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Laryngorhinootologie 2019; 98(10): 725-741
DOI: 10.1055/a-0896-9444
Facharztwissen HNO
© Georg Thieme Verlag KG Stuttgart · New York

Chirurgie des Larynx: Maligne Läsionen

Laryngeal Surgery – Malignant Lesions
Christoph Arens
,
Cornelia Schwemmle
,
Susanne Voigt-Zimmermann
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Publication History

Publication Date:
14 October 2019 (online)

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Zusammenfassung

Bei der Chirurgie maligner Kehlkopftumoren ist es das Ziel, dass die Patienten postoperativ eine möglichst hohe Lebensqualität zurückerlangen. Unter onkologischem Aspekt ist einerseits so radikal wie nötig und andererseits so funktionserhaltend wie möglich zu behandeln. Dieser Beitrag soll einen Überblick über die Chirurgie bei Malignomen des Larynx und den derzeitigen Stand der transoral-endoskopischen Kehlkopfoperationen geben.

Abstract

This article is intended to give an overview of the surgery for laryngeal malignancies and the current state of transoral endoscopic laryngeal surgery. The current therapy concepts in transoral endoscopic laryngeal surgery are presented in combination with the various possibilities of reconstruction. The adequate oncological treatment under functional aspects described plays the decisive role here: treatment goals beyond the cure of the tumor disease are the functional maintenance of the larynx with simultaneous preservation of the voice. In general, the diagnosis and treatment of (pre-) cancerous lesions of the laryngeal mucosa is demanding and requires a great deal of experience of the attending laryngologist. Updated classification systems support level-based categorization. In transoral endoscopic laryngeal surgery, resection using cold instruments and the CO2 laser are currently among the traditional methods, although newer methods such as the angiolytic laser can be used to ablate these lesions. Transoral endoscopic laryngeal surgery is a highly endoscopic-microscopic procedure in (pre-) cancerous lesions, which may presumably continue to evolve from the microlaryngoscopic approach over the next few years due to the introduction of new instruments and high-resolution imaging techniques. Robot-assisted surgery has also found its way into the transoral endoscopic treatment of laryngeal carcinoma. Only in the next few years, however, will it become clear to what extent this technique can supplement, replace or clarify surgical methods, since the individualized surgical strategy currently has a priority position for every single patient.

Schlüsselwörter

Larynxkarzinom - Glottis-Chirurgie - rekonstruktive Verfahren - transorale Larynxchirurgie - Larynxendoskopie

Key words

Laryngeal carcinoma - transoral endoscopic laryngeal surgery - laryngeal reconstruction - robot-assisted surgery
 

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