Laryngeal carcinoma--modifications in surgical technique based on an understanding of tumor growth characteristics.

A study of more than 700 laryngectomy specimens using the technique of whole organ sectioning has resulted in a better understanding of growth and spread of squamous cell carcinoma. The predictability of tumor spread in specific clinical situations has allowed several modifications in surgical technique in order to assure complete removal of the tumor at the time of laryngectomy. These modifications include removal of the thyroid gland on the involved side, removal of pyriform fossa mucosa from the involved side, removal of postcricoid mucosa in tumors involving the posterior commissure, removal of an ellipse of skin from the anterior neck in tumor involving the anterior commissure, and removal of the mucosa of the vallecula in tumors involving the pre-epiglottic space.