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Tricky post-laryngectomy swallows

Despite improvements in chemoradiation therapy and the adoption of organ preservation for some head and neck cancers, total laryngectomy remains the treatment often providing best survival chances for advanced laryngeal cancer. This article reviews the causes of dysphagia post-laryngectomy and...

Supracricoid laryngectomy revisited

In this article, the authors report on the long-term (five- and 10-year) survival, local recurrence rate and cause of death in a cohort of 46 patients with T3M0N0 glottic carcinoma undergoing supracricoid laryngectomy. The five- and 10-year survival were 78%...

Post-total laryngectomy constipation

This cross-sectional study investigated the prevalence of chronic constipation post total laryngectomy (TL) and after total pharyngolaryngectomy (TPL). For the study, the authors used a self-completed patient questionnaire to evaluate the prevalence and factors related to it. Patients using opioids,...

Predicting the need for salvage laryngectomy

The treatment of laryngeal cancer has seen a shift towards organ preservation strategies with non-surgical treatment offering equivalent survival outcomes. Nonetheless, salvage total laryngectomy (SLT) remains an important curative management option in cases of treatment failure or recurrence. The authors...

Themistocles Gluck – the true father of laryngectomy

Most head and neck surgeons and ENT-specialists may know that the first laryngectomy for cancer was performed by Billroth on 31 December 1873. Billroth´s assistant, Vincenz Czerny, had outlined the operation in experimental surgery on dogs in 1870. Three years...

Vascularised tissue in salvage total laryngectomy

Chemoradiation (CRT) has become the mainstay for locally advanced laryngeal cancer since the RTOG 91-11 trial. Unfortunately there is still a substantial demand for salvage laryngectomies, which have a higher complication rate, the most notable being pharyngocutaneous fistula (PCF). Several...

Functional considerations in reconstruction after laryngectomy

With a plethora of different reconstructive options and techniques available after laryngectomy, it can be difficult to clearly see which give the lowest complication rates and best functional outcomes. This article aims to summarise the current evidence in swallowing and...

Pharyngocutaneous fistula after total laryngectomy

Pharyngocutaneous fistula (PCF) after total laryngectomy is a serious complication post-surgery, and can lead to prolonged hospitalisation, adding delays in postoperative chemoradiotherapy. This Turkish retrospective study looked at 166 patients who underwent total laryngectomy for laryngeal cancer, although it is...

Risk factors for post laryngectomy fistula

This is a meta-analysis looking at the postoperative pharyngocutaneous fistula rates following total laryngectomy. The authors ended up with 34 studies with about 2500 patients. The most striking finding was that preoperative radiotherapy was a significant risk factor as well...

Singing after laryngectomy: Shout at Cancer

Thomas Moors is an ENT junior doctor with a background in music and singing. Combining these interests, he has set up a charity to help patients who have had a laryngectomy. He has achieved considerable public attention, and he tells...

Risk factors for pharyngocutaneous fistula after laryngectomy

Pharyngocutaneous or salivary fistula is a feared complication following laryngectomy, causing significant morbidity, prolonged hospital inpatient stay / cost and mortality. Previous radiotherapy / chemoradiotherapy is a well recognised risk factor and leads many surgeons to recommend onlay pectoralis major...

Are elective neck dissections needed during salvage laryngectomy?

There has recently been a move away from elective neck dissections in the setting of salvage laryngectomy. This has mainly resulted from an appreciation of the increase in morbidity, in particular pharyngocutaneous fistula formation, and an improvement in cross-sectional imaging...