title: Primary soft tissue reconstruction after transoral laryngeal tumor resection.
abstract: OBJECTIVE
  Primary reconstruction by endoscopic buccal mucosal grafting can be considered in cancer patients with large defects and in patients with bilateral disease. We present our case series of primary endoscopic buccal grafting after cancer surgery.
  
  
  METHODS
  Seventeen cases in 16 patients treated with buccal primary reconstruction (PR) are compared to 26 subjects without reconstruction (SO) and to 18 radiation patients (RO). The Voice Handicap Index, voice grade, and acoustic analysis were used to compare voice outcomes between groups.
  
  
  METHODS
  Case-control study.
  
  
  RESULTS
  There were more European Laryngological Association type II, III, and type Va resections in the PR group. Acoustic analysis, Voice Handicap Index short form, and perceptual ratings by three expert listeners showed no differences in voice outcomes between groups. There were voice-related differences between surgical patients, with the European Laryngological Association type I patients having better voices than European Laryngological Association type II, III, and Va groups combined. Voice outcomes showed mild to moderate dysphonia in all three groups. The presence of the buccal graft did not hinder tumor surveillance.
  
  
  CONCLUSIONS
  Primary reconstruction appears to be safe in patients with large soft tissue defects. There were no detectable functional differences between the PR, SO, and RO groups.
  
  
  METHODS
  3b
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Icahn School of Medicine, New York, New York, U.S.A.
authors.forename: Peak
authors.initials: P
authors.lastname: Woo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044964:Cervicoplasty / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009055:Mouth; D009061:Mouth Mucosa / Q000637:transplantation*; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Laryngeal cancer; buccal graft; endoscopic surgery; laryngeal reconstruction; voice outcome