-CHEP). This operation is often used for treating laryngeal cancer, a type of throat cancer. The new method combines two approaches - one through the neck (transcervical) and one through the mouth (transoral) - using a flexible robotic surgical system.

The researchers tested this method on six human cadavers and found it was feasible and allowed for a complete reconstruction of the lining of the throat through the mouth. They broke down the procedure into three main steps: making cuts in the throat lining through the mouth to remove the tumor, then making an incision and moving the larynx through the neck, and finally closing up the lining through the mouth.

They suggest that this new approach could have some benefits over the standard technique. This includes being able to directly see the tumor during removal and fully closing up the defect in the throat. This could potentially make recovery after surgery easier and may make the procedure more accessible to patients and surgeons.

The researchers conclude that a clinical trial should be conducted to further validate these findings.

FAQs

  1. What is a hybrid supracricoid partial laryngectomy with cricohyoidoepiglottopexy (hybrid SCPL-CHEP)?
  2. What are the main advantages of the hybrid SCPL-CHEP technique over the standard technique?
  3. What is the role of a flexible single-port robotic surgical system in the hybrid SCPL-CHEP procedure?

Doctor’s Tip

One helpful tip a doctor might tell a patient about laryngectomy is to follow a strict swallowing and speech therapy regimen post-surgery to help improve communication and swallowing function. This can help patients adjust to changes in their voice and swallowing abilities and improve their overall quality of life.

Suitable For

Patients who are typically recommended for laryngectomy are those with laryngeal cancer that is localized and has not spread to other parts of the body. In particular, those who may benefit from a hybrid supracricoid partial laryngectomy with cricohyoidoepiglottopexy (hybrid SCPL-CHEP) include individuals with early-stage laryngeal cancer, as well as those who want to preserve their larynx and maintain their voice and swallowing function. This procedure may also be recommended for patients who are not suitable candidates for total laryngectomy or other types of laryngeal preservation surgeries.

Timeline

  • Before laryngectomy: Patients may experience symptoms such as hoarseness, difficulty breathing or swallowing, persistent cough, and weight loss. They may undergo various diagnostic tests such as imaging studies, biopsy, and endoscopy to confirm the presence of laryngeal cancer.

  • Laryngectomy procedure: The laryngectomy surgery involves the removal of the larynx (voice box) and may include the removal of surrounding tissues and lymph nodes. This surgery can be done through an open approach or minimally invasive techniques such as transoral robotic surgery (TORS).

  • After laryngectomy: Patients will need to undergo a period of recovery in the hospital, where they will receive care to manage pain, monitor for complications, and begin rehabilitation. Speech and swallowing therapy will be important in helping the patient adjust to their new way of speaking and eating.

  • Long-term care: Patients who have undergone laryngectomy will need ongoing follow-up care to monitor for recurrence of cancer, manage any side effects of treatment, and support their quality of life. This may include regular imaging studies, speech therapy, and psychological support.

What to Ask Your Doctor

  1. What is a hybrid supracricoid partial laryngectomy with cricohyoidoepiglottopexy (hybrid SCPL-CHEP) and how does it differ from traditional laryngectomy procedures?
  2. Am I a candidate for a hybrid SCPL-CHEP procedure?
  3. What are the potential risks and complications associated with a hybrid SCPL-CHEP procedure?
  4. How long is the recovery process after a hybrid SCPL-CHEP procedure?
  5. What are the expected outcomes in terms of speech and swallowing function after a hybrid SCPL-CHEP procedure?
  6. Are there any alternative treatment options for laryngeal cancer that I should consider?
  7. How many hybrid SCPL-CHEP procedures have you performed and what is your level of experience with this technique?
  8. Will I need any additional treatments, such as radiation or chemotherapy, after a hybrid SCPL-CHEP procedure?
  9. How often will I need follow-up appointments after the procedure?
  10. Are there any long-term effects or considerations I should be aware of after undergoing a hybrid SCPL-CHEP procedure?

Reference

Authors: Nakayama M, Holsinger FC, Orosco RK. Journal: Laryngoscope. 2019 Sep;129(9):2065-2070. doi: 10.1002/lary.27628. Epub 2018 Dec 19. PMID: 30569529