Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale最新文献

{"title":"Development of a management protocol for internal carotid artery injury during endoscopic surgery: a modified Delphi method and single-center multidisciplinary working group.","authors":"Amr F Hamour,&nbsp;Frederick Laliberte,&nbsp;Vikram Padhye,&nbsp;Eric Monteiro,&nbsp;Ronit Agid,&nbsp;John M Lee,&nbsp;Ian J Witterick,&nbsp;Allan D Vescan","doi":"10.1186/s40463-022-00582-w","DOIUrl":"https://doi.org/10.1186/s40463-022-00582-w","url":null,"abstract":"<p><strong>Background: </strong>Intra-operative internal carotid artery (ICA) injury during transnasal endoscopic surgery is a potentially catastrophic event. Such an injury is life-threatening in the immediate setting, with a reported peri-operative mortality rate of 10%. Nasal packing, muscle patches, direct vessel closure, and endovascular techniques have been described as useful strategies for managing ICA bleeds. The objective of this study was to develop a formalized management protocol for intra-operative ICA injury through engagement with a multi-disciplinary panel.</p><p><strong>Methods: </strong>A modified Delphi method including literature review, iterative rounds of stakeholder feedback, and expert panel discussions was used to develop a management protocol for ICA injury during transnasal endoscopic surgery. The 10-person multi-disciplinary panel included otolaryngologists, neurosurgeons, interventional neuroradiologists, anesthesiologists, and operating room nursing staff.</p><p><strong>Results: </strong>After three rounds of stakeholder engagement with the expert panel, consensus was reached on important elements to include within the protocol. The protocol was divided in three categories: Alert, Control, and Transfer. 'Alert' focusses on early communication with anesthesia and nursing staff. 'Control' focusses on techniques to expose the injury and obtain hemostasis or adequate tamponade. Lastly, 'Transfer' describes the process of contacting neuro-interventional radiology and safely transferring the patient. A one-page handout of the protocol was developed for placement in operating theatres.</p><p><strong>Conclusion: </strong>Due to the life-threatening nature of ICA injury, it is imperative that endoscopic sinus and skull base surgeons are prepared to manage this complication. Using a modified Delphi method with a multidisciplinary expert panel, a protocol for management of intra-operative ICA injury was developed.</p>","PeriodicalId":520683,"journal":{"name":"Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale","volume":" ","pages":"30"},"PeriodicalIF":3.4,"publicationDate":"2022-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9331087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40556069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral reconstruction of the mandibular body with symphyseal preservation using a single fibula free flap: operative technique.","authors":"Riccardo Nocini,&nbsp;Vittorio Favero,&nbsp;Luigi Chiarini,&nbsp;Pier Francesco Nocini","doi":"10.1186/s40463-022-00579-5","DOIUrl":"https://doi.org/10.1186/s40463-022-00579-5","url":null,"abstract":"<p><strong>Background: </strong>Mandibular osteonecrosis may occur in 5% of the patients who undergo radiotherapy for the treatment of head and neck malignancies. Resection and microvascular reconstruction is the treatment of choice in complicated osteoradionecrosis, however multifocal presentation may complicate the management of the disease given the poor quality and limited availability of adequate recipient vessels.</p><p><strong>Operative technique: </strong>A 74-year-old man affected by multifocal severe osteoradionecrosis of the mandible underwent bilateral resection of the mandibular bodies while preserving the symphysis. The defects were reconstructed with a single fibula flap composed by two bony segments connected by a central segment, corresponding to the symphyseal region, in which the bone was dissected and removed. The anastomosis was performed on a single side of the neck. Healing was uneventful and the adopted technique allowed for a quick functional and esthetic recovery.</p><p><strong>Conclusion: </strong>The presented technique provided a safe and efficacious, although technically challenging, solution in a case presenting multifocal osteonecrosis of the jaw. The morbidity of the procedure was limited because the tissue resection and reconstruction processes were minimized.