Channel: Chapter 4 - Transoral cancer surgery - eLarynx

Tumor of the left vocal fold. Cordectomy type V

Wed, 18 Jan 2023 10:55:58 +0100

A 68-year-old male was admitted to the otolaryngology department due to a tumor of the left vocal fold. T2 N0M0. Stroboscope examination showed a tumor infiltrating the entire left vocal fold, anterior commissure and penetrating to the subglottic area. In the computer tomography examination the infiltration of the laryngeal cartilages was not noticed. therefore, a decision was made to perform endoscopic surgery. Type V cordectomy was performed due to the extent of the tumor.
In the first stage of the operation, the left vestibular fold was removed to better visualize the lesion. Then, the soft tissues of the anterior commissure were separated from the thyroid cartilage using a CO2 laser and forceps. Step by step the entire vocal fold was removed, preserving the anatomical structures. During such an extensive resection, a monopolar electrode was used to coagulate bleeding vessels.

Tumor of the right vocal fold. Cordectomy type II

Tue, 24 Jan 2023 11:34:24 +0100

A 63-year-old male was admitted to the otolaryngology department due to a tumor of the right vocal fold. Stroboscopic examination showed a tumor infiltrating the upper and medial surfaces of the right vocal fold, the tumor did not reach the anterior commissure or the subglottic region. The mobility of the right vocal fold was preserved, only limited phonation vibrations were found. Based on stroboscopy and NBI, a decision was made to completely remove the lesion without prior biopsy. Type II cordectomy was performed using a CO2 laser. In order to improve visualization of the surface of the vocal fold, the vestibular fold was partially removed in the first stage of the operation. The epithelium and subepithelial layer were removed, preserving the remaining anatomical structures of the vocal fold.
The specimen was sent for histopathological examination.

T2 hypopharyngeal carcinoma

Fri, 09 Dec 2022 13:50:51 +0100

65-year-old, male, T1 suraglottic squamous cell carcinoma, transoral tumorresection using Medrobotics Flex® Robotic System

Tumor of the right vocal fold. Cordectomy type V

Tue, 17 Jan 2023 14:42:03 +0100

A 72-year-old male was admitted to the otolaryngology department due to a tumor of the right vocal fold. T2 N0M0. Histopathological examination showed squamous cell carcinoma. In the computer tomography examination the infiltration of the laryngeal cartilages was not noticed, therefore it was possible to perform endoscopic surgery with the use of the C02 laser. Type 5 cordectomy was performed due to the extent of the tumor. The tumor involved the entire vocal fold, the anterior commissure and the anterior part of the left vocal fold.
In the first stage of the operation, the right vestibular fold was removed to better visualize the lesion. Then, the soft tissues of the anterior commissure were separated from the thyroid cartilage. Step by step, using a laser, the entire vocal fold was removed, preserving the anatomical structures.

Cordectomy type V

Fri, 09 Dec 2022 13:21:07 +0100

55 year-old, pT1b squamous cell carcinoma of the left glottis, laser cordectomy type V

Supraglottic cancer TOUSS

Sun, 11 Dec 2022 17:02:51 +0100

In this video we perform a resection of a supraglottic cancer with transoral ultrasonic surgery (TOUSS). The cancer was in the laryngeal surface of the epiglottis. We start cutting at the level of the left aryepiglottic fold and then at the level of the right aryepiglottic fold and we proceed towards the base of the tongue. We circle the entire epiglottis, and we removed the whole tumor with sufficient margins.

Cordectomy type II left vocal carcinoma

Fri, 09 Dec 2022 13:08:06 +0100

52-year old, male, pTis verrucous carcinoma of the left vocal cord, multiple drug abuse and infectious diseases, cordectomy II with laser

Second look cordectomy of the left vocal fold

Tue, 24 Jan 2023 11:40:37 +0100

This is a case showing second look operation in a patient who had a type II cordectomy performed 2 months earlier due to cancer of the left vocal fold reaching the anterior commissure.
Due to the positive superficial margin in the area of the anterior commissure and the close deep margin, the decision was made to perform a second look cordectomy.
Using a CO2 laser scanner, the power of 2 watts, the epithelium, subepithelial layer and part of the muscle were removed step by step. The specimen was sent for histopathological examination.

