Laryngeal cancer accounts for less than 1% of all malignancies globally ; however, it is commonly encountered by otolaryngologists and head and neck surgeons. Despite advances in radiotherapy and chemotherapy, surgery continues to play a central role in the treatment. Surgical management of laryngeal cancer, ranging from total and partial laryngectomies to transoral approaches, has evolved significantly over more than two centuries. This evolution began with the first laryngotomy in 1788 and culminated in the first total laryngectomy performed by Theodor Billroth in 1873. Over time, functional preservation techniques have emerged, including vertical and horizontal partial laryngectomies and supracricoid laryngectomy, and have improved oncological outcomes while maintaining voice and swallowing functions. The advent of transoral laser microsurgery (TLM) and transoral robotic surgery (TORS) has further refined the treatment, particularly for early stage tumors. Although TLM remains the gold standard for early glottic cancer, the use of TORS is expanding, especially for supraglottic lesions. However, its role in vocal cord surgery and in advanced cases remains unclear. Understanding the historical and technical progress of laryngeal cancer surgery is essential for modern clinicians, as innovations such as robotic surgery continue to shape the future of laryngeal oncology.

This paper discusses voice restoration after total laryngectomy, focusing on tracheoesophageal speech, particularly the use of tracheoesophageal puncture (TEP) and voice prostheses. Total laryngectomy is an effective treatment for advanced laryngeal cancers, but it results in loss of voice, severely impacting communication and quality of life. The main methods for voice restoration include the use of esophageal speech, the electrolarynx, and tracheoesophageal speech, with the latter gaining popularity owing to its effectiveness in producing clearer speech in a relatively short period. The historical development of tracheoesophageal speech, including the use of voice prostheses such as the Provox series, is reviewed. Tracheoesophageal speech offers advantages over esophageal speech in terms of ease of acquisition and speech clarity. However, it also has potential complications such as prosthesis leakage and the need for periodic replacement. This study highlights the importance of multidisciplinary care involving ENT specialists, speech therapists, and other healthcare providers to ensure optimal outcomes for laryngectomized patients. The ongoing development of voice prostheses and techniques promises further improvement in voice rehabilitation for these patients.

The number of elderly laryngeal cancer patients is increasing in Japan. However, there are no established guidelines supported by sufficient evidence for the management of elderly cancer patients. Chronological age sometimes differs from biological or functional age in elderly cancer patients. In addition, these patients have different comorbidities, physical functions, cognitive functions, family and financial backgrounds, and values. Therefore, it is often necessary to accurately assess the overall health status and concerns of elderly patients with cancer using geriatric assessment (GA) and its screening tools when making treatment decisions. In particular, for elderly patients with locally advanced laryngeal cancer, cisplatin-based chemoradiotherapy, which is the standard nonsurgical treatment for laryngeal preservation, is often difficult to choose in clinical practice because of its toxicity and the possibility of decline in the laryngeal function, especially the swallowing function, during or after treatment. However, laryngectomy is often indicated when GA is proposed appropriately. There may also be cases in which minimally invasive transoral surgery is acceptable. A multidisciplinary team approach by several professionals before, during, and after treatment plays an important role in maintaining the quality of life and improving treatment efficacy.

The management of advanced laryngeal cancer has evolved from surgical strategies centered around total laryngectomy to larynx preservation approaches aimed at maintaining both the anatomical structure and function, along with survival rates. Induction chemotherapy has played a pivotal role in this evolution, beginning with the landmark 1991 VA Laryngeal Cancer Study, which demonstrated that PF (cisplatin, fluorouracil)-based induction chemotherapy could achieve laryngeal preservation without compromising overall survival. The concept of chemo-selection later emerged, allowing treatment to be tailored based on individual responses to induction chemotherapy, further enhancing laryngeal preservation outcomes. While docetaxel, cisplatin, and fluorouracil (TPF) therapy has shown high efficacy, its severe toxicities have presented challenges, leading to the development of alternative regimens such as paclitaxel, carboplatin, and cetuximab (PCE). In addition to anatomical preservation, functional outcomes such as swallowing and voice are increasingly emphasized and supported by patient-reported measures, including MDADI. Advances in imaging biomarkers, such as metabolic tumor volume through FDG-PET/CT and molecular biomarkers, such as circulating tumor DNA for detecting minimal residual disease (MRD) and tumor immune microenvironmental profiles, have shown potential in guiding patient selection and tailoring treatments. Future innovations integrating these biomarkers with immunotherapeutic strategies are anticipated to enhance survival outcomes and quality of life in patients receiving larynx preservation therapy.