</p>","PeriodicalId":520683,"journal":{"name":"Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale","volume":" ","pages":"29"},"PeriodicalIF":3.4,"publicationDate":"2022-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9330650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40557163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circ_0000144 acts as a miR-1178-3p decoy to promote cell malignancy and angiogenesis by increasing YWHAH expression in papillary thyroid cancer.","authors":"Yinli Ma,&nbsp;Dan Yang,&nbsp;Pingan Guo","doi":"10.1186/s40463-022-00574-w","DOIUrl":"https://doi.org/10.1186/s40463-022-00574-w","url":null,"abstract":"<p><p>Papillary thyroid cancer (PTC) is the most common subtype of thyroid cancer. Circular RNA hsa_circ_0000144 (circ_0000144) is related to the progression of thyroid cancer. However, the mechanism by which circ_0000144 accelerates PTC progression is still unclear. Circ_0000144 and YWHAH were upregulated in PTC tissues and cells, while miR-1178-3p had an opposite result. Circ_0000144 silencing constrained PTC cell growth in vitro and in vivo and induced apoptosis and repressed migration, invasion, and angiogenesis of PTC cells in vitro. Circ_0000144 acted as a molecular sponge for miR-1178-3p, which targeted YWHAH. MiR-1178-3p inhibitor reversed circ_0000144 silencing-mediated influence on PTC cell malignancy and angiogenesis. Furthermore, YWHAH overexpression overturned miR-1178-3p mimic-mediated influence on malignant behaviors and angiogenesis of PTC cells. Notably, circ_0000144 regulated YWHAH expression by adsorbing miR-1178-3p. Circ_0000144 promoted cell malignancy and angiogenesis by regulating the miR-1178-3p/YWHAH axis in PTC, offering a novel mechanism for the malignancy and angiogenesis of PTC cells.</p>","PeriodicalId":520683,"journal":{"name":"Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale","volume":" ","pages":"28"},"PeriodicalIF":3.4,"publicationDate":"2022-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9330660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40641139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Image guidance system use amongst Canadian otolaryngologists: a nationwide survey.","authors":"T McHugh,&nbsp;D D Sommer,&nbsp;A Thamboo,&nbsp;M A Tewfik,&nbsp;K A Smith","doi":"10.1186/s40463-022-00589-3","DOIUrl":"https://doi.org/10.1186/s40463-022-00589-3","url":null,"abstract":"","PeriodicalId":520683,"journal":{"name":"Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale","volume":" ","pages":"31"},"PeriodicalIF":3.4,"publicationDate":"2022-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9336095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40654127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Injection laryngoplasty during transoral laser microsurgery for early glottic cancer: a randomized controlled trial.","authors":"Ayham Al Afif,&nbsp;Matthew H Rigby,&nbsp;Colin MacKay,&nbsp;Timothy F Brown,&nbsp;Timothy J Phillips,&nbsp;Usman Khan,&nbsp;Jonathan R B Trites,&nbsp;Martin Corsten,&nbsp;S Mark Taylor","doi":"10.1186/s40463-022-00564-y","DOIUrl":"https://doi.org/10.1186/s40463-022-00564-y","url":null,"abstract":"<p><strong>Background: </strong>Transoral laser microsurgery is widely used for treating T1/T2 glottic cancers. Hyaluronic acid (HA) is commonly used in vocal cord augmentation. We investigated the impact of intra-operative injection laryngoplasty on voice outcomes in early glottic cancer.</p><p><strong>Methods: </strong>Twenty patients were randomized to the treatment group receiving HA injection to the vocal cord contralateral to the lesion; or the control group, receiving no injection. Patients had a Voice Handicap Index-10 (VHI-10) questionnaire and a Maximum Phonation Time (MPT) measurement preoperatively and at 3, 12 and 24 months post-operatively. Mean change in VHI-10 and MPT, compared to baseline and between time points, were compared. Survival estimates were calculated.</p><p><strong>Results: </strong>Mean VHI-10 scores improved over time amongst all patients. There were no changes in mean VHI-10 from pre-operative values to 3, 12 or 24 months post-operatively. There were no significant differences when comparing various timepoints between groups. There were no significant changes in MPT amongst the groups, or the time-points compared. Two-year overall survival was 91.7%; disease free survival was 80.9%; no difference in recurrence free survival was seen between the groups.