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Article ; Online: HFNO for laryngotracheal surgery; when is it worthwhile?

Lionello, Marco / Bertolin, Andy / Grassetto, Alberto

2024 Volume 41, Issue 6, Page(s) 461–462

MeSH term(s)	Humans ; Larynx/surgery ; Trachea/surgery ; Intubation, Intratracheal/methods ; Laryngeal Masks
Language	English
Publishing date	2024-05-08
Publishing country	England
Document type	Letter ; Journal Article
ZDB-ID	605770-6
ISSN	1365-2346 ; 0265-0215
ISSN (online)	1365-2346
ISSN	0265-0215
DOI	10.1097/EJA.0000000000001971
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Article ; Online: Current Status of Partial Laryngeal Surgery for Advanced Laryngeal Cancer: When and Why?

Crosetti, Erika / Fantini, Marco / Bertotto, Ilaria / Bertolin, Andy / Arrigoni, Giulia / Lorenzi, Andrea / Succo, Giovanni

Current oncology reports

2024

Abstract: Purpose of review: This paper aims to evaluate the evolution and current status of partial laryngeal surgery in the treatment of advanced laryngeal cancer (LC). Specifically, recent progress in the selection of both patients and tumors, together with ... ...

Abstract	Purpose of review: This paper aims to evaluate the evolution and current status of partial laryngeal surgery in the treatment of advanced laryngeal cancer (LC). Specifically, recent progress in the selection of both patients and tumors, together with surgical and rehabilitation innovations, have contributed to balancing oncological control with the maintenance of quality of life in naïve and radiorecurrent patients. The main aspect is represented by the recognized role of open partial horizontal laryngectomies (OPHLs) in this new era of laryngeal cancer treatment. Recent findings: Recent advancements highlight OPHLs' efficacy for conservative management of intermediate to advanced stages of LC. Innovations such as supratracheal partial laryngectomy have expanded surgical options, offering a modular approach to complex cases. Improved understanding of tumor biology, enhanced imaging techniques, and more precise preoperative planning have led to better patient outcomes, emphasizing the importance of a conservative function-preserving surgical treatment. These advancements reflect a broader trend towards individualized treatment plans that prioritize both survival and quality of life. OPHLs play an important role in current management of intermediate/advanced LC, effectively balancing oncological control with the preservation of laryngeal functions. Critical factors include meticulous patient and tumor selection, the impact of surgical and technological refinements on functional outcomes, and the necessity of a multidisciplinary approach in treatment planning. Current evidence justifies the use of these interventions in many intermediate T-stage laryngeal tumors, even at risk of upstaging on pathological examination. The oncological results, the preservation of laryngeal function and the laryngectomy-free survival achieved with OPHLs appear to be highly competitive with those of non surgical organ-preservation protocols, aiming to introduce a new standard in the LC treatment.
Language	English
Publishing date	2024-04-22
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2057359-5
ISSN	1534-6269 ; 1523-3790
ISSN (online)	1534-6269
ISSN	1523-3790
DOI	10.1007/s11912-024-01516-7
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Article ; Online: Isoprognostic functional CT map for open partial horizontal laryngectomy.

Bertolin, Andy / Varago, Chiara / Salemi, Michelangelo / Piccoli, Gianluca / Nicolai, Piero / Lionello, Marco

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery

2024 Volume 281, Issue 6, Page(s) 3051–3060

Abstract: Purpose: To identify a radiological map of laryngeal subsites whose involvement by the tumor could predict patients' functional outcomes after open partial horizontal laryngectomy (OPHL).: Methods: The present retrospective analysis concerned 96 ... ...

