Introduction Tracheostomy is essentially a “shortcut” into the airway that “bypasses” the upper airway. Most tracheostomies are performed for ventilator support in critically ill patients or as a temporary airway to accompany surgical procedures on the oral cavity, pharynx, or…
Introduction Bronchoscopy is an important diagnostic tool that can also be used therapeutically. Both rigid ( Fig. 18.1 ) and flexible bronchoscopes ( Fig. 18.2 ) can be used, and both techniques have relative advantages and disadvantages. Although flexible bronchoscopy…
Introduction Total laryngopharyngectomy is employed for cancer of the hypopharynx. The hypopharynx forms the inferior part of the pharynx and is located immediately behind the larynx. It has three subsites—that is, postcricoid, posterior pharyngeal wall, and pyriform sinuses bilaterally. Total…
Introduction The most common location of laryngeal cancer is the glottis, followed by the supraglottis, with the least common site being the subglottis. The American Cancer Society estimates that more than 14,000 new cases of laryngeal cancer will occur in…
Introduction Early supraglottic squamous cell carcinoma may be treated with either surgery or radiation as a single modality with equal results, based on retrospective evidence and extrapolation from larger studies comparing radiation to total laryngectomy. As treatment modalities shifted toward…
Introduction Historically, a variety of partial laryngectomies have been developed to preserve speech and avoid the permanent stoma associated with the classical total laryngectomy. The supracricoid partial laryngectomy was developed to manage selected glottic and/or supraglottic cancers. The procedure can…
Introduction Vertical partial laryngectomy (VLP) is used for cancers extending to or crossing the anterior commissure. Hence the resection as typically performed entails removal of several millimeters of the contralateral vocal cord as well as the midline portion of the…
Introduction Cancer of the larynx arises from three subsites in the larynx: the supraglottis, glottis, and subglottis. Subglottic primaries comprise less than 5% of cancers of the larynx. The incidence of supraglottic versus glottic primaries varies, depending on the relative…
Introduction Transoral CO 2 laser microsurgery is a well-established treatment for cancer of the larynx, particularly for T 1 or T 2 glottic cancer. Alternative treatment options include radiation therapy or hemilaryngectomy for glottic cancer and supraglottic or supracricoid laryngectomy…
Introduction Basic functions of the larynx include being the conduit for air, protecting the airway from aspiration, phonating, coughing, fixing the chest for straining activities, maintaining positive end-expiratory pressure, and swallowing. All these functions can be impaired in patients with…