In recent years, research on brain-machine interfaces or brain-computer interfaces has increasingly focused on establishing systems that enable communication through the extraction of linguistic information from brain activity signals. Studies integrating large-scale language models into brain-machine interfaces have demonstrated the generation of characters and phrases. However, many of these approaches rely on hand or mouth motion data, highlighting the challenge of directly extracting linguistic information. This review introduces global trends in this research field and examines the difficulties and potential of extracting linguistic information from brain-activity signals. In particular, it discusses the feasibility of noninvasive methods in comparison to invasive brain activity recordings, which are primarily being explored for practical applications in the United States, with a focus on the neural representation of linguistic information and individual differences.

Objective : In the last few years, especially during the COVID-19 pandemic, the number of voice disorder cases among INTERNET live streamers performing online live streaming programs has increased sharply. Live streamers are called “raiba-” in Japan. “Raiba-” is a new profession that is characterized by real-time interaction with fans and social tipping, and such “raiba-” are most frequently represented by “YouTubers” who are YouTube stars. This new profession ranks very high in the list of careers that children want to follow in the future. We herein report the case of one “raiba-” who visited our hospital.

Study design : Case and case reports.

Subjects and Methods : 51 “raiba-” visited the Tokyo Voice Center for voice disorders during the three-year period from June 2019 to May 2022. Sex and age were also investigated.

Results : This study included 15 males and 36 females. The average age was 29.3 ± 6.1 (SD) years.

Conclusion : This study is the first report on speech disorders occurring in “raiba-” and with limited cases and information, we have thus been able to gain new insights into the profession of “raiba-”. “Raiba-” are more common in young adults, especially women, around the age of 30. It is important to recognize that a “raiba-” who can be anyone, anywhere, may come to the hospital as a patient with a speech disorder in rural areas in the future.

Kimura’s disease is a chronic inflammatory disease that forms painless masses in subcutaneous soft tissues. It is mainly found in the head and neck region, particularly in the parotid, submandibular, and buccal areas. We herein report a rare case of Kimura’s disease arising from the epiglottis.

The patient was a 33-year-old female with a history of asthma, who presented with enlargement of the epiglottis, which was incidentally noted during the induction of general anesthesia. She had previously undergone a biopsy, which showed no malignant findings or only lymphatic hyperplasia. Consequently, she discontinued her hospital visits on her own.

A blood analysis revealed an elevated peripheral blood eosinophil count, and cervical MRI showed a uniform high-signal mass on T2-weighted imaging. We performed epiglottic tumor resection for diagnostic and therapeutic purposes. Permanent pathology showed an eosinophilic infiltrate, an enlarged lymph follicle with a germinal center, and Wathin-Finkeldey-type multinucleated giant cells. Based on these findings, we made a diagnosis of Kimura’s disease.

A postoperative blood examination revealed a decrease in peripheral blood eosinophil and IgE counts. The patient showed no evidence of recurrence 14 months after surgery. Even in cases of mass lesions at atypical sites, Kimura’s disease should be considered in the differential diagnosis based on the patient’s history and increased peripheral blood eosinophil counts.

The treatment of laryngotracheal stenosis varies according to the severity and extent of the stenosis and often requires long-term planning, especially in pediatric patients whose larynx is still growing. We herein report a nine-year-old boy who developed severe subglottic stenosis after traumatic intubation due to a traffic accident. An initial examination revealed extensive granulation and scar tissue in the subglottic area. A series of staged procedures was implemented, culminating in laryngotracheal reconstruction with mucosa-lined nasal septal cartilage and oral mucosa to maintain airway patency and support future growth. The nasal septal cartilage graft was carefully shaped to align with the tracheal contour, and a T-tube stent was used to maintain the lumen and allow for the vocal function. Postoperatively, gradual enlargement of the stenotic area and preservation of the reconstructed structure were achieved without restenosis. This case highlights the effectiveness of mucosa-lined nasal septal cartilage as a reconstructive material for pediatric laryngotracheal stenosis, offering both structural integrity and physiological compatibility. Long-term stenting and growth-adaptive surgical planning are essential to achieve successful outcomes.

Posterior glottic stenosis causing bilateral vocal cord immobility and airway stenosis most frequently occurs after endotracheal intubation. In recent years, there have been an increasing number of reports of posterior glottic stenosis and laryngotracheal stenosis occurring after endotracheal intubation for COVID-19 patients. We encountered a case in which adhesion was released by the cricothyroid ligament approach for posterior glottic stenosis that developed after intubation for COVID-19. Although adhesion could not be noticed on endoscopy, posterior glottic stenosis was suspected based on CT, which demonstrated soft tissue density between the right and left arytenoid cartilage. Adhesion was visible through the tracheotomy hole, leading to the diagnosis of posterior glottic stenosis. Although we attempted transoral surgery using a direct laryngoscope, adhesion could not be visualized. Therefore, we decided to change to the cricothyroid ligament approach. After excising the cricothyroid ligament, the adhesion was accessible and easily released by a CO₂ laser under rigid endoscopic inspection. The cricothyroid ligament approach may be useful for posterior glottic stenosis when transoral surgery is difficult.