Abstract	Purpose: To identify a radiological map of laryngeal subsites whose involvement by the tumor could predict patients' functional outcomes after open partial horizontal laryngectomy (OPHL). Methods: The present retrospective analysis concerned 96 patients with glottic squamous cell carcinoma, who were radiologically staged with contrast-enhanced neck CT scans before undergoing supracricoid or supratracheal laryngectomy. A radiological map of patients' functional risk was developed by considering the distribution of functional outcomes in relation to the laryngeal subsites involved. The functional outcomes considered were: (i) decannulation at discharge; (ii) time to removal of the nasogastric feeding tube (NFT); (iii) postoperative complication rate; and (iv) length of hospital stay. Results: Involvement of the anterior supraglottis was related to a longer need for NFT, and a longer hospital stay (p = 0.003, and p = 0.003, respectively). Involvement of the posterior glottis negatively affected the time to decannulation, and the likelihood of postoperative complications (p = 0.000, and p = 0.002, respectively). Conclusions: Anterior glottic small tumors (without significant subglottic and/or supraglottic extension) are related to the best functional outcomes after OPHL, since the suprahyoid epiglottis and both the arytenoids are likely to be spared.
MeSH term(s)	Humans ; Laryngectomy/methods ; Male ; Laryngeal Neoplasms/surgery ; Laryngeal Neoplasms/diagnostic imaging ; Laryngeal Neoplasms/pathology ; Retrospective Studies ; Female ; Middle Aged ; Aged ; Carcinoma, Squamous Cell/surgery ; Carcinoma, Squamous Cell/diagnostic imaging ; Carcinoma, Squamous Cell/pathology ; Tomography, X-Ray Computed/methods ; Length of Stay/statistics & numerical data ; Postoperative Complications/epidemiology ; Glottis/diagnostic imaging ; Glottis/surgery ; Adult ; Aged, 80 and over ; Treatment Outcome ; Neoplasm Staging
Language	English
Publishing date	2024-03-30
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1017359-6
ISSN	1434-4726 ; 0937-4477
ISSN (online)	1434-4726
ISSN	0937-4477
DOI	10.1007/s00405-024-08596-y
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Article ; Online: Post-operative outcomes of different surgical approaches to oropharyngeal squamous cell cancer: a case-matched study.

Tirelli, G / Bertolin, A / Guida, F / Zucchini, S / Tofanelli, M / Rizzotto, G / Boscolo-Rizzo, P / Danesi, G / Gardenal, N

The Journal of laryngology and otology

2021 Volume 135, Issue 4, Page(s) 348–354

Abstract: Objective: To compare the post-operative outcomes of transoral laser microsurgery, lateral pharyngotomy and transmandibular surgery in oropharyngeal cancer management.: Methods: Records of 162 patients treated with transmandibular surgery, transoral ... ...

Abstract	Objective: To compare the post-operative outcomes of transoral laser microsurgery, lateral pharyngotomy and transmandibular surgery in oropharyngeal cancer management. Methods: Records of 162 patients treated with transmandibular surgery, transoral laser microsurgery or lateral pharyngotomy were reviewed. The transoral laser microsurgery cohort was matched with the lateral pharyngotomy and transmandibular surgery cohorts for tumour stage, tumour subsite and human papilloma virus status, and the intra- and post-operative outcomes were compared. Results: Duration of surgery and hospital stay were significantly longer for transmandibular surgery. Tracheostomy and nasogastric feeding tube rates were similar, but time to decannulation and to oral feeding were longer in the transmandibular surgery group. Transmandibular surgery more frequently required flap reconstruction and had a greater complication rate. Negative margins were fewer in the lateral pharyngotomy group than in the transoral laser microsurgery and transmandibular surgery groups. Conclusion: In comparison with transmandibular surgery, transoral laser microsurgery and lateral pharyngotomy were associated with fewer complications and faster functional recovery. Lateral pharyngotomy had a higher rate of positive margins than transoral laser microsurgery, with a consequently greater need for adjuvant therapy. Many patients are nonetheless unsuitable for transoral surgery. All these factors should be considered when deciding on oropharyngeal cancer surgical treatment.
MeSH term(s)	Adult ; Case-Control Studies ; Female ; Humans ; Laser Therapy/methods ; Male ; Mandible/surgery ; Microsurgery/methods ; Oropharyngeal Neoplasms/surgery ; Pharyngectomy/methods ; Squamous Cell Carcinoma of Head and Neck/surgery ; Treatment Outcome
Language	English
Publishing date	2021-04-05
Publishing country	England
Document type	Comparative Study ; Journal Article
ZDB-ID	218299-3
ISSN	1748-5460 ; 0022-2151
ISSN (online)	1748-5460
ISSN	0022-2151
DOI	10.1017/S0022215121000876
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Article ; Online: The glottic-subglottic laryngectomy: Surgical technique, oncological, and functional outcomes.

