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      Use of erbium laser in the treatment of persistent post-radiotherapy laryngeal edema: a case report and review of the literature

      case-report
      ,
      World Journal of Surgical Oncology
      BioMed Central
      Erbium, Laser microsurgery, Post-radiotherapy, Laryngeal, Edema

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          Abstract

          Background

          Post-radiotherapy laryngeal edema may affect the patients’ quality of life, leading to repeated treatment attempts, which include massage/physical therapy, inhalations, and/or tracheostomy.

          Case presentation

          We report the surgical treatment approach of a 69-year-old patient with severe persistent post-radiotherapy laryngeal edema. After multiple inpatient admissions and failed conservative therapy, we used the erbium laser to treat the arytenoid edema. After repeated procedures, no complications were observed. The patient remained free of symptoms after 30 months of follow-up.

          Conclusions

          The authors provide an easy-to-perform, safe, and quick surgical technique without non-severe or severe complications. Using this technique repeatedly, complications from excessive thermal damage with CO 2 laser or unpleasant solutions such as tracheostomy can be avoided.

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          Most cited references13

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          Tolerance of normal tissue to therapeutic irradiation

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            Radiation dose-volume effects in the larynx and pharynx.

            The dose-volume outcome data for RT-associated laryngeal edema, laryngeal dysfunction, and dysphagia, have only recently been addressed, and are summarized. For late dysphagia, a major issue is accurate definition and uncertainty of the relevant anatomical structures. These and other issues are discussed. Copyright 2010 Elsevier Inc. All rights reserved.
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              Endoscopic laser medial arytenoidectomy for airway management in bilateral laryngeal paralysis.

              R Crumley (1993)
              A review of our recent experience in patients with bilateral laryngeal paralysis is described. While we continue to use phrenic nerve transfers in patients with mobile arytenoids, patients with fixed arytenoids generally require some sort of vocal cord lateralization, either by arytenoidectomy and arytenoidopexy or by partial vocal cord resection. The endoscopic laser medial arytenoidectomy is a convenient and effective method for opening the posterior glottic airway. One arytenoid is reduced medially with the carbon dioxide laser. After about 3 months the opposite arytenoid can be treated similarly, if necessary. The procedure does not appear to affect arytenoid mobility, as the posterior commissure mucosa and underlying interarytenoid muscle are protected and hence unaffected by the procedure. Those patients with at least one mobile arytenoid cartilage are candidates for posterior cricoarytenoid muscle reinnervation. Although ansa cervicalis and phrenic nerve techniques have been described, the author has concentrated efforts on the phrenic nerve. This report describes the endoscopic laser medial arytenoidectomy procedure, while the phrenic nerve patients will be reported in a subsequent manuscript.
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                Author and article information

                Contributors
                00435050423141 , arisgiotakis@gmail.com
                claus.pototschnig@i-med.ac.at
                Journal
                World J Surg Oncol
                World J Surg Oncol
                World Journal of Surgical Oncology
                BioMed Central (London )
                1477-7819
                27 August 2018
                27 August 2018
                2018
                : 16
                : 176
                Affiliations
                ISNI 0000 0000 8853 2677, GRID grid.5361.1, Department of Otorhinolaryngology, , Medical University of Innsbruck, ; Anichstrasse 35, 6020 Innsbruck, Austria
                Author information
                http://orcid.org/0000-0002-4162-4261
                Article
                1480
                10.1186/s12957-018-1480-9
                6112140
                30149805
                14bce4ce-3cfb-4bda-a197-0acde90624ef
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 30 May 2018
                : 21 August 2018
                Categories
                Case Report
                Custom metadata
                © The Author(s) 2018

                Surgery
                erbium,laser microsurgery,post-radiotherapy,laryngeal,edema
                Surgery
                erbium, laser microsurgery, post-radiotherapy, laryngeal, edema

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