Perineural Invasion of Superior and Inferior Laryngeal Nerves in Advanced Stage Squamous Cell Carcinoma of the Larynx: A Case Series and Review
Objective:To evaluate bilateral superior and recurrent laryngeal nerves for tumor spread in patients of advanced-stage laryngeal carcinoma undergoing surgical resection.Methods:A prospective study was conducted including biopsy-proven cases of laryngeal squamous cell carcinoma (SCC) that were planne...
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| Format: | Article |
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Galenos Yayincilik
2023-03-01
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| Series: | Turkish Archives of Otorhinolaryngology |
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http://turkarchotolaryngol.net/archives/archive-detail/article-preview/perineural-nvasion-of-superior-and-nferior-larynge/61139
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| author | Avinash Shekhar Jaiswal Sumanth Bollu Shilpi Budhiraja Seema Kaushal Kapil Sikka Alok Thakar Hitesh Verma |
| author_facet | Avinash Shekhar Jaiswal Sumanth Bollu Shilpi Budhiraja Seema Kaushal Kapil Sikka Alok Thakar Hitesh Verma |
| author_sort | Avinash Shekhar Jaiswal |
| collection | DOAJ |
| description | Objective:To evaluate bilateral superior and recurrent laryngeal nerves for tumor spread in patients of advanced-stage laryngeal carcinoma undergoing surgical resection.Methods:A prospective study was conducted including biopsy-proven cases of laryngeal squamous cell carcinoma (SCC) that were planned for total laryngectomy. Patients with metachronous or synchronous SCC were excluded from the study. All patients underwent total laryngectomy, where both superior and recurrent laryngeal nerves were harvested along with the specimen, and the proximal ends of the nerves were marked for reference. Perineural invasion (PNI) was assessed in nerves within the tumor and in bilateral extra-laryngeal nerves.Results:The study included 22 patients with a mean age of 58 years. Intra-tumoral PNI was found in 7 of the 22 cases (32%). The free nerve margins of superior and recurrent laryngeal nerves, which were examined from proximal to distal orientation, showed no tumor infiltration in any of the cases.Conclusion:Perineural invasion of minor nerves constitutes a major pathway of spread. On the contrary, invasion of superior or recurrent laryngeal nerves does not constitute a route for tumor spread. Hence, there is no need to extend the surgical boundary for total laryngectomy to include these major nerves separately. |
| first_indexed | 2024-03-12T15:14:58Z |
| format | Article |
| id | doaj.art-65af470f29f74b8a9d24e686e612c23d |
| institution | Directory Open Access Journal |
| issn | 2667-7474 |
| language | English |
| last_indexed | 2024-03-12T15:14:58Z |
| publishDate | 2023-03-01 |
| publisher | Galenos Yayincilik |
| record_format | Article |
| series | Turkish Archives of Otorhinolaryngology |
| spelling | doaj.art-65af470f29f74b8a9d24e686e612c23d2023-08-11T13:49:35ZengGalenos YayincilikTurkish Archives of Otorhinolaryngology2667-74742023-03-01611202410.4274/tao.2023.2023-2-1213049054Perineural Invasion of Superior and Inferior Laryngeal Nerves in Advanced Stage Squamous Cell Carcinoma of the Larynx: A Case Series and ReviewAvinash Shekhar Jaiswal0Sumanth Bollu1Shilpi Budhiraja2Seema Kaushal3Kapil Sikka4Alok Thakar5Hitesh Verma6 Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, India Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, India Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, India Department of Pathology, All India Institute of Medical Sciences, New Delhi, India Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, India Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, India Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, India Objective:To evaluate bilateral superior and recurrent laryngeal nerves for tumor spread in patients of advanced-stage laryngeal carcinoma undergoing surgical resection.Methods:A prospective study was conducted including biopsy-proven cases of laryngeal squamous cell carcinoma (SCC) that were planned for total laryngectomy. Patients with metachronous or synchronous SCC were excluded from the study. All patients underwent total laryngectomy, where both superior and recurrent laryngeal nerves were harvested along with the specimen, and the proximal ends of the nerves were marked for reference. Perineural invasion (PNI) was assessed in nerves within the tumor and in bilateral extra-laryngeal nerves.Results:The study included 22 patients with a mean age of 58 years. Intra-tumoral PNI was found in 7 of the 22 cases (32%). The free nerve margins of superior and recurrent laryngeal nerves, which were examined from proximal to distal orientation, showed no tumor infiltration in any of the cases.Conclusion:Perineural invasion of minor nerves constitutes a major pathway of spread. On the contrary, invasion of superior or recurrent laryngeal nerves does not constitute a route for tumor spread. Hence, there is no need to extend the surgical boundary for total laryngectomy to include these major nerves separately. http://turkarchotolaryngol.net/archives/archive-detail/article-preview/perineural-nvasion-of-superior-and-nferior-larynge/61139 larynx cancersquamous cell carcinomalaryngectomyrecurrent laryngeal nerveperineural spread |
| spellingShingle | Avinash Shekhar Jaiswal Sumanth Bollu Shilpi Budhiraja Seema Kaushal Kapil Sikka Alok Thakar Hitesh Verma Perineural Invasion of Superior and Inferior Laryngeal Nerves in Advanced Stage Squamous Cell Carcinoma of the Larynx: A Case Series and Review Turkish Archives of Otorhinolaryngology larynx cancer squamous cell carcinoma laryngectomy recurrent laryngeal nerve perineural spread |
| title | Perineural Invasion of Superior and Inferior Laryngeal Nerves in Advanced Stage Squamous Cell Carcinoma of the Larynx: A Case Series and Review |
| title_full | Perineural Invasion of Superior and Inferior Laryngeal Nerves in Advanced Stage Squamous Cell Carcinoma of the Larynx: A Case Series and Review |
| title_fullStr | Perineural Invasion of Superior and Inferior Laryngeal Nerves in Advanced Stage Squamous Cell Carcinoma of the Larynx: A Case Series and Review |
| title_full_unstemmed | Perineural Invasion of Superior and Inferior Laryngeal Nerves in Advanced Stage Squamous Cell Carcinoma of the Larynx: A Case Series and Review |
| title_short | Perineural Invasion of Superior and Inferior Laryngeal Nerves in Advanced Stage Squamous Cell Carcinoma of the Larynx: A Case Series and Review |
| title_sort | perineural invasion of superior and inferior laryngeal nerves in advanced stage squamous cell carcinoma of the larynx a case series and review |
| topic | larynx cancer squamous cell carcinoma laryngectomy recurrent laryngeal nerve perineural spread |
| url |
http://turkarchotolaryngol.net/archives/archive-detail/article-preview/perineural-nvasion-of-superior-and-nferior-larynge/61139
|
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