M Zanaret1, A Giovanni, R Gras, M Cannoni. 1. Department of Otorhinolaryngology, Head and Neck Surgery, University of Marseille Medical School, La Timone Hospital, France.
Abstract
INTRODUCTION: Extended partial laryngectomy procedures may offer patients the potential for a cure with preservation of voice. This report characterizes our patients managed with near laryngectomy and reconstructed with epiglottic tissue. MATERIALS AND METHODS: A total of 57 patients with T1 or T2 glottic carcinoma undergoing total laryngectomy with epiglottic reconstruction were reviewed retrospectively. This group included 15 patients with T1 lesions and 42 patients with T2 lesions. In the standard operation the specimen includes the thyroid ala, both vocal cords, both false vocal cords, and one arytenoid cartilage. The epiglottis is mobilized and delivered inferiorly for reconstruction of the glottic larynx. RESULT: Tumor control was obtained in 93% of T1 patients and 79% of T2 patients. All patients tolerated decannulation. After a mean duration of 12 days (range 5 to 22 days), all patients were able to swallow. Voice evaluation revealed 5 patients had whispery voices, 25 were difficult to understand in a noisy environment, and 27 were easily understood. DISCUSSION: This technique is an effective approach to cancer therapy with cure rates comparable to total laryngectomy. The main limitation of this technique is that voice recovery is unpredictable.
INTRODUCTION: Extended partial laryngectomy procedures may offer patients the potential for a cure with preservation of voice. This report characterizes our patients managed with near laryngectomy and reconstructed with epiglottic tissue. MATERIALS AND METHODS: A total of 57 patients with T1 or T2 glottic carcinoma undergoing total laryngectomy with epiglottic reconstruction were reviewed retrospectively. This group included 15 patients with T1 lesions and 42 patients with T2 lesions. In the standard operation the specimen includes the thyroid ala, both vocal cords, both false vocal cords, and one arytenoid cartilage. The epiglottis is mobilized and delivered inferiorly for reconstruction of the glottic larynx. RESULT: Tumor control was obtained in 93% of T1 patients and 79% of T2 patients. All patients tolerated decannulation. After a mean duration of 12 days (range 5 to 22 days), all patients were able to swallow. Voice evaluation revealed 5 patients had whispery voices, 25 were difficult to understand in a noisy environment, and 27 were easily understood. DISCUSSION: This technique is an effective approach to cancer therapy with cure rates comparable to total laryngectomy. The main limitation of this technique is that voice recovery is unpredictable.