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Fulltext Vertical Partial Laryngectomy For Glottic Cancer; Report Of Three Cases.

Ahmad, R., Ishlah, W., Norie A.

International Medical Journal Malaysia, 2006;5(2):1-5.
MyJurnal

The ultimate goal of treatment of glottic malignancy is eradication of the cancer and preservation of maximum function. Ideally this would mean return of normal speech, respiration and deglutition. The foundation of vertical partial laryngectomy (VPL) is based on the knowledge of laryngeal anatomy and an understanding of how cancers invade the larynx. The VPL surgery of the glottic cancer is based on oncological sound principles, which will be further disscussed in this article. For the purpose of description we briefly presented 3 of our cases that underwent vertical partial laryngectomy for glottic cancer.

Matched MeSH terms: Laryngectomy
Fulltext Repair of pharyngocutaneous fistula (PCF) using montgomery salivary bypass tube after salvage total laryngectomy following failed primary radiotherapy: a case report

Teh, H. M., Mohd Sayuti, R., Kahairi, A., Bathma, D. S., Salman, A., Nor Kamaruzaman Esa, et al.

Asian Journal of Medicine and Biomedicine, 2018;2(1):0-0.
MyJurnal

The occurrence of pharyngocutaneous fistula (PCF) after total salvage laryngectomy following radiotherapy
as primary treatment is quite common. In most cases, pharyngocutaneous fistula can heal spontaneously
with conservative measures. Here, we are reporting a 69-year-old male with a residual carcinoma of the
larynx following failed radiotherapy as primary treatment whose later underwent a salvage total
laryngectomy. Post-operatively, it was complicated by the formation of pharyngocutaneous fistula which
was failed to heal with conservative measures and few attempts of surgical repair. The fistula later healed
with the application of Montgomery Salivarybypass tube after 3 weeks. The application of the salivary
bypass tube should be considered and used to promote healing in persistent pharyngocutaneous fistula
especially in a post radiotherapy patient.

Matched MeSH terms: Laryngectomy
Stomal recurrence after total laryngectomy: a 10-year review in Universiti Kebangsaan Malaysia Medical Center

bte Abdul Rashid NH, Yunus MR, bte Baki MM, bte Ami M, Athar PP

J Pak Med Assoc, 2012 May;62(5):466-9.
PMID: 22755311

To determine the frequency of stomal recurrence in patients following total laryngectomy in our center and to compare the frequency of previously reported risk factors such as preoperative tracheostomy, subglottic invasion and the level of lymph node metastases, with the rest of the world.

Matched MeSH terms: Laryngectomy/methods*
Carbon dioxide laser stomaplasty for tracheostomal stenosis

Sani A

J Laryngol Otol, 1998 May;112(5):467-8.
PMID: 9747477

A method of treating tracheostomal stenosis post-laryngectomy is described. The carbon dioxide (CO2) laser is used to fashion and ablate two triangular areas lateral to the stenosed stoma to provide an immediate enlarged stoma for comfortable breathing. This simple procedure is done under local anaesthesia, is almost bloodless, safe and takes just 10 minutes. Over the last five years eight patients underwent this procedure and seven had a satisfactory stoma without the need to use a tracheostomy tube.

Matched MeSH terms: Laryngectomy/adverse effects
Three-layer technique to close a persistent tracheo-oesophageal fistula

Lee LM, Razi A

Asian J Surg, 2004 Oct;27(4):336-8.
PMID: 15564191

This report of a patient with a persistent tracheo-oesophageal (TE) fistula after removal of a speech valve describes a modification of the technique described by Rosen et al for closing TE. Under local anaesthesia, an incision was made above the stoma edge from 9 o'clock to 3 o'clock. The trachea was separated from the oesophagus to beyond the fistula, and the fistula tract was excised. The oesophageal opening was closed in layers and a local flap rotated from the adjacent sternocleidomastoid muscle and sutured over the oesophageal closure. The trachea was then closed separately.

Matched MeSH terms: Laryngectomy
Prevention of aspiration following recurrent dislodgement of voice prosthesis: a patient's innovation

Masaany M, Marina MB, Asma A, Sani A

J Laryngol Otol, 2009 Jun;123(6):680-2.
PMID: 18544175 DOI: 10.1017/S0022215108002958

To demonstrate a simple, practical, cheap method of preventing potentially fatal aspiration of a dislodged voice prosthesis; this method was developed by a laryngectomised patient.

Matched MeSH terms: Laryngectomy/rehabilitation
Complications following tracheoesophageal puncture: a tertiary hospital experience

Dayangku Norsuhazenah PS, Baki MM, Mohamad Yunus MR, Sabir Husin Athar PP, Abdullah S

