ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

Early Vocal Fold Cancer Presents Delicate Choices

by Thomas R. Collins • March 1, 2009

  • Tweet
  • Email
Print-Friendly Version

The choice with which laryngologists are faced when it comes to early vocal-fold cancer is a delicate one: How invasive does the treatment need to be at this stage?

You Might Also Like

  • Serial Excision Does Not Reduce Vocal Fold Laryngeal Dysplasia Grade
  • Engineered Vocal Fold Tissue May Treat Patients with Laryngeal Damage
  • Vocal Fold Paresis: A Well-Recognized Condition of Ambiguous Significance
  • Laryngeal Reinnervation for Unilateral Vocal Fold Paralysis: Are We Ready
Explore This Issue
March 2009

A panel of distinguished physicians talked about this fine balance that they must try to strike as they discussed three cases presented by Jesus Medina, MD, Chair of the Department of Otorhinolaryngology at the University of Oklahoma Health Sciences Center in Oklahoma City. The experts sometimes opted for an attempt at an endoscopic procedure and at other times suggested an open procedure, and debated the use of radiation therapy.

At all times, though, they cautioned that all angles should be kept in mind and that, when a treatment can go one way or the other, a fully informed patient will be the best-treated patient.

First Case Study: Persistent Hoarseness

The case that prompted the most discussion was that of a 52-year-old man who arrived at the clinic after having hoarseness for six months. He reported minimal throat discomfort and did not report any ear pain or painful swallowing. At one time, he had smoked 30 pack-years, but had quit smoking when he was 35. He reported no other medical problems.

An image showed that the lesion involved the anterior two-thirds of the left vocal cord but the anterior commissure was not involved (Figure 1).

Figure 1. A 52-year-old man presented with a lesion that involved the anterior two-thirds of the left vocal cord but the anterior commissure was not involved.

click for large version
Figure 1. A 52-year-old man presented with a lesion that involved the anterior two-thirds of the left vocal cord but the anterior commissure was not involved.

Dr. Medina first posed a question to William M. Mendenhall, MD, Professor of Radiation Oncology at the University of Florida College of Medicine in Gainesville, about the extent of the radiation portals.

Radiation portals are usually five by five centimeters in a case like this, he said. Why do we have to cover such a wide field with all the advances in localizing radiation to very small tumors? Why can we not make that field smaller so that we don’t have to deal with the cumbersome edema that sometimes develops with radiating a lesion like that?

Dr. Mendenhall said that the problem is that the target moves. The problem is organ motion, he said. You set him up, the patient swallows, and the tumor can slide out of the field or move toward the edge of the field. And normally we set it up by the surface anatomy.

Pages: 1 2 3 4 5 6 | Single Page

Filed Under: Everyday Ethics, Head and Neck, Laryngology Issue: March 2009

You Might Also Like:

  • Serial Excision Does Not Reduce Vocal Fold Laryngeal Dysplasia Grade
  • Engineered Vocal Fold Tissue May Treat Patients with Laryngeal Damage
  • Vocal Fold Paresis: A Well-Recognized Condition of Ambiguous Significance
  • Laryngeal Reinnervation for Unilateral Vocal Fold Paralysis: Are We Ready

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Weaning Patients Off of PPIs
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Podcasts Becoming More Popular Method of Education for Otolaryngologists
    • How to Embrace Optimism in the Midst of the COVID-19 Pandemic
    • Tips on How to Approach Conversations with Patients about the COVID-19 Vaccine
    • Steps You Should Take to Protect Your Voice and Hearing During Telemedicine Sessions
    • Routine Postoperative Adjunct Treatments Unnecessary for Idiopathic Cerebrospinal Fluid Leaks

Polls

Have you spoken with your patients about receiving the COVID-19 vaccine?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2021 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.