High frequency jet ventilation during transoral laser microsurgery for Tis-T2 laryngeal cancer

Francesco Mora, Francesco Missale, Fabiola Incandela, Marta Filauro, Giampiero Parrinello, Alberto Paderno, Palmiro Della Casa, Cesare Piazza, Giorgio Peretti

Research output: Contribution to journalArticle

Abstract

Background: Transoral laser microsurgery (TLM) for early to intermediate laryngeal squamous cell cancer (SCC) can be technically challenging when adequate exposure of the posterior laryngeal compartment is required due to the presence of the orotracheal tube. The goal of our study was to analyze the efficacy of high frequency jet ventilation (HFJV) in achieving appropriate laryngeal exposure and safe oncologic resection of lesions located in such a position. Methods: We reviewed the clinical records of 62 patients affected by Tis-T2 SCC of the posterior laryngeal compartment treated by TLM between 02/2012 and 12/2016. The cohort was divided into two groups according to the anesthesiologic technique used: Group A included patients treated using intraoperative infraglottic HFJV, while Group B encompassed patients treated by standard orotracheal intubation. The main outcome was postoperative surgical margin status. Group comparison analysis was performed. Results: Significant difference in deep margin status was observed between the two groups: in Group A, the rate of negative deep margins was 86% compared to 56% in Group B (p = 0.04). A trend of better overall and superficial margin control was observed for patients treated using HFJV (Group A), although no statistical significance was achieved. Conclusion: Use of HFJV during TLM allows easier and safer management of patients affected by Tis-T2 SCC of the posterior laryngeal compartment, reducing the rates of positive superficial and deep surgical margins.

Original languageEnglish
Article number282
JournalFrontiers in Oncology
Volume7
Issue numberNOV
DOIs
Publication statusPublished - Nov 29 2017
Externally publishedYes

Keywords

  • Carbon dioxide laser
  • Glottic cancer
  • High frequency jet ventilation
  • Laryngeal cancer
  • Narrow band imaging
  • Supraglottic cancer
  • Surgical margins
  • Transoral laser microsurgery

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Mora, F., Missale, F., Incandela, F., Filauro, M., Parrinello, G., Paderno, A., Casa, P. D., Piazza, C., & Peretti, G. (2017). High frequency jet ventilation during transoral laser microsurgery for Tis-T2 laryngeal cancer. Frontiers in Oncology, 7(NOV), [282]. https://doi.org/10.3389/fonc.2017.00282