Bertolin, Andy / Lionello, Marco / Baldovin, Maria / Ghirardo, Guido / Rizzotto, Giuseppe

Journal of surgical oncology

2021 Volume 125, Issue 2, Page(s) 145–150

Abstract: Objectives: The aim of this article was to describe the surgical technique and report the oncological and functional outcomes of the partial glottic-subglottic laryngectomy (GSL).: Methods: A retrospective review of the clinical charts of patients ... ...

Abstract	Objectives: The aim of this article was to describe the surgical technique and report the oncological and functional outcomes of the partial glottic-subglottic laryngectomy (GSL). Methods: A retrospective review of the clinical charts of patients who underwent GSL for laryngeal cancer from 1989 to 2020 at the Otolaryngology Unit of the Vittorio Veneto Hospital, a referral center for laryngeal cancer treatment. Results: The present article considered 36 patients who were submitted to GSL for laryngeal cancer. The pathological exam found squamous cell carcinoma (SCC) in 16 cases, adenoid-cystic carcinoma (ACC) in 9 cases, laryngeal chondrosarcoma in 8 cases, 1 giant cell carcinoma, 1 carcinosarcoma, and 1 metastasis of colon adenocarcinoma. Considering the 16 SCC cases we observed a recurrence rate of 31%, the overall survival (OS) and disease-specific survival (DSS) were 75%. The 9 ACC cases had a recurrence rate of 23% and OS/DSS of 88%. In the 8 chondrosarcomas no relapses were reported and the OS/DSS were 100%. Among the patients without recurrence of the disease, a definitive decannulation was achieved in 21 cases (75%). Conclusions: The GSL represents a valid alternative to total laryngectomy in selected cases of laryngeal cancer involving the glottic and subglottic regions.
MeSH term(s)	Adult ; Aged ; Carcinoma, Squamous Cell/surgery ; Chemoradiotherapy ; Female ; Glottis/surgery ; Humans ; Laryngeal Neoplasms/mortality ; Laryngeal Neoplasms/surgery ; Laryngectomy/adverse effects ; Laryngectomy/methods ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Retrospective Studies ; Young Adult
Language	English
Publishing date	2021-09-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	82063-5
ISSN	1096-9098 ; 0022-4790
ISSN (online)	1096-9098
ISSN	0022-4790
DOI	10.1002/jso.26675
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Article ; Online: Modular Approach to Open Partial Horizontal Laryngectomy: Step-by-Step Anatomic Dissection.

Molteni, Gabriele / Bertolin, Andy / Gazzini, Luca / Sacchetto, Andrea / Marchioni, Daniele

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

2021 Volume 166, Issue 3, Page(s) 601–602

Abstract: Open partial laryngectomies still play an important role in contemporary conservative management of laryngeal cancer. A comprehensive and systematic classification of open partial horizontal laryngectomies (OPHLs) was presented by the European ... ...

Abstract	Open partial laryngectomies still play an important role in contemporary conservative management of laryngeal cancer. A comprehensive and systematic classification of open partial horizontal laryngectomies (OPHLs) was presented by the European Laryngological Society working committee in 2014. The aim of this video is to show the main surgical steps in OPHL using a cadaveric dissection and to explain the modular approach for removal of laryngeal tumors.
MeSH term(s)	Dissection ; Humans ; Laryngeal Neoplasms/pathology ; Laryngeal Neoplasms/surgery ; Laryngectomy ; Otolaryngology
Language	English
Publishing date	2021-06-29
Publishing country	England
Document type	Journal Article ; Video-Audio Media
ZDB-ID	392085-9
ISSN	1097-6817 ; 0161-6439 ; 0194-5998
ISSN (online)	1097-6817
ISSN	0161-6439 ; 0194-5998
DOI	10.1177/01945998211026528
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Article ; Online: Fragility and contagiousness of the total laryngectomy patient in the COVID-19 pandemic.

Bertolin, Andy / Lionello, Marco / de Robertis, Valentina / Barbara, Francesco / Cariti, Francesco / Barbara, Michele

Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale

2022 Volume 42, Issue Suppl. 1, Page(s) S68–S72

Abstract: Objective: The Coronavirus disease 2019 (COVID-19) pandemic has posed significant problems for patients who have undergone total laryngectomy (TL). The lack of specific guidelines and paucity of information available to the public on this topic has ... ...

