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Transoral Approach for Extended Cancers (T3–T4a)

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Textbook of Surgery of Larynx and Trachea

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Abstract

Transoral surgery (TOS) is a minimally invasive surgical approach to laryngeal cancer that includes different techniques, based on the system used for visualization (microscope or videoendoscope), the instruments employed for the resection (laser, monopolar spatula, ultrasound forceps, etc.), and the potential assistance of a robotic platform. Among them, transoral laser microsurgery (TOLMS) has demonstrated its usefulness in all the areas of the larynx. Transoral robotic surgery (TORS), transoral videoendoscopic surgery (TOVS), and transoral ultrasonic surgery (TOUSS) are mainly feasible in the supraglottis, with difficult access to the glottic region.

Although TOS has been mainly indicated in early laryngeal tumors, locally advanced cases are also amenable to be removed through a transoral approach. The indications mainly include selected T3 supraglottic and glottic tumors. In the present chapter we review the indications, relevant technical aspects, and oncologic and functional outcomes of TOS for advanced tumors of the larynx.

Results published in the literature are mainly limited to TOLMS and evidence that in those tumors involving the anterior compartments of the larynx, TOS is a minimally invasive surgical alternative, with adequate oncologic and functional outcomes, reduced morbidity, and high percentage of larynx and function preservation.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Hospital Clínic, University of Barcelona, Barcelona, Spain

    Isabel Vilaseca & Manuel Bernal-Sprekelsen

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  1. Isabel Vilaseca
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  2. Manuel Bernal-Sprekelsen
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Correspondence to Isabel Vilaseca .

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Editors and Affiliations

  1. Department of Oto-Rhino-Laryngology, Centre Hospitalier de Luxembourg (CHL), Luxembourg, Luxembourg

    Marc Remacle

  2. Department of Oto-Rhino-Laryngology, A.ö. Landeskrankenhaus Klagenfurt, HNO, Klagenfurt, Austria

    Hans Edmund Eckel

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Vilaseca, I., Bernal-Sprekelsen, M. (2022). Transoral Approach for Extended Cancers (T3–T4a). In: Remacle, M., Eckel, H.E. (eds) Textbook of Surgery of Larynx and Trachea. Springer, Cham. https://doi.org/10.1007/978-3-031-09621-1_25

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  • DOI: https://doi.org/10.1007/978-3-031-09621-1_25

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