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Supracricoid Partial Laryngectomies after Failure of Radiation Therapy

Authors

  • Marc Makeieff MD,

    Corresponding author
    1. Department of Otolaryngology—Head and Neck Surgery, Hopital Gui de Chauliac, University of Medecine, Montpellier, France.
    • Dr. Makeieff Marc, University Hospital Head and Neck Surgery, 80 Avenue A. Fliche, Hopital Gui de Chauliac, Chu Montpellier, Montpellier 34295, France.
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  • Delphine Venegoni MD,

    1. Department of Otolaryngology—Head and Neck Surgery, Hopital Gui de Chauliac, University of Medecine, Montpellier, France.
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  • Guisepe Mercante MD,

    1. Department of Otolaryngology—Head and Neck Surgery, Hopital Gui de Chauliac, University of Medecine, Montpellier, France.
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  • Louis Crampette MD,

    1. Department of Otolaryngology—Head and Neck Surgery, Hopital Gui de Chauliac, University of Medecine, Montpellier, France.
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  • Bernard Guerrier MD

    1. Department of Otolaryngology—Head and Neck Surgery, Hopital Gui de Chauliac, University of Medecine, Montpellier, France.
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Abstract

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.

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