Abstract	Objective: The Coronavirus disease 2019 (COVID-19) pandemic has posed significant problems for patients who have undergone total laryngectomy (TL). The lack of specific guidelines and paucity of information available to the public on this topic has clearly emerged during the ongoing pandemic. The aim of the present study is to investigate our personal experience in managing the stoma in TL patients during the COVID-19 pandemic. Methods: A questionnaire was administered by phone to laryngectomised patients who had previously been seen at the outpatient otolaryngology clinics of Vittorio Veneto and Barletta Hospitals from January to December 2020. Results: A total of 92 patients were included. Twenty-five patients (27%) had been tested for SARS-CoV-2. Among these, 19 (76%) had been investigated with a nasal swab, 5 (20%) with a tracheal swab and 1 with a serological assay. Five patients were positive for SARS-CoV-2 (in 4 cases as a result of the nasal swab, in one case with the bronchial aspirate). Eighty-four patients (91%) used a heat moisture exchanger over the stoma every day, but 6 patients (6.5%) were unaware of the importance of protecting the stoma. Conclusions: We conclude that TL patients should always be adequately informed by healthcare staff about how to manage their stoma. Specific guidelines are needed for testing TL patients for SARS-CoV-2.
MeSH term(s)	COVID-19/epidemiology ; Humans ; Laryngectomy ; Otolaryngology ; Pandemics ; SARS-CoV-2
Language	English
Publishing date	2022-06-28
Publishing country	Italy
Document type	Journal Article
ZDB-ID	604898-5
ISSN	1827-675X ; 0392-100X
ISSN (online)	1827-675X
ISSN	0392-100X
DOI	10.14639/0392-100X-suppl.1-42-2022-07
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Article ; Online: Pre-operative CT cephalometry and functional outcomes after open partial horizontal laryngectomy.

Lionello, Marco / Cercato, Cristina / Varago, Chiara / Franz, Leonardo / Grillone, Saverio / Piccoli, Gianluca / Nicolai, Piero / Bertolin, Andy

Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale

2023 Volume 43, Issue 2, Page(s) 123–129

Abstract: Objectives: To identify pre-operative radiological parameters that are able to predict the functional outcomes of open partial horizontal laryngectomy (OPHL).: Methods: The present retrospective study concerned a cohort of 96 patients with laryngeal ... ...

Abstract	Objectives: To identify pre-operative radiological parameters that are able to predict the functional outcomes of open partial horizontal laryngectomy (OPHL). Methods: The present retrospective study concerned a cohort of 96 patients with laryngeal squamous cell carcinoma who underwent pre-operative radiological staging with contrast-enhanced computerised tomography of the neck, and subsequent supracricoid or supratracheal laryngectomy. Univariate and multivariate analyses were run to assess the prognostic value of the main demographic and surgical variables, and the pre-operative cephalometric values, respectively, in terms of predicting patients' functional outcomes. Results: Multivariate analysis showed that a larger anteroposterior cross-sectional dimension of the aero-digestive tract in the mid-retroglossal area, and a greater distance between the genial tubercle and the hyoid bone in the mid-sagittal plane correlated significantly with better functional outcomes in terms of decannulation rate at discharge. Conclusions: Our findings show that larger pre-operative upper aero-digestive tract diameters and volumes coincide with better post-operative functional outcomes after OPHL.
MeSH term(s)	Humans ; Laryngectomy/methods ; Treatment Outcome ; Retrospective Studies ; Cephalometry ; Cross-Sectional Studies ; Laryngeal Neoplasms/diagnostic imaging ; Laryngeal Neoplasms/surgery ; Laryngeal Neoplasms/pathology ; Carcinoma, Squamous Cell/diagnostic imaging ; Carcinoma, Squamous Cell/surgery ; Carcinoma, Squamous Cell/pathology ; Head and Neck Neoplasms/surgery
Language	English
Publishing date	2023-04-26
Publishing country	Italy
Document type	Journal Article
ZDB-ID	604898-5
ISSN	1827-675X ; 0392-100X
ISSN (online)	1827-675X
ISSN	0392-100X
DOI	10.14639/0392-100X-N2255
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Article ; Online: Laryngeal adenoid cystic carcinoma: Radical or conservative surgery?

