Our Summary

This research paper is about a new surgical procedure for laryngeal cancer, called the hybrid supracricoid partial laryngectomy with cricohyoidoepiglottopexy (SCPL-CHEP). This procedure was previously done using a robotic surgical platform. The researchers wanted to see if they could do the surgery using a more traditional, less high-tech method: endoscopic transoral surgery, which involves inserting a small camera (an endoscope) into the patient’s mouth to view the surgical area and using handheld instruments to perform the surgery. They tested this method on two human cadavers and found it was successful and comparable to the robotic method. These initial results suggest that this less high-tech method could be a viable option for this type of surgery, but the researchers call for more studies to confirm its feasibility and benefits for patients.

FAQs

  1. What is the hybrid supracricoid partial laryngectomy with cricohyoidoepiglottopexy (SCPL-CHEP) procedure?
  2. What is the difference between robotic surgery and endoscopic transoral surgery for laryngeal cancer?
  3. What were the results of the initial tests of the endoscopic transoral method for SCPL-CHEP, and what further research is needed?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laryngectomy is to practice good communication techniques, such as using a speaking valve or electrolarynx, to help restore speech after the surgery. Additionally, maintaining good oral hygiene and staying hydrated can help prevent complications and promote healing in the surgical area. It is also important for patients to follow up with their healthcare provider regularly to monitor their progress and address any concerns.

Suitable For

Patients who are typically recommended for laryngectomy are those with advanced laryngeal cancer that cannot be treated with other less invasive methods such as radiation or chemotherapy. This includes patients with tumors that are too large or have spread to surrounding tissues, as well as those who have recurrent or persistent cancer despite previous treatments. Additionally, patients who have severe dysphonia (difficulty speaking) or dysphagia (difficulty swallowing) due to laryngeal cancer may also be candidates for laryngectomy. Ultimately, the decision to recommend laryngectomy is based on the individual patient’s specific medical history, tumor characteristics, and overall health status.

Timeline

  • Before laryngectomy:
  1. Patient is diagnosed with laryngeal cancer through imaging tests and biopsies.
  2. Patient undergoes various treatments such as radiation therapy, chemotherapy, or a combination of both to shrink the tumor and reduce cancer cells.
  3. If these treatments are not successful or if the cancer is too advanced, the patient may be recommended for a laryngectomy.
  4. Patient meets with a team of healthcare professionals including surgeons, speech therapists, and counselors to discuss the procedure and its potential impact on their quality of life.
  5. Patient undergoes preoperative evaluations and tests to assess their overall health and fitness for surgery.
  • After laryngectomy:
  1. Patient undergoes the surgical procedure, which involves removing the larynx and creating a stoma (opening) in the neck for breathing.
  2. Patient may experience pain, swelling, and difficulty swallowing in the immediate postoperative period.
  3. Patient receives postoperative care and rehabilitation to help them adjust to breathing through the stoma and communicating without a voice box.
  4. Patient works with speech therapists to learn new ways of speaking such as using a voice prosthesis, esophageal speech, or communication devices.
  5. Patient may undergo further treatments such as radiation therapy or chemotherapy to ensure that all cancer cells are eradicated.
  6. Patient attends regular follow-up appointments to monitor their recovery and overall health.

What to Ask Your Doctor

  1. What is the purpose of the laryngectomy procedure and why is it recommended for my condition?
  2. What are the potential risks and complications associated with the laryngectomy surgery?
  3. What is the expected recovery time and what can I do to help speed up my recovery?
  4. Will I need any additional treatments or therapy after the laryngectomy surgery?
  5. How will the surgery affect my ability to speak, swallow, and breathe?
  6. What changes can I expect in my quality of life after the laryngectomy procedure?
  7. Are there any alternative treatment options available for my condition?
  8. What is the success rate of the hybrid supracricoid partial laryngectomy with cricohyoidoepiglottopexy (SCPL-CHEP) compared to other surgical methods?
  9. What are the long-term outcomes and prognosis for patients who undergo this type of surgery?
  10. Are there any support groups or resources available for patients who have undergone a laryngectomy procedure?

Reference

Authors: Nakayama M, Orosco RK, Holsinger FC, Spriano G, Succo G, De Virgilio A, Oridate N. Journal: Ann Otol Rhinol Laryngol. 2020 Mar;129(3):273-279. doi: 10.1177/0003489419885139. Epub 2019 Oct 31. PMID: 31672022