Personalized multidisciplinary strategy for the restoration of laryngeal respiratory function in tumor stenosis

The problem of surgical treatment of laryngeal cancer (LC) of the initial stages (T1–T2) remains relevant in the practice of an oncologist and otorhinolaryngologist. Despite the high efficiency and low trauma of organ-preserving resections, one of the key tasks is to prevent the development of postoperative iatrogenic stenosis, which can negate the functional benefits of the operation. It is important to note that even in the initial stages of LC, the tumor leads to the development of clinically significant narrowing of the organ lumen, which makes the problems of reconstruction of the lumen of the larynx after resection for early LC largely similar to those in the treatment of chronic laryngeal stenosis of other etiology. Existing methods of restoring the lumen of the larynx, including the use of standard prostheses, do not always allow to achieve a stable result and may be accompanied by a recurrence of stenosis. The article analyzes modern approaches to the surgical treatment of tumor-related laryngeal stenosis (TLS) developing after organ-preserving operations. Based on the analysis of literature data and our own clinical experience, we justify the need to introduce a personalized algorithm for the diagnosis and treatment of TLS. This approach integrates preoperative 3D modeling of the defect based on data from multislice computed tomography and the use of an individual laryngeal lumen shaper manufactured according to the patient’s anatomical features. The proposed solution is aimed at improving functional outcomes and reducing the frequency of postoperative complications in cancer patients.
Keywords: laryngeal cancer, chronic laryngeal stenosis, organ-preserving surgery, reconstructive surgery, laryngotracheoplasty, individual laryngeal lumen shaper
Conflict of interest. The authors have no conflicts of interest.
Funding. Absent.