</p><p><strong>Conclusion: </strong>Subjective voice scores improved over time in both groups; there were no improvements in VHI-10 or MPT scores in the injection group, over control, at any time points. We saw no significant impact for intra-operative HA injection laryngoplasty on subjective or objective voice outcomes following surgery for early glottic cancers.</p>","PeriodicalId":520683,"journal":{"name":"Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale","volume":" ","pages":"12"},"PeriodicalIF":3.4,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8939150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40315360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction and expression of PIK3CA^E545K in a papillary thyroid cancer BRAF^V600E cell line leads to a dedifferentiated aggressive phenotype.","authors":"Nicole Pinto,&nbsp;Kara M Ruicci,&nbsp;Mohammed Imran Khan,&nbsp;Mushfiq Hassan Shaikh,&nbsp;Yu Fan Peter Zeng,&nbsp;John Yoo,&nbsp;Kevin Fung,&nbsp;S Danielle MacNeil,&nbsp;Adrian Mendez,&nbsp;Joe S Mymryk,&nbsp;John W Barrett,&nbsp;Paul C Boutros,&nbsp;Anthony C Nichols","doi":"10.1186/s40463-022-00558-w","DOIUrl":"https://doi.org/10.1186/s40463-022-00558-w","url":null,"abstract":"<p><p>Anaplastic thyroid cancer (ATC) is a rare, aggressive form of undifferentiated thyroid cancer, which exhibits rapid progression and is almost universally fatal. At least a subset of ATC is thought to arise from pre-existing well-differentiated thyroid cancer, most frequently papillary thyroid cancer (PTC). While PIK3CA mutations are rare in PTC, they are common in ATC and tend to co-occur with BRAF mutations. This provided the rationale for our study to identify the potential role of PIK3CA mutations in the progression from well-differentiated to undifferentiated thyroid cancer. We introduced PIK3CA^E545K into the LAM1 PTC cell line, which carries a BRAF^V600E mutation. In culture, the engineered cell line (LAM1:PIK3CA^E545K) proliferated faster and demonstrated increased clonogenic potential relative to the parental line carrying an empty vector (LAM1^EV). Both the LAM1^EV and LAM1:PIK3CA^E545K edited lines were implanted into hind flanks of athymic nude mice for in vivo determination of disease progression. While tumour weights and volumes were not significantly higher in LAM1:PIK3CA^E545K mice, there was a decrease in expression of thyroid differentiation markers TTF-1, thyroglobulin, PAX8 and B-catenin, suggesting that introduction of PIK3CA^E545K led to dedifferentiation in vivo. Collectively, this study provides evidence of a role for PIK3CA^E545K in driving disease progression from a well-differentiated to an undifferentiated thyroid cancer; however, over-expression was not a determinant of an accelerated growth phenotype in ATC.</p>","PeriodicalId":520683,"journal":{"name":"Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale","volume":" ","pages":"7"},"PeriodicalIF":3.4,"publicationDate":"2022-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8862267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39945029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hereditary oral squamous cell carcinoma associated with CDKN2A germline mutation: a case report.","authors":"Ah-Reum Jeong,&nbsp;Kimberly Forbes,&nbsp;Ryan K Orosco,&nbsp;Ezra E W Cohen","doi":"10.1186/s40463-022-00556-y","DOIUrl":"https://doi.org/10.1186/s40463-022-00556-y","url":null,"abstract":"<p><strong>Background: </strong>Germline CDKN2A mutations are a well-known cause of familial atypical multiple mole melanoma (OMIM #155601) and melanoma-pancreatic cancer syndrome (OMIM #606719). Increased risk of head and neck squamous cell carcinoma (HNSCC), particularly oral squamous cell carcinoma (OSCC) in those with germline CDKN2A mutations, has been described. However, screening for HNSCC is not a routine practice in patients with CDKN2A germline mutations and these mutations are not a conventional test for HNSCC patients without obvious risk factors.</p><p><strong>Case presentation: </strong>We describe a female with no smoking history who developed oral squamous cell carcinoma at age 39 and had a complex clinical course of recurrent multifocal squamous cell carcinoma (SCC) and carcinoma in situ of the oral cavity and oropharynx. Detailed family history demonstrated that her mother was diagnosed with OSCC and melanoma in her 40 s, and her maternal grandfather was diagnosed with metastatic melanoma in his 40 s. Genetic testing of the patient and her mother revealed CDKN2A c.301G>T mutation. She was referred to genetic counseling as well as to dermatology, gastroenterology, and neurology for cancer surveillance. She was treated with resections and has no evidence of disease 3 years after diagnosis.