Introduction Total glossectomy is used for advanced cancers of the tongue, mostly squamous cell, either as a primary surgical resection or as salvage following previous (chemo)radiation when partial glossectomy will not achieve adequate resection margins. A key clinical decision is…
Introduction Cancer of the tongue is most common in 60- to 70-year-old male drinkers and smokers but is also encountered in much younger and older individuals without a history of smoking or ethanol use. Most cancers of the tongue are…
Introduction The lip is the most common site of origin for squamous cell carcinoma of the oral cavity. Unlike other cancers of the oral cavity, the etiology and clinical outcomes of squamous cell carcinoma more closely resemble squamous cell carcinoma…
Introduction Speech restoration is of great significance for the social and economic welfare of patients who undergo total laryngectomy. As outlined in Chapter 75 , Voice Restoration After Total Laryngectomy, speech restoration is most often accomplished with the use of…
Introduction Although nonsurgical methods such as electrolarynx and esophageal speech are available for patients, tracheoesophageal puncture (TEP) is considered the best means of voice restoration after total laryngectomy (TL). A TEP allows a patient to channel air from the lungs…
Introduction Stenosis of the tracheostoma following laryngectomy is an infrequent but distressing complication that may occur despite meticulous attention to the construction of the tracheostoma. Stenosis can result from a variety of factors and usually occurs in the early months…
Introduction A tracheocutaneous fistula (TCF) is a sequela of a tracheostomy and is usually associated with an unsightly depressed tracheostomy scar ( Fig. 23.1 ). Formation of this fistula is predicated on squamous epithelium migrating from the skin into the…
Introduction Tracheal resection may be undertaken for tracheal strictures and tracheal tumors. Most commonly the trachea is exposed through a cervical incision, but for distal tracheal or carinal access either a sternotomy or a right thoracotomy may be required. Up…
Introduction 1. Airway protection is the most fundamental role of the mammalian larynx. (See Additional Sources for in-depth discussion.) 2. For some patients, laryngeal function is compromised by disease processes to the extent that its airway protection role becomes inadequate…
Introduction Endoscopic percutaneous dilatational tracheostomy (PDT) is a safe and simple bedside procedure that is particularly well suited to patients in the intensive care unit (ICU). Almost two-thirds of tracheostomies are performed in ICU patients. These critically ill patients, usually…