Gross tumour volume has been proposed as a complementary prognostic marker in laryngeal squamous cell carcinoma. This systematic review and meta-analysis evaluates the prognostic value of pre-treatment gross tumour volume.

MEDLINE, Embase and Scopus were systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting pre-treatment gross tumour volume and survival outcomes in laryngeal cancer were included. The primary outcome was overall survival, and the secondary outcome was disease-free survival. Hazard ratios were pooled using random-effects meta-analysis. Risk of bias was assessed using the Quality in Prognosis Studies tool, and certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation approach.

Eight retrospective studies including 1351 patients were included. Increasing gross tumour volume was significantly associated with worse overall survival (pooled hazard ratio per 1 cm3 increase: 1.03; 95 per cent confidence interval: 1.02–1.05), with a similar association observed for disease-free survival. Overall risk of bias was moderate.

Higher gross tumour volume is independently associated with poorer survival in laryngeal cancer and may provide prognostic information beyond tumour-node-metastasis staging.

As rheumatoid arthritis of the cricoarytenoid joint can be life-threatening, this study aimed to provide a comparison of survival and decannulation after tracheostomy for those with this condition.

Following Preferred Reporting Items for Systematic Review and Meta-Analyses (‘PRISMA’) guidelines, PubMed, Web of Science, Scopus, Embase and MEDLINE library databases were queried to find all reported cases of rheumatoid arthritis of the cricoarytenoid joint.

A total of 55 articles with 82 patients were included in the analysis. The mean age at diagnosis was 60.1 ± 11.2 years. In cases of bilateral involvement, 71.2 per cent of patients required a tracheostomy. For those who had bilateral cricoarytenoid joint involvement and a tracheostomy, there was a significant relationship between having a primary laryngeal surgery, with or without medical management, and overall survival with ultimate decannulation compared with those with just medical management (p = 0.0022).

Tracheostomy is often necessary for acute symptom management of rheumatoid arthritis of the cricoarytenoid joint, and laryngeal surgery may be offered to facilitate ultimate decannulation.

This study aimed to investigate the risk of laryngopharyngeal reflux in Hubble Bubble smokers in comparison to non-smokers

The medical records of patients who presented with hoarseness were reviewed. Patients with a history of Hubble Bubble smoking and a control group of non-smokers were included in the study. The risk of laryngopharyngeal reflux was assessed using the Reflux Symptom Index and the Reflux Finding Score.

Eighty-six Hubble Bubble smokers and 86 controls were included in the study. There was a statistically significant difference in the mean RSI between the two subgroups (10.05 ± 8.27 vs. 5.05 ± 6.58; p < 0.001). Hubble Bubble smokers were 4.24 times more likely to have a Reflux Symptom Index score greater than 13 in comparison to non-smokers (odds ratio = 4.24; 95 per cent confidence interval: 1.97–9.14).

Hubble Bubble smoking increases the risk of laryngopharyngeal reflux by two-fold. A larger prospective study is needed to substantiate the association between Hubble Bubble smoking and laryngopharyngeal reflux.

There is increasing demand for high-quality anatomy teaching for medical undergraduates. This study investigates medical students’ perspectives on using virtual reality to learn laryngeal anatomy.

Thirty-six Year 4 university teaching hospital medical students participated in a virtual reality laryngeal anatomy learning experience (Oculus Quest 2® headsets). Students interacted with a VR model and completed a confidential feedback survey assessing their virtual reality exposure, learning environment, perceived usefulness and willingness to use virtual reality in future training.

A total of 75 per cent of students had minimal prior virtual reality exposure. Despite this, 69.5 per cent agreed that virtual reality helped them learn the anatomy better than traditional lectures; 76.1 per cent believed virtual reality enhanced their learning; and 80 per cent expressed willingness to use virtual reality in their training. High satisfaction was reported regarding the learning environment, with 97.2 per cent feeling comfortable and engaged.

Virtual reality is a useful adjunct to laryngeal anatomy education, providing an interactive, engaging and resource-efficient adjunct to traditional methods.