Ann Acad Med Singap, 2010 Jul;39(7):565-4.
PMID: 20697675

INTRODUCTION: In laryngectomised patients, tracheoesophageal speech is the gold standard for voice rehabilitation. This study evaluated complications related to the tracheoesophageal puncture (TEP) and the success rate in voice prosthesis after total laryngectomy at our institution over a 10-year period.
MATERIALS AND METHODS: A retrospective review of 22 TEPs was performed between January 1998 and December 2008. The timing of TEP, type of voice prosthesis, surgical and prosthesis-related complications, and TEP closure were noted.
RESULTS: Eighteen percent of the patients underwent primary and 82% secondary TEP. Our patients were predominantly males (95.4%) of Chinese descent with a mean age of 62.1 years. The types of voice prostheses used were ProvoxTM (n = 15), Voicemasters (n = 6), and Blom-Singer (n = 1). Prosthesis- related complications occurred in 77.3%. Notable complications were leakage (82.5%), prosthesis displacement (41.2%), intractable aspiration (29.4%), and aspiration of prosthesis (23.5%). The most common surgical-related complication was tracheostomal stenosis. An array of interventions comprising resizing or changing prosthesis type, nasogastric catheter insertion, stomaplasty, purse string suturing, and bronchoscopic removal of bronchial aspirated prosthesis were implemented to address encountered complications. In a mean follow-up of 34.8 months, 68.2% of patients achieved functional tracheoesophageal speech (75% of primary TEP and 67% of secondary TEP). There were 7 TEP closures indicated by persistent leakage, recurrent dislodgement, phonatory failure and, in 1 patient, persistent pain.
CONCLUSIONS: TEP has become an integral part in the rehabilitation of a laryngectomee. However, management of the frequent complications related to TEP requires specific efforts and specialistic commitments in order to treat them.

Matched MeSH terms: Laryngectomy/rehabilitation*
Fulltext Microbiome of tracheoesophageal prosthesis: who are they?

Syatirah Abdullah, Janet Quinn, Mohamed EL-Badawey, Nicholas Jakubovics

Malaysian Journal of Medicine and Health Sciences, 2019;15(108):44-44.
MyJurnal

Introduction: Laryngectomy patients undergo voice rehabilitation that requires implantation of trachea-oesophagal speech valves (TESV). Usually, laryngeal cancer patients require insertion of these devices post-operatively to im-prove their quality of life. Implantation of TESV dates back to 1979 by pioneering work of Blom and Singer. There are cases of aspiration of TESV wearer reported, and obstruction of the TESV causes leakage through the valve and is suggested as a main reason for replacement of the device. The dysfunctional failure may be caused by microbial colonization on the valve or physical malfunction and requires immediate replacement is desirable. The aim of this study is to identify the microbial community members of selected TESVs using both culture-independent techniques (Next-generation sequencing) to analyse the microbiota, including unculturable species, and routine microbiology techniques (culture-dependent method) and to obtain representative isolates that can form the basis for experiments to enable increased understanding of the community. Methods: Biofilms were harvested from 16 explanted speech valves from patients visiting the ENT clinic in Freeman Hospital, Newcastle, UK. Routine microbiology techniques (culture-dependent method) including ChromeID® plates and Matrix-Assisted Laser Desorption/Ionization Time of Flight (MALDI-TOF) Mass Spectrometry were used for identification of TESV microbiome. Sequencing of the samples was performed at MR DNA (www.mrdnalab.com, USA) on a MiSeq following the manufacturer’s guidelines in order to determine the bacteria and candida composition in the biofilm community. Results: The most frequently isolated fungal species was C. albicans, which was cultured from 11 out of 16 TESVs (79%), followed by five TESVs with C. tropicalis (36%), three TESVs had C. glabrata (21%) and only one TESV contained S. cerevisiae (7%). Interestingly no biofilm communities contained more than two fungal species and 2 TESVs (12%) possessed only bacterial species. There were only 16 species of bacteria cultured and identified by MALDI-TOF MS. This was far lower than the 91 species that were detected by NGS. Species from the genus Lactobacillus were found in 10 of 16 TESVs (63%), the highest frequency of any bacterial genus isolated from TESVs followed by S. aureus found in eight TESVs of 16. S. epidermidis was identified in two TESVs (13%), Streptococcus spp., K. oxytoca and O. anthropi were both identified in five different TESVs, while the gut bacterium E. faecium was found in four TESVs. Only one TESV contained E. coli. Conclusion: TESV biofilm composition was dominated by Candida spp. and occasionally contained other types of eukaryote such as Saccharomycetes. It was not uncommon for more than one Candida species to be present. The biofilms also harboured a mixture of bacteria, with lactic acid producers (Lactobacillus sp. and Streptococcus sp.) normally accompanying Candida sp. in the biofilm.

Matched MeSH terms: Laryngectomy
Fulltext Triple primary cancers of the larynx, lung and thyroid presenting in one patient

Iqbal FR, Sani A, Gendeh BS, Aireen I

Med J Malaysia, 2008 Dec;63(5):417-8.
PMID: 19803306 MyJurnal

Patients with multiple malignant primary tumours are often described, based on their chronology of presentation, as simultaneous, synchronous or metachronous tumours. Lung malignancies presenting in association with head and neck tumours are well documented while there have been small series of thyroid synchronous cancers presenting with laryngeal lesions in literature. No cases, to our knowledge, have been reported in literature of a single patient with all three laryngeal, lung and thyroid malignancies. We report one such case of a 71-year-old Chinese man who had undergone a total laryngectomy for a recurrent cancer of the larynx only to be found to have tumours of the lung and thyroid in the post-operative period and he eventually died of post-operative complications. We also discuss screening for lung and thyroid malignancies in patients with head and neck squamous cell carcinoma (SCC).

Matched MeSH terms: Laryngectomy