By Wolfgang Steiner, P. Ambrosch
The best way to use a strong scientific enhance in head and neck oncology - from the masters of the process! Endoscopic Laser surgical procedure of the higher Aerodigestive Tract Wolfgang Steiner, MD, Professor, ENT medical institution, college of Gottingen,Germany Petra Ambrosch, MD, inner most Professor, college of Gottingen, Germany The identify Wolfgang Steiner is synonymous with transoral laser microsurgery for head and neck melanoma. He has tirelessly promoted this cutting edge process during the global and his health facility is taken into account the pioneering middle in Europe. hundreds of thousands of scholars and practitioners have benefited from his instructing and lectures, letting them deal with chosen sufferers extra adequately and successfully than ever notion attainable. Now for the 1st time, you've gotten at your fingertips Dr. Steiner's distinctive, step by step ideas for transoral laser microsurgery of the top and neck, exhibiting easy methods to excise tumors, protect the larynx and different key buildings, and dramatically lessen mortality. you'll study the insights and technical refinements that let you tailor your surgical procedure to the level of the melanoma, even removing it in definite localized parts. you can see the best way to paintings in a fragment of the time, steer clear of complicated throat and neck reconstructions, shield voice buildings, and drastically improve the patient's caliber of lifestyles. designated beneficial properties of this landmark ebook contain: - Written by means of the builders of this cutting edge, minimally invasive procedure - three hundred endoscopic colour photos and explanatory drawings illustrate the diagnostic and surgeries on a step by step foundation - perfect for college students in addition to for practitioners trying to develop their remedies - deals an advent to a quickly becoming regular within the box of head and neck oncology. For the newbie in addition to the skilled health professional, this publication deals masterful tips on utilizing glossy laser expertise to accomplish conservative laryngeal and different head and neck melanoma surgical procedures, leading to well-documented, reduce morbidity premiums. it's going to improve and increase your abilities and open a variety of cures that you should provide your sufferers. remain updated with new know-how; reserve your reproduction at the present time! "To those that think, no clarification is important, however the Steiner e-book provides technical refinements and insights that may extend the surgeon's ability. to people who are skeptical, the booklet addresses the fundamental rules of ...a nice event and possibly the foremost optimistic swap in head and neck oncology of the final 3 or 4 decades." From the Foreword by way of Lawrence W. Desanto, MD, Professor Emeritus, Mayo clinical university, Rochester, Minnesota 2001/145 pp./300 colour illus./hardcover/ISBN 0-86577-904-X/$129.00 Contents: advent. getting ready surgical procedure. Endoscopic Laser Microsurgery of Benign ailments of the Trachea and Esophagus. Endoscopic Laser Microsurgery of Malignant illnesses of the Trachea and Esophagus. Anesthetic difficulties linked to ENT Laser surgical procedure. software of Laser surgical procedure of the Larynx in Phoniatric problems. Laser recommendations and safety opposed to Radiation. destiny views. Literature. Index
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Extra info for Endoscopic laser surgery of the upper aerodigestive tract: with special emphasis on cancer surgery
Patients with premalignant conditions of the oral cavity or larynx. In these patients, risk factors such as smoking habits, alcohol consumption, occupation, and age must be considered. Timing of Panendoscopy a) Simultaneously with the diagnostic pretherapeutic staging; in the case of advanced tumors when the indications for curative laser surgery are still uncertain. • A biopsy of the primary tumor is taken when: – smear cytology is negative, or – radiochemotherapy and/ or radical surgery are planned, • during assessment of the extent of the primary tumor.
Extralaryngeal growth with break-through – via cricothyroid membrane – via thyroid cartilage CT usually superior. N-staging is, however, possible with MRI. The choice depends on the imaging method chosen for the primary tumor. Detection of clinically occult metastases (N0 becomes pN+) In advanced cervical metastatic disease Skull base involvement, encroachment of carotid artery. infiltration of carotid artery? Preoperative Diagnosis 35 b a Fig. 1 Contrasted CT scans of the neck showing some contraindications for transoral microsurgical laser resection of tumors in larynx and hypopharynx.
Even in more extensive lesions, routine preoperative imaging is not performed for the following reasons: • Our approach is primarily one of endoscopic resection initially; • At the time of endoscopy the tumor extension is determined under direct microscopic vision while the lesion is resected, organ preservation being the major objective. For assessment of nodal spread, we prefer US to CT or MRI as an initial examination. The value of imaging for the preoperative assessment of larger tumors is in determining local spread into the neck.