Presented at the First World Congress on Head and Neck Oncology, Madrid, Spain, November 29–December 3, 1998.
Supracricoid Partial Laryngectomy With Cricohyoidoepiglottopexy and Cricohyoidopexy for Glottic and Supraglottic Carcinomas†
Article first published online: 14 MAY 2009
Copyright © 2000 The Triological Society
Volume 110, Issue 4, pages 627–634, April 2000
How to Cite
Bron, L., Brossard, E., Monnier, P. and Pasche, P. (2000), Supracricoid Partial Laryngectomy With Cricohyoidoepiglottopexy and Cricohyoidopexy for Glottic and Supraglottic Carcinomas. The Laryngoscope, 110: 627–634. doi: 10.1097/00005537-200004000-00017
- Issue published online: 14 MAY 2009
- Article first published online: 14 MAY 2009
- Manuscript Accepted: 5 JAN 2000
- Laryngeal cancer;
- supracricoid laryngectomy;
- laryngeal function.
Objectives To review the patients operated in our department with supracricoid partial laryngectomy with either cricohyoidoepiglottopexy (CHEP) (59 cases) or cricohyoidopexy (CHP) (10 cases) technique, for primary or recurrent glottosupraglottic squamous cell carcinoma and compare the technique with other surgical or conservative approaches for treatment of laryngeal carcinoma.
Methods From hospital charts, we retrospectively reviewed 69 patients who had undergone supracricoid partial laryngectomy with the CHEP or CHP technique between 1983 and 1996 for primary or recurrent glottosupraglottic squamous cell carcinoma in our department. Statistical evaluation of oncological and functional results were conducted. Results were compared with other surgical and conservative treatment for glottosupraglottic carcinoma of the larynx that were published previously in the literature.
Results Sixty-nine patients had CHEP or CHP for glottosupraglottic carcinoma of the larynx. Thirteen percent of the patients received adjuvant radiotherapy. Minimum follow-up was 2 years or until death. Five-year actuarial survival (Kaplan-Meier method) was 68%. Global local control was achieved in 84% of cases. Among previously untreated patients (n = 54), local control rate was 94.5%. After 1 year, 92.7% of patients achieved normal swallowing and respiration. Salvage total laryngectomy had to be performed in four patients (5.7%) for persistent aspiration and in five patients (7.2%), who were previously treated with radiotherapy, for local recurrence. No permanent tracheostomy or gastrostomy was required.
Conclusions Our experience with supracricoid partial laryngectomy with either CHP or CHEP suggests that this technique is a valuable alternative to radiotherapy for T2–T4 glottosupraglottic carcinomas, particularly those with extension and invasion of the anterior commissure. It allows for preservation of a good laryngeal function without altering the long-term survival, keeping total laryngectomy as a salvage procedure.