Head and Neck Cancer Surgery
The newest area in head and neck surgical management is the removal of tumors trans-orally. This obviates the need for removing structures, such as the mandible, to gain access to tumors as in the past.
The benefits are multiple: faster recovery times, earlier swallowing, no external disfigurement, and avoidance in many cases of a tracheotomy. Further, if it is determined that adjunctive radiation therapy is indicated, we and a few other centers are exploring decreased dosing of radiation. The clearly reduces morbidity.
Dr. Marshall Strome was one of the earliest to embrace the techniques in this country and has been doing it for more than 10 years. A microscope enhances visualization and lasers are used to resect the tumors.
An advance for laryngeal cancer pioneered by Dr. Strome is using gryotherapy after laser resection for vocal cord malignancies. Dr. Strome and his colleagues found that freezing following laser resection resulted in better voices than just using the laser alone. In fact, the voices are at least the equivalent of those obtained with radiation therapy. Yet, where radiation therapy takes on average seven weeks, laser therapy and cryoablation take several hours, often as an outpatient procedure. For early larynx malignancies, Dr. Strome believes it is the treatment of choice.
Laryngeal Transplantation
In 1998, Dr. Marshall Strome performed the world’s first total larynx transplant. Eleven and one half years later, the patient is still speaking. This is the only transplant in history performed for the first time when immunosuppressive drugs were used to function this long.
Much research has been done in Dr. Strome's lab in the past decade furthering the understanding of head and neck transplantation issues. Most important are the discoveries that it is possible to suppress tumor growth while preserving oral integrity. This opens the door to future transplantation in patients with cancer.
For properly selected cases, Dr. Strome and his team are prepared to perform more of these procedures on a larger scale.