Search

OBJECTIVES:: To introduce a new tool for phonosurgical training and education. A multitude of innovations in complex laryngeal surgery has catalyzed new educational initiatives. Establishing dexterity in phonomicrosurgery is often difficult to achieve while working on patients because of the narrow margin for success. Furthermore, laryngoplastic phonosurgery and open partial laryngectomy require sophisticated knowledge of precise anatomic relationships, which can be difficult to express in images. Finally, many teaching programs do not have a high volume of these procedures, and there is a significant need to transmit this information in continuing education courses. STUDY DESIGN:: Prototype design. METHODS:: A laryngeal dissection station (LDS) was designed to facilitate the acquisition of high-level procedural skill sets for both transoral and transcervical techniques. RESULTS:: This LDS can be used in existing temporal-bone laboratories by using cadaveric larynges. A rectangular frame supports two adjustable holders, one for the larynx and one for the examining speculum of a laryngoscope. Procedures are performed with the larynx fixed in space by a novel fixator. Variation in position and orientation of the components affords simulation of both microlaryngoscopy and open surgery. The dissection station can accommodate virtually any laryngoscope, regardless of size or shape. CONCLUSIONS:: This training apparatus should facilitate laryngeal surgical instruction in residency training and continuing medical education. This device and others like it can help establish clinical competency in laryngology, should this become necessary in future educational models of residency training and recertification. [ABSTRACT FROM AUTHOR]

SUMMARY: During the last 30 years, there has been expansion of the role of endoscopic partial laryngectomy procedures since Jako, Strong, and Vaughan explored the possibilities of CO2 laser microlaryngeal procedures. Despite the fact that a number of investigators have verified the validity of endolaryngeal laser resection of mid-sized glottic cancer, there are many who are unfamiliar with the technique and others who are uncomfortable with sectioning the tumor to facilitate its resection. In the past 3 years, 15 patients underwent successful en block resection of mid-sized glottic cancer (T1b 2, T2b 11, T3 2). Because en block resection is more consistent with open oncologic approaches, this method should widen the acceptance of this approach in selected lesions. The nuances of en block endoscopic frontolateral laryngectomy are presented with the hope that more surgeons will adopt this philosophy as an aspect of their armamentarium. [ABSTRACT FROM AUTHOR]