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Donor aortic graft improves reconstruction after partial laryngectomy
Date:5/21/2012

Massachusetts General Hospital (MGH) surgeons have developed a new technique for reconstructing the larynx after surgery for advanced cancer. In the May Annals of Otology, Rhinology and Laryngology, they describe how this approach which uses cryopreserved aortas from deceased donors to replace removed larynx tissue allowed patients to avoid a permanent tracheotomy and maintain voice and swallowing function with no need for immunosuppressive 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.

"Without this new reconstructive technique, most of these patients would have required a total laryngectomy," says Zeitels, corresponding author of the report. "I don't believe anything like this has been achieved before especially for larynx cancer reconstruction in patients whose tumors recurred after radiotherapy."

Although small laryngeal tumors can be successfully removed through minimally invasive laser surgery or treated with radiation, advanced tumors require more invasive procedures to remove the affected area, especially when chemotherapy and radiation have failed as initial treatment. In these situations, problems with the healing of tissues previously exposed to radiation and the lack of reliable reconstructive techniques have meant that a majority of patients having partial laryngectomy still needed a permanent tracheotomy an opening through the neck and into the trachea resulting in substantial voice and swallowing dysfunction. Since the quality of life would probably be better with removal of the entire larynx, patients and their surgeons often chose a total laryngectomy.

To address the reconstructive limitations of partial laryngectomy, Zeitels and Wain developed an approach using the body's largest blood vessel, the aorta, to reconstruct the larynx.
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Contact: Mike Morrison
mdmorrison@partners.org
617-724-6425
Massachusetts General Hospital
Source:Eurekalert

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