title: Intraoral midline mandibulotomy improves laryngeal access for transoral resection of laryngeal cancer.
abstract: Intraoral midline mandibulotomy is a technique that can be used to increase exposure for transoral endoscopic laser microsurgery (TLS). We describe the case of a 51 year old male with persistent T1 glottic carcinoma. At initial diagnosis, he had been referred for curative radiotherapy as laryngeal access was not sufficient for TLS. For treatment of his recurrence, we describe the technique of performing a midline mandibular osteotomy to improve access to the larynx allowing for safe and effective transoral endoscopic laser microsurgery. Surgical access to the larynx was greatly improved, and we were able to perform TLS in a case that would have otherwise not been amenable to TLS. An intraoral midline mandibulotomy can improve access to the larynx and allow for successful transoral resection of laryngeal cancer in patients with otherwise inaccessible tumors.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Mount Sinai Hospital, USA. Electronic address: aloktsaini@gmail.com.
authors.forename: Alok T
authors.initials: AT
authors.lastname: Saini
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Mount Sinai Hospital, USA.
authors.forename: Arjun K
authors.initials: AK
authors.lastname: Parasher
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Mount Sinai Hospital, USA.
authors.forename: Jason I
authors.initials: JI
authors.lastname: Kass
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, USA.
authors.forename: Kenneth W
authors.initials: KW
authors.lastname: Altman
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Mount Sinai Hospital, USA.
authors.forename: Brett A
authors.initials: BA
authors.lastname: Miles
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D063168:Mandibular Osteotomy / Q000379:methods*; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009055:Mouth; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D012189:Retrospective Studies