Commissure Involvement (commissure + involvement)

Distribution by Scientific Domains

Kinds of Commissure Involvement

  • anterior commissure involvement


  • Selected Abstracts


    Endoscopic laser surgery of early glottic cancer: Involvement of the anterior commissure,

    HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 5 2009
    Ralph M. W. Rödel MD
    Abstract Background Early glottic cancer can be cured with transoral laser resection, but in cases with anterior commissure involvement, there is still controversy concerning the best treatment modality. Methods The impact of anterior commissure involvement on local control was analyzed in a retrospective review of 444 patients with early glottic cancer (pT1a,pT2a) treated between 1986 and 2004 with transoral laser microsurgical resection. Results The anterior commissure was involved in 153 cases; the 5-year local control rate with and without anterior commissure involvement was 73% versus 89% for T1a and 68% versus 86% for T1b tumors. For T2a lesions, the 5-year local control rate was 76%, irrespective of anterior commissure involvement. Conclusion In early glottic cancer treated by transoral laser microsurgery, a decrease in local control is evident in case of anterior commissure involvement for T1a and T1b but not for T2a tumors. © 2009 Wiley Periodicals, Inc. Head Neck, 2009 [source]


    Evaluation of treatment results with regard to initial anterior commissure involvement in early glottic carcinoma treated by external partial surgery or transoral laser microresection

    HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 4 2009
    Florian Sachse MD
    Abstract Background Modalities of surgical treatment of early glottic carcinoma include transoral laser microresection and external partial surgery. Methods This is a retrospective analysis of 119 glottic carcinomas treated by external partial surgery (57 pT1a, 1 pT1b, 10 pT2) or transoral laser microresection (46 pT1a, 4 pT1b, 1 pT2) with special regard to initial anterior commissure involvement. Results Local recurrence in external partial surgery was 12%. Three- and 5-year local control was 86%. Local recurrence in transoral laser microresection was 16%. Three- and 5-year local control was 88% and 70%, respectively. No significant correlation was found between local control and surgical approach. An analysis of all 119 tumor revealed that anterior commissure involvement significantly decreased local control. Conclusion Initial anterior commissure involvement was associated with a higher risk of local recurrence. Overall, treatment of glottic carcinoma involving the anterior commissure requires much experience and advanced surgical skills regardless which technique is preferred. © 2009 Wiley Periodicals, Inc. Head Neck 2009 [source]


    Supracricoid partial laryngectomy as salvage surgery for radiation therapy failure

    HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 8 2008
    Alberto Deganello MD
    Abstract Background The main concern in the treatment of laryngeal carcinomas is tumor control with preservation of laryngeal functions. We believe that salvage supracricoid partial laryngectomy (SPL) should be carefully considered in selected cases of radiotherapy failure, because it can offer the possibility of achieving adequate tumor control with preservation of laryngeal functions. Methods A series of 31 patients who underwent an SPL as salvage procedure after radiotherapy failure was reviewed. Results Locoregional control rate was 75%, with 60% 5-year overall survival; no patients were lost to follow-up, and a death-from-disease rate of 19.35% was recorded. Restoration of laryngeal functions was achieved in 89.29% of the patients. No statistically significant differences were found in locoregional control regarding anterior commissure involvement, elective neck dissection versus wait-and-see policy, pathologic positive neck disease, and restage I,II versus restage III,IV. Conclusion The oncologic and functional results indicate the consistency of salvage SPL, proposing this type of operation as a serious alternative to total laryngectomy in carefully selected cases. © 2008 Wiley Periodicals, Inc. Head Neck, 2008 [source]


    Endoscopic Vertical Partial Laryngectomy,

    THE LARYNGOSCOPE, Issue 2 2004
    R Kim Davis MD
    Abstract Objective: To explain the significant difference between microlaryngoscopy with cordectomy and endoscopic vertical partial laryngectomy (EVPL), to describe the efficacy of EVPL on T1b and T2 glottic squamous cell carcinoma, and to evaluate EVPL with postoperative irradiation in T2 glottic cancer with impaired true vocal cord mobility. Study Design: Retrospective review. Methods: Twenty-six patients seen at the University of Utah Health Science Center between 1987 and 2000 with bilateral T1 (T1b) or T2 squamous cell carcinoma of the glottic larynx underwent EVPL. T2 cancers were classified as follows: a = unilateral disease, b = bilateral disease; i = impaired mobility. T1b and T2a glottic cancer patients received surgery alone, whereas impaired mobility patients (T2ai + T2bi) patients received surgery followed by planned postoperative irradiation. Patients were assessed for primary site control, perioperative and long-term complications, and ultimate cancer control. Results: Survival in the total group was 88.5%, with local control at 92.3%. The two recurrent patients were salvaged by total laryngectomy. For the whole group, anterior commissure involvement was present in 57.7% (15 of 26). Thirteen T2 (5 T2ai + 8 T2bi) carcinoma patients underwent combined therapy, with 8 (61.5%) of these patients having anterior commissure involvement. Two of these patients were upstaged at surgery, one to T3 and one to T4. Local control was 84.5%. Thirteen patients were treated by surgery only, with five of these patients having failed previous irradiation. Survival was 92.3% and local control 100%. This group included two T2bi patients, two patients upstaged to T4 on the basis of extension beyond the subglottis to the anterior wall of the trachea, 3 T2b, and 6 T2a patients. Anterior commissure involvement was seen in 7 (53.8%) of these patients. Conclusions: EVPL alone controlled all T1b and T2a glottic cancer patients, even in the presence of greater than 50% anterior commissure involvement. The significant difference between EVPL and classical microlaryngoscopy with cordectomy was carefully described. EVPL with planned postoperative irradiation resulted in an 85% local control rate in clinically staged T2ai and T2bi cancer patients, including the three upstaged patients. [source]