Resection of vallecular cyst

Fri, 09 Dec 2022 12:42:41 +0100

50 year-old, female, vallecular cyst, resection of the cyst with cold steel

Tumor of the left vocal fold. Cordectomy type III

Tue, 17 Jan 2023 14:26:52 +0100

A 65-year-old man was admitted to the otolaryngology department due to recurrence of left vocal fold cancer. Eight months earlier, a type I chordectomy of the left vocal fold was performed due to carcionoma in situ. Stroboscopic examination revealed a tumor covering the anterior 2/3 of the vocal fold and a complete disturbance of phonation vibrations. Due to the penetration of the tumor into the subepithelial layer and infiltration of the vocalis muscle, a type III cordectomy was performed. Using the CO2 laser the pathology can be excised step by step respecting the anatomical layers. Finally the carcinoma can be removed and sent for histopathological examination.

Vallecula cyst

Fri, 09 Dec 2022 13:53:54 +0100

67-year-old, female, vallecular cyst, cyst excision with laser

Cordectomy type III right vocal cord

Fri, 09 Dec 2022 12:47:16 +0100

69 year old, male, pT1a squamous cell carcinoma of the right vocal cord, cordectomy type III, laser

Tumor of the left vocal fold. Leucoplakia. Cordectomy type I/II

Tue, 24 Jan 2023 11:36:44 +0100

This case shows the small tumor of the middle part of the left vocal fold. In the stroboscopic examination, the mobility of the fold was preserved and the vibrations were slightly limited in the middle part. Cordectomy typ I partial typ II was performed to excise the lesion. Cotton swab was used to secure the intubation tube. In the first stage, using a laser, we mark the resection margin, then we remove the epithelium but in some parts also subepithelial layer of the vocal fold, preserving the deeper layers, such as the vocal ligament or the vocal muscle. The specimen was sent for histopathological examination.

Vallecula cyst resection

Fri, 09 Dec 2022 13:35:42 +0100

72-year old, female, vallecular cysts, resection of vallecular cysts with laser

Tumor of the left vocal fold. Cordectomy type II

Tue, 17 Jan 2023 14:09:25 +0100

A 56-year-old woman was admitted to the otolaryngology department due to a tumor of the left vocal fold. The patient was smoking 20 cigarettes per day for over 30 years. 3 weeks earlier, a biopsywas taken, which showed the neoplastic nature of the lesion. Type II cordectomy was performed using a CO2 laser. In order to improve visualization of the surface of the vocal fold, the vestibular fold was partially removed in the first stage of the operation.

The specimen was sent for histopathological examination.

Tumor of the left vocal fold. Cordectomy type II

Tue, 17 Jan 2023 13:51:54 +0100

A 61-year-old man was admitted to the otolaryngology department due to cancer of the left vocal fold. Cordectomy type II was performed.
In the first stage, the resection margin was marked, and then the epithelium and subepithelial layer together with Reinke's space were removed. The specimen was sent for histopathological examination.

Cordectomy type III of the left vocal cord

Fri, 09 Dec 2022 12:21:34 +0100

65-year old, male, pT1 squamous cell carcinoma of the left vocal cord, Laser cordectomy type III

Cordectomy III right vocal cord

Fri, 09 Dec 2022 13:32:42 +0100

71-year old, male, pT1 cN0 cM0 laryngeal squamous cell carcinoma, right vocal cord, cordectomy Type III

Tumor of the right vocal fold. Cordectomy type II. SSTOLM

Tue, 17 Jan 2023 14:01:53 +0100

A 53-year-old man was admitted to the otolaryngology department due to hoarseness that had been present for several months. Stroboscopic examination revealed a tumor of the right vocal fold. The mobility of the fold was preserved, but the phonation vibrations of the right vocal fold were disturbed. Single stage transoral laser microsurgery was perform.
The epithelium and the subepithelial layer of the vocal fold were removed with the use of a CO2 laser. The specimen was sent for histopathological examination.

T1 supraglottic carcinoma

Fri, 09 Dec 2022 13:41:47 +0100

70 year old, male, T1 suraglottic squamous cell carcinoma, transoral tumor resection using Medrobotics Flex® Robotic System

Cordectomy II left vocal cord

Fri, 09 Dec 2022 13:17:01 +0100

Male, 65 year- old, pT1 squamous cell carcinoma of the left vocal cord, cordectomy type III, laser