Patients with locally advanced laryngeal malignancy may be offered total laryngectomy or chemoradiotherapy. Laryngeal dysfunction is a consequence of non-surgical treatment and can result in issues with airway, voice, and swallow.

Semi-structured qualitative interviews explore the experiences of patients who have undergone functional laryngectomy for non-functional larynx in one UK health board.

3 patients were identified and interviewed. Thematic Analysis generated four main themes: Preparation for treatment, Tipping Points, Post-Operative Quality of Life and Attitudes to Future Healthcare. These themes uncover the functional and psychological experiences of patients undergoing functional laryngectomy.

This study explores the many facets of the decision to undergo functional laryngectomy; namely recognising a patient’s tipping point and changes in attitudes towards surgical intervention. Ultimately this enhances our understanding of the rationale of patient’s choices, which can aid in the counselling of future patients.

To explore the treatment options and prognostic factors of vocal fold leukoplakia.

The study examined conservative and surgical treatment approaches, and analysed prognostic factors influencing vocal fold leukoplakia outcomes.

In the conservative treatment group, lesion size (p = 0.035) and smoking (p < 0.001) were identified as independent factors influencing treatment outcomes. In the surgical treatment group, lesion size (p = 0.018) was identified as an independent factor affecting recurrence. There was no statistically significant difference in the effectiveness of conservative versus surgical treatment for patients with hyperplasia (p = 0.223), mild dysplasia (p = 0.634) and moderate dysplasia (p = 0.758).

Smoking and lesion size are key factors influencing the outcome of conservative treatment, while lesion size is a significant factor affecting recurrence in surgically treated patients. More importantly, conservative treatment should be prioritised for patients with moderate dysplasia and milder vocal fold leukoplakia.

Laryngeal dysplasia is a pre-cancerous lesion within the larynx. This study aims to identify factors influencing progression to cancer by analysing long-term follow-up data.

Data from 221 patients diagnosed between 2005 and 2017 were reviewed retrospectively. Patient demographics, treatment strategies and follow-up results were compared.

Progression to cancer occurred in 26 patients (11.7 per cent). A significant association was found between cancer progression and initial biopsies obtained from the anterior commissure (34.6 per cent in progressing cases vs. 6.2 per cent in non-progressing; p < 0.001). Carcinoma in situ cases showed a higher progression rate (21.7%) compared to mild dysplasia (3.4 per cent) (p = 0.007). The group with cancer progression also had higher rates of other cancers (15.4 per cent vs. 2.1 per cent; p = 0.008), including lung cancer (11.5 per cent vs. 0 per cent; p = 0.001).

The study determined an 11.7 per cent progression rate of laryngeal dysplasia to cancer. Lesions involving the anterior commissure carried an approximately 8.1-fold increased risk of progression.

Recurrent respiratory papillomatosis is a benign disease caused by human papillomavirus that often requires frequent surgical intervention. In the UK, microdebridement is the most common technique compared to 3.3 per cent of procedures performed with coblation. This is the first study to compare the efficacy and safety profile of microdebriders versus coblation in children.

Demographic data and surgical outcomes were collected retrospectively for all children with recurrent respiratory papillomatosis over an eight-year period.

Seventeen children with recurrent respiratory papillomatosis underwent a total of three hundred operations, including 182 coblation (60.7 per cent) and 113 microdebrider procedures (37.7 per cent). The complication rate was 3.8 per cent for coblation and 7.1 per cent for microdebridement (p = 0.22). There was no significant difference in the time interval between coblation and microdebrider procedures (p = 0.21).

In children with recurrent respiratory papillomatosis, this study demonstrated a comparable efficacy and safety profile for surgical intervention with coblation versus the currently favoured microdebrider technique.

Laryngopharyngeal reflux disease can affect functioning of Eustachian tube which is responsible for maintenance of normal middle ear physiology. Our study aims to assess the effect of laryngopharyngeal reflux disease on middle ear physiology and whether any functional derangement can be reversed by anti-reflux therapy.

