43 research outputs found
Developing a new diagnostic algorithm for human papilloma virus associated oropharyngeal carcinoma: an investigation of HPV DNA assays
modeling the laser ablation process
This chapter focuses on the problem of modeling the laser ablation process from a geometrical point of view. The objective is to create a model capable of describing the laser incision depth based on the knowledge of the laser parameters and inputs. The discussion starts with a statement of the problem, which is defined in terms of a supervised regression. Our approach is compared with existing heuristic models for the prediction of ablation depth
cognitive supervision for transoral laser microsurgery
This chapter introduces the problem of the automatic supervision of laser-induced effects during laser surgery. A top-down approach is used to tackle this problem: specific circumstances in which surgeons would value enhanced information regarding the effects of their laser actions on tissues are identified. The problem is grounded in the identification of variables of interest that are selected as target for the supervision. In the scope of this thesis, we explore the application of artificial cognitive approaches to monitor these variables in a surgical scenario
Supracricoid partial laryngectomy in the management of t3 laryngeal cancer
Objective. To evaluate the oncologic results only in T3 glottic and supraglottic cancers regarding supracricoid partial laryngectomy (SCPL) not requiring total laryngectomy and to assess functional results by self-evaluation by the patient. Study Design. Case series with medical record review. Setting. Single tertiary care center. Subjects and Methods. Thirty-two patients with laryngeal squamous cell carcinoma, previously untreated, who underwent SCPL with cricohyoidopexy or cricohyoidoepiglottopexy were reviewed. Results. At 1, 3, and 5 years, the disease-free survival rates were 96.9%, 89.4%, and 78.2%; overall survival rates were 96.9%, 93.2%, and 87.3%; local control and locoregional control rates were 100%, 96.2%, and 96.2%; and distant metastasis-free survival rates were 100%, 100%, and 88.2%, respectively. Aspiration pneumonia was the most common complication observed. The 3 laryngeal functions (speech, swallowing, and breathing) were spared in 83.9% of patients. Conclusion. Supracricoid partial laryngectomy for selected glottic and supraglottic T3 tumors has excellent oncologic and functional results
Transoral laser microsurgery for laryngeal cancer: A primer and review of laser dosimetry
Transoral laser microsurgery (TLM) is an emerging technique for the management of laryngeal and other head and neck malignancies. It is increasingly being used in place of traditional open surgery because of lower morbidity and improved organ preservation. Since the surgery is performed from the inside working outward as opposed to working from the outside in, there is less damage to the supporting structures that lie external to the tumor. Coupling the laser to a micromanipulator and a microscope allows precise tissue cutting and hemostasis; thereby improving visualization and precise ablation. The basic approach and principles of performing TLM, the devices currently in use, and the associated dosimetry parameters will be discussed. The benefits of using TLM over conventional surgery, common complications and the different settings used depending on the location of the tumor will also be discussed. Although the CO2 laser is the most versatile and the best-suited laser for TLM applications, a variety of lasers and different parameters are used in the treatment of laryngeal cancer. Improved instrumentation has lead to an increased utilization of TLM by head and neck cancer surgeons and has resulted in improved outcomes. Laser energy levels and spot size are adjusted to vary the precision of cutting and amount of hemostasis obtained
Transoral laser microsurgery for the treatment of oropharyngeal cancer: the Dalhousie University experience
Subcranial craniotomy in surgical management of advanced oral cavity malignancies: a technical note
Postoperative bleeding in transoral laser microsurgery for upper aerodigestive tract tumors
Robotic lateral oropharyngectomy following diagnostic tonsillectomy is oncologically safe in patients with high risk human papillomavirus related squamous cell cancer.
PURPOSE
Diagnostic tonsillectomy is rarely an oncologic operation owing to close or positive margins. The standard of care is for further treatment to the primary site, typically with adjuvant radiotherapy.
METHODS
14 patients with close or positive margins following a diagnostic tonsillectomy underwent transoral robotic surgery (TORS) and lateral oropharyngectomy; five patients with the longest follow-up had their excision specimens examined with a step serial sectioning technique (SSS).
RESULTS
Conventional histopathological examination of the TORS resection specimens did not demonstrate residual carcinoma in 13 patients, confirmed by examination using SSS in 5 patients. There were no post-operative complications or long-term functional deficit. Seven patients received surgery alone with 100% overall and disease specific survival, respectively (median follow-up 27.5Â months; range 5.2-50.4).
CONCLUSIONS
This prospective study suggests that TORS lateral oropharyngectomy alone is an oncologically safe treatment when close or positive margins are identified on diagnostic tonsillectomy in HPV-positive SCC