Objective: To assess the opinion, practices, and challenges of international key opinion leaders about two minimal invasive surgical techniques in supraglottic laryngeal tumours: transoral laser microsurgery (TLM) and the transoral robotic surgery (TORS).
Methods: Design of a questionnaire composed of seven sections and fifty questions covering descriptive data of participants, practitioners experience procedural sequences, considerations related to airways, feeding, and voice, intraoperative haemorrhage, postoperative management, and a comparative analysis of TLM and TORS in treating supraglottic laryngeal cancer.
Results: A total of 27 head and neck surgeons replied to the survey. The experts had an average experience in laryngeal surgery of 20.0 ± 9.4 years, ranging from 5 to 36 years. We noted a significantly shorter installation time in TLM compared to TORS (19% of experts estimated the installation time of over 20 min with TLM vs 44% with TORS; p = 0.02). According to complications, the experts considered that bleeding was the major concern with supraglottic laryngeal surgery, especially intraoperative bleeding in TLM (52% in TLM vs 26% in TORS) (p = 0.09) and postoperative bleeding in TORS (56% in TORS vs 44% in TLM).
Conclusion: The experts did not identify a clear superiority of one technology (TLM) over the other (TORS). The two techniques seemed equivalent to the experts, except for the control of intraoperative haemostasis and visualisation of the surgical field, where TORS was perceived as superior to TLM.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1007/s00405-024-09070-5 | DOI Listing |
Acta Otorhinolaryngol Ital
December 2024
IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Objectives: Several devices have been developed to improve head and neck surgery. 3D exoscopes provide surgeons a viable alternative to microscopes. We propose our setting for transoral exoscopic oropharyngeal (TOEOS) and transoral exoscopic laryngeal surgery (TOELS).
View Article and Find Full Text PDFJ Anaesthesiol Clin Pharmacol
September 2024
Department of Onco-Anesthesiology and Palliative Medicine, DRBRAIRCH, AIIMS, New Delhi, India.
Interventional endoscopy procedures are challenging for anaesthesiologists due to the various patient, procedural, logistic, and position-related issues. Complex endoscopic procedures like biliary interventions and endoscopic myotomy necessitate longer procedural duration. The mode of anaesthesia is usually deep sedation without any definitive airway device and is frequently associated with hypoxemia events which can be catastrophic.
View Article and Find Full Text PDFLaryngoscope
January 2025
School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.
Background: Laryngeal squamous cell cancer (LSCC) accounts for around one-third of head and neck cancers, with smoking and alcohol as major risk factors. Despite advances in organ preservation, survival rates have stagnated globally over recent decades. The impact of socioeconomic deprivation on LSCC outcomes in the West of Scotland remains underexplored.
View Article and Find Full Text PDFFront Med (Lausanne)
December 2024
Department of Anaesthesiology and Intensive Therapy, Medical University of Lodz, Łódź, Poland.
Background: The Laryngeal Mask Airway Vision Mask (LMA VM) is a supraglottic airway device (SAD) with a vision guidance system. The ideal head and neck position for direct laryngoscopy is known, but the ideal position for placing a LMA is not. The objective of this study is to evaluate and compare the optimal position for placement of a video laryngeal mask airway.
View Article and Find Full Text PDFCureus
November 2024
Anesthesiology and Critical Care, Kindai University Faculty of Medicine, Osaka, JPN.
Background: Epiglottic masses are often asymptomatic, making them difficult to detect during preoperative examinations. Consequently, anesthesiologists may face ventilation difficulties with no apparent cause. Epiglottic masses can sometimes obstruct laryngoscope insertion into the epiglottic vallecula, complicating general anesthesia induction.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!