Patients with both laryngopharyngeal reflux disease and asymptomatic middle ear dysfunction (n = 50) were prescribed anti-reflux therapy and followed up for eight weeks. Audiometric evaluations were done routinely to assess changes.

Post-intervention, 72 per cent of affected ears had improved thresholds with reduction in mean and median over each serial evaluation (p = 0.003). Tympanograms showed reversal to normal in 38 per cent of cases with increasing compliance over each successive visit (p < 0.001).

Laryngopharyngeal reflux disease can result in middle ear dysfunction. Early detection and treatment is crucial for restoration of normalcy and prevention of progression to other complications.

Redundant supraglottic and laryngeal mucosa associated with obstructive sleep apnoea is a rare pathology with limited representation in the literature. This article presents the novel case of a 40-year-old male patient with obstructive sleep apnoea for whom previous conservative treatments proved ineffective.

Drug-induced sleep endoscopy identified excess mucosa around the aryepiglottic folds leading to laryngeal inlet occlusion during inspiration and resulting in apnoeic episodes.

Following drug-induced sleep endoscopy, targeted ablation of the redundant mucosa was performed, leading to improvements in their obstructive sleep apnoea and subjective quality of life. This case represents the first report with videographic evidence of drug-induced sleep endoscopy used both for pre-treatment phenotyping and post-treatment assessment of this condition.

Although the pathophysiological mechanisms linking redundant supraglottic mucosa to obstructive sleep apnoea remain poorly understood, drug-induced sleep endoscopy has proven to be a valuable diagnostic tool. The authors advocate for routine airway examination extending to the larynx to identify patients with this condition.

This article aimed to summarize the clinical characteristics and our experience with the diagnosis and management of laryngocele. We offer our perspectives for cases associated with laryngeal cancer.

A retrospective study of 14 patients with laryngocele was accomplished from June 2014 to June 2024. Clinical data were analyzed through descriptive statistical methods.

A total of 14 laryngocele patients were divided into internal type (n = 11; 78.6 per cent) and combined type (n = 3; 21.4 per cent). Nine laryngocele patients (n = 9; 64.3 per cent) were accompanied by laryngeal cancer. The transoral approach was applied in 11 internal laryngocele patients with no post-operative complications or recurrences.

Laryngoscopy and imaging examination are helpful for diagnosis especially to exclude laryngeal cancer. The transoral approach is effective for the internal type, and the key is to resect the anterior part of the false vocal fold. For patients with concomitant laryngeal cancer, the laryngocele should be promptly managed.

This study investigates the association between a history of previous cancers and the subsequent risk of developing head and neck cancer.

A retrospective case–control design was employed, analysing 561 patient records from two National Health Service hospitals, with 273 patients diagnosed with head and neck cancer and 288 patients serving as controls.

Statistical analysis revealed a significant association between prior cancer history, particularly squamous cell carcinoma (SCC), and increased risk of developing head and neck cancer (p < 0.05). Subtype analysis highlighted specific head and neck cancers, such as oropharyngeal and laryngeal cancers, as particularly associated with a history of SCC.

The findings suggest that previous cancer diagnoses, especially SCC, may predispose individuals to head and neck cancer, challenging the traditional focus on tobacco, alcohol and human papillomavirus as primary risk factors. These results underscore the need for incorporating prior cancer history into risk assessment protocols and surveillance strategies to improve early detection and patient outcomes.

This study measured the effectiveness of an in-house designed, cast silicone airway model in addressing the lack of easily accessible, validated transoral laser microsurgery simulation models.

Participants performed resection of two marked vocal fold lesions on the model. The model underwent face, content and construct validation assessment using a five-point Likert scale questionnaire measuring the mean resection time for each lesion and the completeness of lesion excision. Comparative analyses were performed for these measures.

Thirteen otolaryngologists participated in this study. The model achieved validation threshold on all face and content measures (median, ≥4). Construct validation was demonstrated by the improvement in mean resection time between lesions one and two (86 vs 54 seconds, W = 11, p = 0.017). The mean resection time was lower amongst more senior otolaryngologists (61.5 vs 107.1 seconds, W = 11, p = 0.017).