</p><p><strong>Conclusions: </strong>We report a family with a CDKN2A c.301 G>T mutation who also have significant history of OSCC, adding to the growing body of literature suggesting increased risk of HNSCC, particularly OSCC, in CDKN2A germline mutation carriers. It is important to consider CDKN2A mutation testing in familial HNSCC and young patients without obvious risk factors. Moreover, surveillance for HNSCC should be routine practice in those with a CDKN2A germline mutation.</p>","PeriodicalId":520683,"journal":{"name":"Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale","volume":" ","pages":"5"},"PeriodicalIF":3.4,"publicationDate":"2022-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8818223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39594747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translation, cross-cultural adaptation and validation of the Mandarin version of the BDDQ-AS for rhinoplasty patients.","authors":"Wilson A Wijaya,&nbsp;Yu Liu,&nbsp;Min Zhou,&nbsp;Yong Qing,&nbsp;Zhengyong Li","doi":"10.1186/s40463-022-00557-x","DOIUrl":"https://doi.org/10.1186/s40463-022-00557-x","url":null,"abstract":"<p><strong>Background: </strong>The BDDQ-AS (Body Dysmorphic Disorder Questionnaire-Aesthetic Surgery) is a simple and reliable patient-reported outcome measure. It can be used as a screening tool for body dysmorphic disorder (BDD) in patients undergoing aesthetic rhinoplasty. The aim of this study was to translate and culturally adapt the Mandarin version of the BDDQ-AS (M-BDDQ-AS) and evaluate its selected psychometric validation in patients after rhinoplasty.</p><p><strong>Method: </strong>According to international guidelines, the BDDQ-AS questionnaire was translated from English to Mandarin. Twenty Mandarin-speaking rhinoplasty patients were interviewed in order to evaluate the understandability and acceptability of the translation and produce a final version. It was then administered to 137 patients with a mean age of 38.75 ± 6.24 years. Psychometric validation were evaluated using reliability (internal consistency, test-retest reliability) and item-reponse theory (IRT) test.</p><p><strong>Result: </strong>High internal consistency of 0.823 was found using Cronbach's α coefficient. Reliability of the M-BDDQ-AS resulted in Intraclass Correlation Coefficient (ICC) = 0.863. Besides, based on IRT analysis, the discrimination abilities of all the items were good (over 2.0), and their difficulty estimates were reasonable.</p><p><strong>Conclusion: </strong>The M-BDDQ-AS is a reliable and valid self-reported questionnaire that can be used in rhinoplasty patients. The very good psychometric validation of the M-BDDQ-AS indicates that it can be used in clinical practice and scientific research.</p>","PeriodicalId":520683,"journal":{"name":"Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale","volume":" ","pages":"6"},"PeriodicalIF":3.4,"publicationDate":"2022-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8818153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39891601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a patient reported outcome instrument for chronic sialadenitis.","authors":"Fatemeh Ramazani,&nbsp;Amr Hamour,&nbsp;Caroline C Jeffery,&nbsp;Vincent Biron,&nbsp;Yaser Alrajhi,&nbsp;Daniel O'Connell,&nbsp;David W J Côté","doi":"10.1186/s40463-022-00555-z","DOIUrl":"https://doi.org/10.1186/s40463-022-00555-z","url":null,"abstract":"<p><strong>Background: </strong>Sialendoscopy assisted treatments are a minimally invasive management modality for chronic sialadenitis. Clinicians report improved patient quality of life (QoL) following sialendoscopy assisted treatments, but there exist gaps in current literature about patient reported outcomes (PROs). PROs are outcome measures developed based on patient perceptions.</p><p><strong>Objective: </strong>The objective of this study was to create a PRO instrument for chronic sialadenitis, to assess the efficacy of sialendoscopy assisted treatments in improve patients' QoL.