Colizza Andrea, Ralli Massimo, Di Stadio Arianna, Cambria Francesca, Zoccali Federica, Cialente Fabrizio, Angeletti Diletta, Greco Antonio, de Vincentiis Marco
Department of Sense Organs, Sapienza University of Rome, 00161 Roma, Italy.
Department GF Ingrassia, University of Catania, 95125 Catania, Italy.
J Clin Med. 2022 Aug 14;11(16):4741. doi: 10.3390/jcm11164741.
Background: Open partial horizontal laryngectomies (OPHL) are one of the surgical techniques used for the conservative management of laryngeal cancers. The aims of this study are to analyze the oncological and functional results of a group of patients affected by laryngeal squamous cell carcinoma (LSCC) treated with OPHL, performed using a minimally invasive technique. Methods: This is a prospective case−control study. We enrolled 17 consecutive patients with LSCC treated with OPHL through a lateral cervical approach (LCA). Patients were evaluated using their Penetration Aspiration Scale score (liquid, semiliquid and solid) and Voice Handicap Index (VHI) at three different endpoints: 15 days (T1), 3 months (T2), and 6 months (T2) after surgery. Results: The functional outcomes of the LCA are stackable with that of the classical anterior cervical approach in terms of respiration, swallowing, and speech. One-way ANOVA was performed to evaluate the variances of PAS and VHI scores at the three different observation points. No statistically significant differences were observed between OPHL- PAS scores for liquid (p = 0.1) at the three different observation points. A statistically significant improvement was observed in the OPHL- PAS score for semisolids and solids (p < 0.00001) between T1 and T3 (p = 0.0001) and for solids between T2 and T3 (p < 0.00001). The improvement of VHI-10 was statistically significative (p < 0.00001) at the three different observation points (T1−T2 and T2−T3). Conclusion: The LCA is a potential approach for laryngeal surgery in selected cases. The preoperative staging and planning are of the utmost importance to ensure oncological radicality. The main advantage of this approach is the preservation of the healthy tissues surrounding the larynx and the functional and oncological outcomes are stackable with the classic anterior cervical approach.
开放性部分水平喉切除术（OPHL）是用于喉癌保守治疗的手术技术之一。本研究旨在分析一组采用微创技术进行OPHL治疗的喉鳞状细胞癌（LSCC）患者的肿瘤学和功能结果。方法：这是一项前瞻性病例对照研究。我们纳入了17例连续接受经外侧颈部入路（LCA）的OPHL治疗的LSCC患者。在术后三个不同时间点：15天（T1）、3个月（T2）和6个月（T3），使用穿透性误吸量表评分（液体、半液体和固体）和嗓音障碍指数（VHI）对患者进行评估。结果：就呼吸、吞咽和言语功能而言，LCA的功能结果与经典的颈前入路相当。进行单因素方差分析以评估三个不同观察点的PAS和VHI评分的差异。在三个不同观察点，OPHL液体误吸量表评分之间无统计学显著差异（p = 0.1）。在T1和T3之间，OPHL半固体和固体误吸量表评分有统计学显著改善（p < 0.00001）（p = 0.0001），在T2和T3之间固体误吸量表评分也有统计学显著改善（p < 0.00001）。在三个不同观察点（T1 - T2和T2 - T3），VHI - 10的改善具有统计学显著性（p < 0.00001）。结论：对于特定病例，LCA是一种潜在的喉部手术入路。术前分期和规划对于确保肿瘤根治性至关重要。该入路的主要优点是保留喉周围的健康组织，其功能和肿瘤学结果与经典的颈前入路相当。
