Surgical Alternatives in the Therapy of Hypopharyngeal Tumours of Various Locations - 30 Years (1986-2018) of Experience at the Department of Otorhinolaryngology, Head, and Neck Surgery, University of Szeged, Hungary

Background and Aim: The authors present advances in the surgical management of hypopharyngeal tumours in Hungary, specifically at the department of otorhinolaryngology and Head-Neck Surgery, Faculty of Medicine, University of Szeged. Resective and function-preserving surgical interventions performed via open operation are described separately. Indications for external exploration and the endoscopic-microscopic approach are also detailed, and the surgical repertoire used in the management of hypopharyngeal tumours at the department is presented. Results: At the department of Otorhinolaryngology, Head, and Neck Surgery, University of Szeged we have experienced a continuous increase in the number of hypopharyngeal tumours since the 1980s. It is not only the increased incidence that we have noted but the tumours are also getting more advanced. When focusing on the surgical management of hypopharyngeal tumours, we aim to achieve radical removal as well as retain certain functions, such as the ability of speech, which is an important aspect of the quality of life. Conclusion: Resection of hypopharyngeal tumors with laser increases the risk of recurrence, therefore it is only considered safe in some selected cases. Laryngoscopic assess and the straight line of CO2 laser determines the direction of laser line, which makes it difficult for surgeon to evaluate the involvement of deeper tissues. However, if the indications are closely observed, laser surgery is a potential alternative to surgical intervention in the treatment of small hypopharyngeal tumors

Endoscopic Arytenoid Abduction Lateropexy with Endolaryngeal Thread Guide Instrument for Bilateral Vocal Fold Paralysis

The treatment of upper airway stenosis is considered to be one of the most difficult fields in laryngology. In the 100-year-old history of airway stenosis surgery several important works of Hungarian authors (Rethi, Lichtenberger, Pytel) are found.At the Department of Oto-Rhino- Laryngology and Head- Neck Surgery, University of Szeged our workgroup has been working on the treatment of upper airway stenosis for more than 30 years.Hereby we introduce our surgical concept for bilateral vocal fold paralysis, the minimally invasive endoscopic arytenoid abduction lateropexy (EAAL), which provides an immediate adequate airway with acceptable voice quality, and good swallow function.A new Endolaryngeal Thread Guide instrument (ETGI) is also presented here, which is essential for a safe, accurate, and fast suture loop creation around the arytenoid cartilage for this surgical procedure

Immunohistochemical Diagnosis of Primary Laryngeal Melanoma as a Rare Malignant Laryngeal Tumour

In this case presentation, the authors discuss the prevalence, diagnosis and surgical treatment of the exceedingly rare primary laryngeal melanoma. The importance of immunohistochemical investigations is emphasised since the condition tends to mimic laryngeal carcinomas. Laryngeal melanomas have a very poor prognosis; their five-year survival is less than 10% in international literature. However, the patient presented in this article is still asymptomatic and has no metastases 7 years after the removal of the lesion with transoral laser microsurgery

Changes in the Quality of Life of Our Neonatal Patients Born with Severe Laryngomalacia and Treated with Endoscopic UDP Laser Supraglottoplasty

Background: Laryngomalacia is one of the most common causes of neonatal dyspnea and inspiratory stridor. In 20% of the cases laryngomalacia in newborns may lead to respiratory failure, feeding difficulties and failure to thrive. The aim of this study was to assess the changes in the quality of life of the patients with laryngomalacia in the first year following ultra-dream pulse laser supraglottoplasty.Case presentation:  the assessment relevant parameters of 6 newborn patients with laryngomalacia (4:2 male:female, average age at the time of operation 12,5 days) who underwent ultra-pulse laser supraglottoplasty.Conclusion: Ultra-dream pulse laser supraglottoplasty for laryngomalacia is a safe and effective surgical modality, even if it is performed in the neonatal age

IgG4-Related Laryngeal Disease as a Possible Cause of Idiopathic Subglottic Stenosis: A Case Report

Introduction: Immunoglobulin G4-related disease (IgG4-RD) is a systemic fibro-inflammatory disorder.  Laryngotracheal manifestation is very rare; therefore, it is usually associated with complex diagnostic and therapeutic problems.   Case Report: Herein, we report the case of a 35-year-old woman with idiopathic subglottic stenosis (ISGS) treated with one-step laryngotracheal reconstruction surgery. Postoperatively, the lesion was found to be a part of the IgG4-RD spectrum. Objective and subjective phoniatric tests, spirometry, and Quality of Life Questionnaire were used for the evaluation of postoperative functional results. Slide laryngotracheoplasty as a one-step surgery without stenting and tracheostomy ensured a sufficiently wide subglottic space with no adverse effect on voice quality. During a follow-up period of 22 months, endoscopy and computed tomography scan revealed no significant restenosis. The patient was able to return to premorbid activities of daily living without any further medical treatment. Conclusion: The laryngeal involvement of IgG4-RD is uncommon; however, it is a manifestation that should be included in the differential diagnosis of subglottic stenoses (SGS). Furthermore, subglottic IgG4-RD might be a potential etiological factor of ISGS and acquired airway stenosis after short-term intubation. Slide laryngotracheoplasty might be a favorable solution without stenting and tracheostomy even in special cases of SGS