2010, Number 5
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ABSTRACTBackground: In recent years preservation of the larynx has been one of the most studied subjects in the field of cervicofacial oncology and is the secondary target in the treatment of laryngeal cancer after locoregional control.
Discussion: Treatment of cancers originating generally in the mucosa of the head and neck and in particular of the larynx has evolved greatly during the past 10 years. Inclusion of induction chemotherapy and the association of concomitant chemotherapy/radiotherapy in the medical armamentarium has totally changed the therapeutic strategy for this neoplasm. Since the beginning of the 20th century, numerous techniques for voice preservation surgery have been described. These techniques allow extirpation of the neoplastic portion of the organ, obtaining oncological treatment but preserving voice function, understandable phonation, normal swallowing function and breathing without tracheotomy. It is important to determine whether these techniques are still useful in the present context of multidisciplinary treatment of laryngeal cancer. The objective of this study is to demonstrate techniques, indications and errors to avoid in three surgical techniques considered useful to treat endolaryngeal tumors, preserving function.
Conclusions: In neoplasms of the larynx, in early as well as intermediate stages, these techniques offer excellent voice quality and suitable control specific to tumors located within the larynx. It is currently known that these tumors imply a lower rate of response. In these patients, partial surgery offers adequate oncological control and a safe therapeutic and functional alternative.
American Society of Clinical Oncology; Pfister DG, Laurie SA, Weinstein GS, Mendenhall WM, Adelstein DJ, Ang KK, et al. American Society of Clinical Oncology clinical practice guideline for the use of larynx-preservation strategies in the treatment of laryngeal cancer. J Clin Oncol 2006;24:3693-3704.