Lionello, Marco / Canal, Fabio / Presotto, Francesca / Palumbo, Raffaella / Rizzotto, Giuseppe / Bertolin, Andy

American journal of otolaryngology

2021 Volume 42, Issue 4, Page(s) 102974

Abstract: Purpose: The present paper describes our experience in surgical treatment of laryngeal ACC, and discuss the effectiveness of conservative surgery.: Methods: We retrospectively reviewed the clinical charts of 17 patients with laryngeal ACC treated ... ...

Abstract	Purpose: The present paper describes our experience in surgical treatment of laryngeal ACC, and discuss the effectiveness of conservative surgery. Methods: We retrospectively reviewed the clinical charts of 17 patients with laryngeal ACC treated surgically at the Otolaryngology Unit of Vittorio Veneto Hospital (Italy) from November 1989 to April 2020. Results: Fourteen patients underwent partial laryngectomy, and three had a total laryngectomy. Five patients (29%) experienced a laryngeal ACC relapse after a disease-free survival of 66.6 ± 50.1 months. The distant metastasis rate was 17%. At latest follow-up, two patients had died of distant metastatic disease after 156 and 243 months. Conclusions: Radical surgery for laryngeal ACC does not warrant free margins and even cases with positive deep margins rarely experience any relapsing disease. We recommend that surgical treatment for laryngeal ACC be as conservative as possible.
MeSH term(s)	Adult ; Aged ; Carcinoma, Adenoid Cystic/mortality ; Carcinoma, Adenoid Cystic/surgery ; Conservative Treatment/methods ; Female ; Follow-Up Studies ; Humans ; Laryngeal Neoplasms/mortality ; Laryngeal Neoplasms/surgery ; Laryngectomy/methods ; Larynx/surgery ; Male ; Margins of Excision ; Middle Aged ; Neoplasm Recurrence, Local ; Retrospective Studies ; Survival Rate ; Time Factors ; Treatment Outcome
Language	English
Publishing date	2021-02-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	604541-8
ISSN	1532-818X ; 0196-0709
ISSN (online)	1532-818X
ISSN	0196-0709
DOI	10.1016/j.amjoto.2021.102974
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Article ; Online: Voice and communication after open partial horizontal laryngectomies: A cross-sectional outcome study.

Fantini, Marco / Crosetti, Erika / Pizzorni, Nicole / Sprio, Andrea Elio / Bertolin, Andy / Rizzotto, Giuseppe / Schindler, Antonio / Succo, Giovanni

Head & neck

2022 Volume 44, Issue 10, Page(s) 2248–2256

Abstract: Objective: The present study evaluates voice and communication after open partial horizontal laryngectomies (OPHLs), according to surgery and patient-related variables.: Methods: Fifty-eight patients were included: 18 type I OPHL, 20 type II OPHL and ...

Abstract	Objective: The present study evaluates voice and communication after open partial horizontal laryngectomies (OPHLs), according to surgery and patient-related variables. Methods: Fifty-eight patients were included: 18 type I OPHL, 20 type II OPHL and 20 type III OPHL. Acoustic, aerodynamic, endoscopic, perceptual and self-assessment analyses were carried out. Surgery-related variables and patient-related variables were considered for the analysis. Results: Type I OPHL revealed the best phonatory outcomes. Type II and type III OPHL showed similar and poor results, with a highly deteriorated voice quality. A significant difference in MTP was found for patients who had both arytenoids/cricoarytenoid units preserved. Age and time from surgery showed significant correlations with voice quality after OPHLs. Conclusions: Voice and communication outcomes after OPHLs are heterogeneous and might be influenced by several factors. Knowing variables with a substantial impact on phonatory outcomes may help clinicians in the preoperative decision-making process and the postoperative rehabilitative program.
MeSH term(s)	Communication ; Cross-Sectional Studies ; Humans ; Laryngeal Neoplasms/surgery ; Laryngectomy/methods ; Outcome Assessment, Health Care
Language	English
Publishing date	2022-07-06
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	645165-2
ISSN	1097-0347 ; 0148-6403 ; 1043-3074
ISSN (online)	1097-0347
ISSN	0148-6403 ; 1043-3074
DOI	10.1002/hed.27132
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