Early glottic tumours with anterior commissure involvement. Literature review and consensus document. Head and Neck and Skull Base Commission, SEORL-CCC. / Tumores glóticos precoces con afectación de la comisura anterior. Revisión bibliográfica y documento de consenso. Comisión de cabeza y cuello y base de cráneo. SEORL-CCC.

The choice of the most appropriate treatment in early-stage glottic cancer with anterior commissure involvement remains controversial. Its therapeutic management is complex because it is a significant prognostic indicator of local control with 37% recurrence, due to the difficulty in establishing tumour extension with understaging of up to 40%, and due to the comparison of results in series on tumours that behave variably as they progress, such as T1a, T1b and T2a with commissure involvement. Furthermore, the complexity of the surgical approach using transoral CO2 laser microsurgery requires surgical skill, appropriate equipment and experience. Aspects to be reviewed in this document are: an updated anatomical definition of the anterior commissure, tumour progression based on histopathological studies, usefulness of videostroboscopy and NBI in diagnostic accuracy, validity of imaging tests, oncological results published in series reviews, systematic reviews and meta-analyses, tumour margin treatment and voice evaluation.Finally, by way of a summary, the document includes a series of recommendations for the treatment of these tumours.

A predictive model for recurrence in patients with glottic cancer implemented in a mobile application for Android.

OBJECTIVES: The existing predictive models of laryngeal cancer recurrence present limitations for clinical practice. Therefore, we constructed, internally validated and implemented in a mobile application (Android) a new model based on a points system taking into account the internationally recommended statistical methodology. MATERIALS AND METHODS: This longitudinal prospective study included 189 patients with glottic cancer in 2004-2016 in a Spanish region. The main variable was time-to-recurrence, and its potential predictors were: age, gender, TNM classification, stage, smoking, alcohol consumption, and histology. A points system was developed to predict five-year risk of recurrence based on a Cox model. This was validated internally by bootstrapping, determining discrimination (C-statistics) and calibration (smooth curves). RESULTS: A total of 77 patients presented recurrence (40.7%) in a mean follow-up period of 3.4 ±â€¯3.0 years. The factors in the model were: age, lymph node stage, alcohol consumption and stage. Discrimination and calibration were satisfactory. CONCLUSION: A points system was developed to obtain the probability of recurrence of laryngeal glottic cancer in five years, using five clinical variables. Our system should be validated externally in other geographical areas.

Laryngeal manifestation of B-cell non-Hodgkin lymphoma.

Laryngeal lymphomas are rare, involving less than 1% of all laryngeal tumours. Extranodal non-Hodgkin lymphomas generally appear in places where lymphoid tissue exists, such as the small bowel or parotid; they are very unusual in organs with little or no presence of lymphoid tissue, such as the larynx. When advanced stages are established, initial lymphoma manifestation at the laryngeal level has rarely been documented. We present a case of a small cell lymphocytic lymphoma at stage IV/E with initial laryngeal symptoms and indicate its management and follow up.

Extraosseous chordoma of nasopharynx in paediatric age.

Intracranial chordomas are relatively rare locally aggressive tumours that probably originate from embryonic remnants of the notochord. They typically arise from the sacrum and secondly in the skull base/clivus region. When skull base chordomas occur at an extraosseous location (without lytic bone destruction), they may mimic other lesions of the nasopharynx. We present a case of primarily extraosseous chordoma in paediatric age, involving the nasopharynx, to improve preoperative diagnosis and postoperative management of this rare tumour.

[Papillomas & laryngeal papillomatosis. Treatment with CO2 laser surgery. Our experience over 15 years]. / Papilomas y papilomatosis laríngea. Tratamiento con láser CO2. Nuestra experiencia en 15 años.

OBJECTIVES: The study goal was to evaluate the efficacy of CO2 laser surgery in the treatment of laryngeal papillomatosis. We analysed several parameters such as gender, average age, relapse rate and viral serotype. MATERIAL AND METHODS: A total of 26 diagnosed patients were included in this retrospective descriptive review. All of them were treated with CO2 laser for laryngeal papillomas between 1995 and 2010. RESULTS: This pathology was more prevalent in males (65.5%), with a slight predominance of a single larynx localisation over multiple lesion locations. Human papillomavirus (HPV) DNA was detected in 75.8% of the cases; genotypes 6 and 11 prevailed. Of the patients in this review, 44.8% relapsed; the relapse average was 2-3 episodes per patient. A total of 20.7% of cases were in remission (no relapse in the last 2 months); 34.5%, clearing (no apparent relapse in the last 3 years); and 41.3% in the healing stage (without relapse in the last 5 years). There was only one case that showed malignancy. CONCLUSION: Papillomatosis is characterised as a pathology with an unpredictable course and with a low probability of malignancy. CO2 laser surgery has meant a revolution in symptomatic treatment, but there is presently no curative treatment.