Specimen Type: TOTAL LARYNGECTOMY Procedure: Orient specimen and determine structures present If radical neck dissection present, remove from larynx and process as described in the manual Preserve soft tissue relationships if tumor is grossly involving the organ May remove thyroid if present and uninvolved Ink the external soft tissue, avoid inking over mucosa Black- right Blue- left 3. Remove inferior tracheal ring (marin) 4. Open along the posterior midline (may need to crack cartilage) and prop open and fix overnight 5. Photograph 6. Describe mucosa and presences of lesion(s)/ulcerations a. Indicate location of lesion -supraglottic: (extends from the tip of epiglottis to the apex of ventricle and includes the epiglottis, aryepiglottic folds, arytenoids, false vocal cords, and the ventricle) -glottic: (extends from the ventricle to 0.5-1.0 cm below the true vocal cord and includes the anterior and posterior commissures) -subglottic: (extends from 1.0 cm below the true vocal cord to inferior rim of the cricoid cartilage) -transglottic * note if lesion crosses the midline b. Indicate extent of lesion: document if lesion involves base of tongue, epiglottis, piriform sinus, aryepiglottic folds, arytenoid mucosa, anterior and posterior midlines, hyoid bone, thyroid, cartilage (thyroid and/or cricoid), strap muscles, and involvement of any additional tissue/organs present 7. Shave the mucosal margins 8. Section along anterior midline and photograph cut surface 9. Document maximum thickness of lesion and distance to all margins - superior epiglottis - inferior tracheal ring - right and left lateral inked soft tissue - anterior and posterior inked soft tissue - superior inked soft tissue (base of tongue)
Specimen Type: TOTAL LARYNGECTOMY Procedure: Orient specimen and determine structures present If radical neck dissection present, remove from larynx and process as described in the manual Preserve soft tissue relationships if tumor is grossly involving the organ May remove thyroid if present and uninvolved Ink the external soft tissue, avoid inking over mucosa Black- right Blue- left 3. Remove inferior tracheal ring (marin) 4. Open along the posterior midline (may need to crack cartilage) and prop open and fix overnight 5. Photograph 6. Describe mucosa and presences of lesion(s)/ulcerations a. Indicate location of lesion -supraglottic: (extends from the tip of epiglottis to the apex of ventricle and includes the epiglottis, aryepiglottic folds, arytenoids, false vocal cords, and the ventricle) -glottic: (extends from the ventricle to 0.5-1.0 cm below the true vocal cord and includes the anterior and posterior commissures) -subglottic: (extends from 1.0 cm below the true vocal cord to inferior rim of the cricoid cartilage) -transglottic * note if lesion crosses the midline b. Indicate extent of lesion: document if lesion involves base of tongue, epiglottis, piriform sinus, aryepiglottic folds, arytenoid mucosa, anterior and posterior midlines, hyoid bone, thyroid, cartilage (thyroid and/or cricoid), strap muscles, and involvement of any additional tissue/organs present 7. Shave the mucosal margins 8. Section along anterior midline and photograph cut surface 9. Document maximum thickness of lesion and distance to all margins - superior epiglottis - inferior tracheal ring - right and left lateral inked soft tissue - anterior and posterior inked soft tissue - superior inked soft tissue (base of tongue)
Head_Neck_2018.docx