Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
Otolaryngol Head Neck Surg. 2024 Jan;170(1):289-292. doi: 10.1002/ohn.487. Epub 2023 Aug 18.
Supraglottic laryngectomy has evolved from open to transoral endoscopic approaches with advancements in surgical techniques and instruments such as lasers, endoscopes, ultrasonic devices, and robotics. Transoral laser-assisted microsurgery has emerged as an effective treatment option, offering faster functional recovery and serving as an alternative to partial laryngectomy or non-surgical therapies. Traditional endoscopic supraglottic laryngectomy involves resection of both suprahyoid and infrahyoid supraglottic structures. However, in cases where the tumor is limited to the infrahyoid epiglottis, a new technique known as transoral laser-assisted infrahyoid supraglottic laryngectomy allows for tumor removal while preserving the suprahyoid epiglottis, aryepiglottic folds, and vallecula, ensuring optimal preservation of laryngopharyngeal function. This procedure enables patients to swiftly return to their daily routines with minimal complications. This article discusses the surgical technique, potential indications, and advantages and disadvantages of the new approach for infrahyoid epiglottic cancer.
声门上喉切除术已经从开放式手术发展为经口内镜手术，手术技术和器械的进步如激光、内窥镜、超声设备和机器人的应用起到了推动作用。经口激光辅助显微手术已成为一种有效的治疗选择，提供更快的功能恢复，并可作为部分喉切除术或非手术治疗的替代方法。传统的内镜声门上喉切除术涉及切除会厌前间隙和会厌下的声门上结构。然而，在肿瘤仅限于会厌下的情况下，一种新的技术，即经口激光辅助会厌下声门上喉切除术，可以在保留会厌前间隙、杓会厌皱襞和声门上区的情况下切除肿瘤，确保喉咽功能的最佳保留。该手术使患者能够迅速恢复日常活动，并发症最小。本文讨论了该新方法治疗会厌下型声门上区肿瘤的手术技术、潜在适应证以及优缺点。
