Modified subtotal laryngectomy with cricohyoidoepiglottopexy-long term results in 81 patients

• Published in: Head & neck 1999-03, Vol.21 (2), p.95-103
• Main Authors: Crampette, Louis, Garrel, Renaud, Gardiner, Quentin, Maurice, Norbert, Mondain, Michel, Makeieff, Marc, Guerrier, Bernard
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; anterior commissure; Biological and medical sciences; cricohyoidoepiglottopexy; Cricoid Cartilage - surgery; Female; glottic carcinoma; Glottis - surgery; Guerrier technique; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; Hyoid Bone - surgery; Laryngeal Neoplasms - mortality; Laryngeal Neoplasms - surgery; Laryngectomy - methods; Male; Medical sciences; Middle Aged; Neoplasm Recurrence, Local; Neoplasms, Second Primary; Postoperative Complications; Retrospective Studies; subtotal laryngectomy; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the upper aerodigestive tract; Survival Rate
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/(SICI)1097-0347(199903)21:2<95::AID-HED1>3.0.CO;2-F

Background Standard treatment of early glottic carcinoma is radiotherapy, but involvement of the anterior commissure leads to a reduced cure rate.1 We investigated retrospectively whether our modified subtotal laryngectomy had improved results for early glottic carcinomas involving the anterior commissure, without causing excessive disability to laryngeal functions. Methods Eighty‐one patients with T1 or T2 glottic carcinoma involving the anterior commissure were reviewed. Follow‐up was at least 3 years. Speech was assessed by subjective evaluation and a computer‐assisted voice analysis device. Results Three‐year overall survival rate and 3‐ and 5‐year actuarial survival rates were, respectively, 90.1%, 95%, and 90.8%, with no difference between the different T stages involved (p > 0.46). The local recurrence rate was 7.4%. Speech recovered in all patients and was evaluated as satisfactory in 86% of cases. Conclusion For early glottic carcinomas involving the anterior commissure, subtotal laryngectomies appear to be more effective than radiotherapy, and our modified technique simplifies the procedure. © 1999 John Wiley & Sons, Inc. Head Neck 21: 95–103, 1999.