This synthetic silicone model is a low-cost, easily reproducible, high-fidelity synthetic airway model, demonstrating face, content and construct validity.

Our centre (Freeman Hospital, Newcatle Upon Tyne NHS Trust) has favoured primary surgery over chemoradiotherapy for specific advanced laryngeal cancer patients (e.g. large-volume tumours, airway compromise, significant dysphagia, T4 disease). This study reports the survival outcomes for a modern, high-volume head and neck centre favouring surgical management to determine whether this approach improves survival.

Retrospective analysis of patient data over a seven-year period from a tertiary cancer centre.

In total, 121 patients were identified with T3 (n = 76) or T4 (n = 45) laryngeal cancer (mean follow up 2.9 years). In the cohort treated with curative intent (n = 104, 86.0 per cent), the 2- and 5-year estimated disease-specific survival rates were 77.9 and 64.1 per cent. chemoradiotherapy had the highest 2-year disease-specific survival (92.5 per cent), followed by surgery with adjuvant therapy (81.8 per cent), radiotherapy alone (75 per cent) and surgery alone (72.4 per cent).

For a centre favouring primary surgery for certain advanced laryngeal cancers, the disease-specific survival appears no higher than that found in the published literature. To enhance survival, future research should focus on precision medicine to define treatment pathways in this disease.

Recurrent respiratory papillomatosis is a rare disease characterised by growth of papilloma within the respiratory tract. The disease course is variable but can require frequent surgical interventions alongside adjuvant medical treatments. There is no definitive curative treatment or gold-standard guidelines for management. We aimed to evaluate current and potential future adjuvant treatments and propose a management guideline for adult patients.

Relevant articles were identified through searching databases, reference lists and grey literature.

Systemic bevacizumab appears to be the most effective adjuvant treatment currently available. However, intralesional cidofovir also achieves a high complete-response rate in adults and the Gardasil vaccine demonstrates preventative and therapeutic value. The INO-3107 DNA vaccine is a promising potential future adjuvant treatment.

This review provides a detailed examination of current and potential future adjuvant treatments. Based on the literature, we have developed a management guideline for adult patients with recurrent respiratory papillomatosis.

Most otolaryngologists advocate absolute voice rest after laryngeal surgery, which proves difficult for patients, so we decided to evaluate the role of absolute voice rest versus relative voice rest in the post-operative management of benign lesions.

Forty patients were recruited and divided in two groups: absolute voice rest and relative voice rest. Pre- and post-operative voice analysis (fundamental frequency, jitter, shimmer, voice handicap index, voice-related quality-of-life scale scores and compliance) were noted at one week and one month.

Voice analysis parameters including jitter (p = 0.035), shimmer (p = 0.020), voice handicap index (p < 0.001) and compliance (p < 0.001) were better in the relative voice-rest group. Frequency, number of voice breaks and voice-related quality of life showed no statistically significant results.

There was no significant benefit of absolute voice rest on post-operative outcomes as determined by acoustic variables. Compliance and quality-of-life scores were low in the strict voice-rest group. Therefore, we should reconsider post-surgical voice-rest protocol.

Dental and mucosal injuries from laryngoscopy in the peri-operative period are common medico-legal complaints. This study investigated lawsuits arising from laryngoscopy.

Westlaw, a legal database containing trial records from across the USA, was retrospectively reviewed. Plaintiff and/or defendant characteristics, claimed injuries, legal outcomes and awards were extracted.

Of all laryngoscopy-related dental or mucosal injuries brought before a state or federal court, none (0 per cent) resulted in a defence verdict against the provider or monetary gain for the patient. Rulings in the patient's favour were observed only when laryngoscopy was found to be the proximate cause of multiple compounding complications that culminated in severe medical outcomes such as exsanguination, septic shock or cardiopulmonary arrest.

Proper laryngoscopy technique and a robust informed-consent process that accurately sets patients' expectations reduces litigation risk. Future litigation pursuits should consider the low likelihood of malpractice allegation success at trial.