Supracricoid Partial Laryngectomies after Failure of Radiation Therapy
Article first published online: 3 JAN 2009
Copyright © 2005 The Triological Society
Volume 115, Issue 2, pages 353–357, February 2005
How to Cite
Makeieff, M., Venegoni, D., Mercante, G., Crampette, L. and Guerrier, B. (2005), Supracricoid Partial Laryngectomies after Failure of Radiation Therapy. The Laryngoscope, 115: 353–357. doi: 10.1097/01.mlg.0000154751.86431.41
- Issue published online: 3 JAN 2009
- Article first published online: 3 JAN 2009
- Manuscript Accepted: 1 SEP 2004
- partial surgery;
Background: Conservation of laryngeal function is a key surgical objective in cases of limited recurrence after previously irradiated T1b or T2 glottic carcinoma. Only a few articles have mentioned the use of supracricoid partial laryngectomies (SCPL) to treat recurrent T1/T2 tumors that cannot be managed with vertical partial laryngectomy.
Objectives: To evaluate oncologic and functional results of SCPL in selected cases of T1/T2 glottic carcinoma recurrence after primary irradiation therapy.
Method: Between 1986 and 2000, 23 selected patients (T1b, 12 cases; T2, 11 cases) underwent SCPL as salvage treatment: cricohyoidepiglottopexy (CHEP) in 18 cases and cricohyodopexy (CHP) in 5 cases.
Results: The mean cannulation time was 28 (14–90) days. The mean nasogastric feeding tube time for CHP and CHEP was 55 (28–96) days and 21 (9–45) days, respectively. Four (17.4%) patients had major swallowing recovery problems. Three patients died in the postoperative period, one of intercurrent disease and two because of aspiration pneumonia. Six (26.08%) patients relapsed and underwent total laryngectomy. Three were subsequently controlled. The T stage was correlated with the onset of a new recurrence (P = .0258). The surgical margins were not correlated with recurrence (P = .0741). At 3 and 5 years, the global survival rate was 82.9% and 69.04%. The success rate for oncologic control and oncologic control with organ preservation was 74% and 66.6%, respectively.
Conclusion: In selected cases of limited recurrence after radiation therapy for T1/T2 vocal cord carcinomas, SCPL can be an alternative to total laryngectomy when partial vertical surgery appears unsuitable.