We had the pleasure of interviewing Dr. Masoud Kazemi following his very successful complete removal of laryngeal mass surgery on a patient who came to him at Mc Body Clinic. Mc Body Clinic is on its way to being a renowned provider of wide-range medical and beauty services in the UAE, delivering excellent and beyond compare treatment and procedure outcomes for patients while maintaining a high level of customer satisfaction, integrity, and quality.
Dr. Masoud Kazemi is a board certified ENT specialist with fellowship of Laryngology in Dubai. His impressive accolades and qualifications include being an Expert Member of ORDINEX, Paris, since 2017 as a consultant ORL. He is also an experienced faculty member with 25 years of academic background.
"DrMK Laryngologist" is well known for his experience in highly accurate diagnosis and precise treatment of laryngeal diseases. He is also a:
How did the patient first present to you in this case?
The patient is a 54 year old woman who came to me for diagnosis of laryngeal cancer. She had a voice change two years ago, went to doctors and received treatment, but during the Covid19 pandemic the follow-up did not continue.
Last month, she went to the emergency room with severe shortness of breath, her airway was opened with a tracheostomy. In the new evaluation and examination of the larynx, involvement of both sides of the larynx and immobility of the vocal folds were seen, along with the involvement of the lymph nodes around the voice box. There were no signs of the tumor spreading to other parts of the body.
The tumor was Squamous Cell Carcinoma, the most common malignant tumor of the larynx. All of these details were compatible with the advanced laryngeal tumor in stage 4a.
What was your plan of action once you diagnosed the patient?
At this stage, due to the patient's young age, our goal was to achieve complete recovery by completely eradicating the tumor and its roots. Therefore, the entire larynx, half part of the throat, half of the thyroid gland, and the surrounding lymph nodes had to be removed.
I explained the details of the disease and treatment plan to the patient and his relatives. Fortunately, the patient who was an experienced nurse in her home country was well aware of the situation and expressed her agreement.
Were there any risks involved in going forward with this surgery for this particular patient?
There were some other problems, such as high blood sugar, hypertension, and anemia, but the main challenge was that the patient was not allowed to transfuse blood with hemoglobin 10.
Can you tell us why the patient was not allowed to transfuse blood?
In some religions, blood transfusions are not allowed. In Arabic language, a doctor is called a Tabib(طبیب); that is, someone who causes "happiness and peace of mind" of sick people. As doctors we have no right to harm the soul when we want to cure a person's physical illness. So in such cases with unique religious beliefs we avoid blood transfusions as much as possible.
Tell us a little bit about the day of the surgery, and how the procedure progressed.
The patient entered the operating room in Canadian Hospital Dubai at 8 A.M. on Saturday, 18th June. All the necessary arrangements had been made by the operating room and anesthesia staff over the past few days.
Our aim was to try our best to have the surgery with minimal bleeding. Tissue adhesion was very high due to previous tracheotomy surgery, but fortunately, we did not encounter any unusual problems, the bleeding was minor, and we did not require a blood transfusion.
Everyone was excited about the scene of the complete removal of the tumor because this is not a surgery that is done every day.
The surgery ended at 2:30pm, and by 3:30pm the patient was transferred from the operating room to the intensive care unit in good condition and in full consciousness.
48 hours after the operation, she was fully awake, her vital signs were under control, and she had no breathing problems and no bleeding, and her blood sugar was controlled at an acceptable level. She was allowed to get out of bed and walk.
Feeding will be through the nasal tube for up to two weeks until the wound completely heals.
So far, everything is going well, and I hope, thank God, we will announce her full recovery and discharge from the hospital in the coming days.
Can you tell us why this is a surgery that is not done often?
Because only a handful of surgeons and hospitals are prepared for such a large-scale operations.
What should people know about the first signs of a possible laryngeal mass? And when to go get it checked?
In anyone with a voice change lasting more than two weeks, the larynx must be carefully examined and photographed. If the tumor can be diagnosed early, then we can remove the tumor with the help of a laser and through the mouth without cutting the skin and therefore preserving the patient's larynx and voice.
Hoarseness for more than two weeks is equal to a laryngeal mass unless proven otherwise.
Finally, the most important point I need to emphasize is that there are specific recommendations for early detection of cancers anywhere in the body: in breast tumors, periodic breast exams are recommended, in melanoma skin cancer, changes in the appearance of moles are important, and so on. In laryngeal tumors, voice change is one of the first symptoms.
What will the patients follow up and rehabilitation involve?
After complete healing of the surgical wound, the patient should undergo chemoradiotherapy. Almost three months after the end of the treatment, during a very exciting surgery, we implant a device in the patient's neck that can speak again despite not having a larynx. This is a revolution in the rehabilitation of laryngeal cancer patients.
Since the COVID19 pandemic, some people who have had the virus can have throat related symptoms. Other than prolonged hoarseness and changes in voice, are there any other signs we should look out for just to be safe?
In addition to voice changes, other symptoms to consider include painful swallowing, a lump in the neck, shortness of breath, and unexplained earache in an adult.
What are some of the risk factors for laryngeal cancer? And what is the long term prognosis for someone who has been diagnosed?
The most important causes and risk factors for laryngeal cancer are smoking and drinking alcohol. But other causes such as HPV infection, asbestos in car brake pads, wood dust, cement dust, working with aromatic compounds, and the family background of cancer. Some articles even consider gastric acid reflux into the throat and larynx to be effective in causing laryngeal cancer. We also recommend that any gastric reflux be controlled and treated as soon as possible.
Regarding the prognosis, I must say that if laryngeal cancer is diagnosed in the early stages 1 and 2, we can treat it completely with the help of laser and through the mouth without skin incision, and after that the patient does not need chemoradiotherapy and their longevity will be normal.
-For further information on laryngeal cancer treatment options visit mcbodyclinic.com
We want to thank Dr.Kazemi for his time and congratulate him on a successful surgery. You can visit him at Mc Body clinic on Al Wasl Road, Jumeirah and call +971 4 385 5552 for appointments and further information, or follow Mc Body on instagram @mcbodyclinic
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