Throat Cancer Patients Take Heart

Larynx cancer reconstruction using heart valves saves voices

(RxWiki News) Most early throat (larynx) cancers are easily treated with laser surgery or radiation. Treating advanced throat cancers is a whole different story with a better ending these days.

Thanks to a new surgical technique.

Surgeons from Massachusetts General Hospital (MGH) have developed a way to use the aortic valve in reconstructive oral cancer surgery.

The procedure offered remarkable results.

"Ask your surgeon about all the techniques available. "

The approach uses recovered frozen - cryopreserved - aortas from deceased donors to replace larynx tissue that was removed during surgery.

This lets patients avoid having a permanent tracheotomy, which helps them keep their voice and ability to swallow without any need for other medications.

The pioneering surgery was a collaborative effort between Steven Zeitels, MD, Director of the MGH Center for Laryngeal Surgery, and John Wain, MD, Surgical Director of the MGH Lung Transplantation Service.

Advanced throat cancers require more in-depth surgery to remove the malignancy, followed by chemotherapy and radiation.

It's very difficult for the delicate tissues of the throat to heal from all this. And current surgical methods usually leave patients with a hole in the throat because the voice boxes had to be removed.

This hole makes speech impossible without assistive devices and swallowing a real challenge.

"Without this new reconstructive technique, most of these patients would have required a total laryngectomy [removal of the larynx or voicebox]," says report co-author, Dr. Zeitels.

"I don't believe anything like this has been achieved before – especially for larynx cancer reconstruction in patients whose tumors recurred after radiotherapy."

Drs. Zeitels and Wain performed the first rudimentary version of this surgery in 2009. Since then, they have performed this operation on 15 patients, most of whom had received radiation.

This is a one-stop procedure that removes diseased tissue and reconstructs at the same time.

All of the patients were able to resume breathing normally without the need of a tracheotomy tube. They were also able to talk without any devices to help them speak. Voice quality may have changed, depending on how much tissue was removed.

All but one recovered and were able to swallow. Two patients had a recurrence of the disease which did require a total laryngectomy.

Zeitels adds, "Given the success in this extremely challenging surgical scenario, it's likely that there will be many other uses for cryopreserved vascular grafts as supportive structures and tissue patches for surgery in other parts of the body."

A report on this procedure was published in the May, 2012 edition of Annals of Otology, Rhinology and Laryngology.

Financial disclosures were not publicly available. 

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Review Date: 
May 25, 2012