Abstract
Introduction
The modern availability in daily practice of different DICOM viewers allows physicians to routinely evaluate computed tomography (CT) and magnetic resonance (MR) scans of patients in the pre-, intra-, and postoperative settings. Their systematic use, together with a close surgeon–radiologist cooperation, may greatly improve outcomes of patients to be treated by transoral microsurgery for laryngeal cancer.
Materials and methods
We herein propose guidelines for systematic evaluation of CT/MR images taken from patients affected by supraglottic and glottic cancer to be treated by transoral microsurgery.
Results
A methodical, step-by-step approach focused on laryngeal anatomy, systematically looking at each true and false vocal folds, anterior commissure, laryngeal ventricle, subglottic area, epiglottis, thyroid, cricoid, and arytenoid cartilages, posterior commissure, crico-arytenoid unit, paraglottic and pre-epiglottic spaces, and possible extra-laryngeal extension is proposed. This checklist may be useful before imaging performance (to focus on specific issues to be detailed by the radiologist), as well before and during surgery for the specific evaluation of details to be cleared during transoral microsurgery.
Conclusion
Detailed preoperative evaluation of supraglottic and glottic anatomy is essential prior to any transoral approach for neoplastic disease. The proposed imaging checklist described herein represents a step-by-step guide to surgeons performing this kind of interventions and an aid in achieving a meticulous approach from a surgical perspective.
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References
Agnello F, Cupido F, Sparacia G, Midiri F, Miroddi M, Grassedonio E et al (2017) Computerised tomography and magnetic resonance imaging of laryngeal squamous cell carcinoma: a practical approach. Neuroradiol J 30:197–204
Becker SS (2010) Preoperative computed tomography evaluation in sinus surgery: a template-driven approach. Otolaryngol Clin North Am 43:731–751
Peretti G, Piazza C, Mora F, Garofolo S, Guastini L (2016) Reasonable limits for transoral laser microsurgery in laryngeal cancer. Curr Opin Otolaryngol Head Neck Surg 24:135–139
Succo G, Peretti G, Piazza C, Remacle M, Eckel HE, Chevalier D et al (2014) Open partial horizontal laryngectomies: a proposal for classification by the working committee on nomenclature of the European Laryngological Society. Eur Arch Otorhinolaryngol 271:2489–2496
Succo G, Crosetti E, Bertolin A, Piazza C, Molteni G, Cirillo S et al (2018) Treatment for T3 to T4a laryngeal cancer by open partial horizontal laryngectomies: Prognostic impact of different pathologic tumor subcategories. Head Neck 40:1897–1908
Bon F, Piazza C, Lancini D, Paderno A, Bosio P, Taboni S et al (2019) Open partial horizontal laryngectomies for T3–T4 laryngeal cancer: prognostic impact of anterior vs posterior laryngeal compartmentalization. Cancers (Basel). 11.pii:E289
Remacle M, Arens C, Eldin MB, Campos G, Estomba CC, Dulguerov P et al (2017) Laser-assisted surgery of the upper aero-digestive tract: a clarification of nomenclature. A consensus statement of the European Laryngological Society. Eur Arch Otorhinolaryngol 274:3723–3727
Basterra J, Frias S, Alba JR, Zapater E (2006) A new device for treating laryngeal carcinoma using microdissection electrodes. Laryngoscope 116:2232–2234
Remacle M, Prasad VMN (2018) Preliminary experience in transoral laryngeal surgery with a flexible robotic system for benign lesions of the vocal folds. Eur Arch Otorhinolaryngol 275:761–765
Remacle M, Eckel HE, Antonelli A, Brasnu D, Chevalier D, Friedrich G et al (2000) Endoscopic cordectomy. A proposal for a classification by the Working Committee, European Laryngological Society. Eur Arch Otorhinolaryngol 257:227–231
Remacle M, Van Haverbeke C, Eckel H, Bradley P, Chevalier D, Djukic V et al (2007) Proposal for revision of the European Laryngological Society classification of endoscopic cordectomies. Eur Arch Otorhinolaryngol 264:499–504
Remacle M, Hantzakos A, Eckel H, Evrard AS, Bradley PJ, Chevalier D et al (2009) Endoscopic supraglottic laryngectomy: a proposal for a classification by the working committee on nomenclature, European Laryngological Society. Eur Arch Otorhinolaryngol 266:993–998
Piazza C, Del Bon F, Peretti G, Nicolai P (2011) “Biologic endoscopy”: optimization of upper aerodigestive tract cancer evaluation. Curr Opin Otolaryngol Head Neck Surg 19:67–76
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Chiesa-Estomba, C.M., Ravanelli, M., Farina, D. et al. Imaging checklist for preoperative evaluation of laryngeal tumors to be treated by transoral microsurgery: guidelines from the European Laryngological Society. Eur Arch Otorhinolaryngol 277, 1707–1714 (2020). https://doi.org/10.1007/s00405-020-05869-0
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DOI: https://doi.org/10.1007/s00405-020-05869-0