title: Open partial horizontal laryngectomies: is it time to adopt a modular form of consent for the intervention?
abstract: Nowadays, open partial horizontal laryngectomies (OPHLs) are well-established procedures for treatment of laryngeal cancer. Their uniqueness is the possibility to modulate the intervention intraoperatively, according to eventual tumour extension. An OPHL procedure is not easy to understand: there are several types of procedures and the possibility to modulate the intervention can produce confusion and lack of adherence to the treatment from the patient. Even if the surgery is tailored to a patient's specific lesion, a unified consent form that discloses any possible extensions, including a total laryngectomy, is still needed. We reviewed the English literature on informed consent, and propose comprehensive Information and Consent Forms for OPHLs. The Information Form is intended to answer any possible questions about the procedure, while remaining easy to read and understand for the patient. It includes sections on laryngeal anatomy and physiology, surgical aims and indications, alternatives to surgery, complications, and physiology of the operated larynx. The Consent Form is written in a "modular" way: the surgeon defines the precise extension of the lesion, chooses the best OPHL procedure and highlights all possible expected extensions specific for the patient. Our intention, providing these forms both in Italian and in English, is to optimise communication between the patient and surgeon, improving surgical procedure arrangements and preventing any possible misunderstandings and medico-legal litigation.
authors.affiliation: Otolaryngology Service, Head and Neck Department, "San Raffaele" Hospital, "Vita-Salute" University, Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Giordano
authors.affiliation: Otolaryngology Service, Head and Neck Department, "San Raffaele" Hospital, "Vita-Salute" University, Milan, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Di Santo
authors.affiliation: Head and Neck Oncology Service, IRCCS FPO Candiolo Cancer Institute Turin, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Crosetti
authors.affiliation: Otolaryngology Service, Vittorio Veneto Hospital, Treviso, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Bertolin
authors.affiliation: Otolaryngology Service, Vittorio Veneto Hospital, Treviso, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Rizzotto
authors.affiliation: Otolaryngology Service, Oncology Department, "San Luigi Gonzaga" Hospital, University of Turin, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Succo
authors.affiliation: Otolaryngology Service, Head and Neck Department, "San Raffaele" Hospital, "Vita-Salute" University, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bussi
mesh_terms: D006801:Humans; D007258:Informed Consent; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D011996:Records
keywords: Informed consent; Larynx cancer Treatment; Modular consent; Open partial horizontal laryngectomies