</p><p><strong>Design: </strong>This four-phase qualitative study employed grounded theory methodology and a modified Delphi technique. In Phase I, ten patients were interviewed to identify the QoL domains impacted by chronic sialadenitis. In Phase II, these QoL domains were presented to a focus group of different chronic sialadenitis patients, who were asked to rank them by order of importance. A conceptual framework of QoL domains impacted by chronic sialadenitis was created based on patient consensus. Itemization of the PRO questionnaire was done by a focus group of four Otolaryngologists in phase III. Lastly, the questionnaire was completed in Phase IV by cognitive interviewing of five new chronic sialadenitis patients; ensuring ease of understanding and clarity.</p><p><strong>Results: </strong>Patients identified 15 domains of QoL impacted by chronic sialadenitis, divided into three sub-scales: physical symptoms, psychosocial symptoms, and activity restriction. These domains provided the basis for creation of a 22-item PRO questionnaire, with a Likert-type response scale.</p><p><strong>Conclusion: </strong>Clinical application of the novel questionnaire produced by this study will allow for a patient-centered assessment of the patient reported effectiveness of sialendoscopy assisted therapies for management of chronic sialadenitis. Level of evidence Level V.</p>","PeriodicalId":520683,"journal":{"name":"Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale","volume":" ","pages":"4"},"PeriodicalIF":3.4,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8815140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39592460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncological and functional outcomes following treatment of T1a glottic squamous cell carcinoma with transoral laser microsurgery.","authors":"Dennis E Curry,&nbsp;David Forner,&nbsp;Matthew H Rigby,&nbsp;Jonathan R Trites,&nbsp;Martin Corsten,&nbsp;S Mark Taylor","doi":"10.1186/s40463-021-00553-7","DOIUrl":"https://doi.org/10.1186/s40463-021-00553-7","url":null,"abstract":"<p><strong>Background: </strong>Laryngeal cancers of glottic origin comprise a large proportion of head and neck malignancies. Transoral laser microsurgery (TLM) and radiation therapy are mainstays in the treatment of early stage glottic cancer, but debate persists as to which modality is functionally superior. Furthermore, there is a paucity of North American data related to functional and oncological outcomes in T1a glottic cancer. Here, we assessed oncological and functional outcomes of T1a glottic squamous cell carcinoma (SCC) with TLM to supplement evidence from jurisdictions outside North America.</p><p><strong>Methods: </strong>This study is a retrospective cohort study performed from a prospectively collected tertiary center institutional TLM database. Patients who were diagnosed with T1a glottic SCC and underwent TLM as their primary treatment were included. Functional outcomes were analyzed using the Voice Handicap Index-10 (VHI-10) questionnaire. Ultimate control with TLM only was considered to be those patients with locoregional control with repeat TLM procedures, but without addition of other modalities. Student's t-test was used to test significance and Kaplan-Meier survival analysis was used to assess oncological outcomes.</p><p><strong>Results: </strong>48 patients met study criteria. The mean follow-up time was 74 months. The 5-year locoregional, ultimate control with TLM only and laryngeal preservation rates were 83.2%, 90.4% and 100%, respectively. The overall survival and disease-specific survival were 87.2% and 100%, respectively. VHI-10 scores were available for 13/48 patients and mean scores improved non-significantly from pre-op (mean: 11.23; range: 2 to 30; median: 10) and post op (mean: 7.92; range: 0 to 18; median: 8) scoring (p-value = 0.15). Sub-stratification of voice data revealed a significant improvement between pre and post-operative scores (mean difference - 10.6, 95% CI: - 0.99 to - 20.21, p-value = 0.035) for patients with abnormal pre-operative scores (VHI > 11).</p><p><strong>Conclusion: </strong>To our knowledge, the current work represents one of the first North American studies to report both functional and oncologic outcomes for TLM treatment of T1a glottic SCC. The oncologic and functional outcomes presented here add to existing evidence in favor of TLM as a safe and effective primary treatment option for early staged T1a glottic cancer.</p>","PeriodicalId":520683,"journal":{"name":"Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale","volume":" ","pages":"2"},"PeriodicalIF":3.4,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8772184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39719885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}