6 T1b Glottic Cancer, Vertical Partial Laryngectomy

AbstractAttention is drawn to the problems of surgical resection by partial laryngectomy after full therapeutic dosage of telecobalt irradiation. Material is presented from two treatment centres to indicate trends in surgical treatment and the complications experienced. Results will be given which confirm a reasonable expectation of cure and functional conservation by vertical partial laryngectomy for recurrence of glottic cancer after irradiation. The results of treatment of recurrent supraglottic cancer by horizontal partial laryngectomy gave more cause for concern in terms of complications and survival. In conclusion an attempt is made, based on the quoted experience, to define the position of conservation surgery in two centres for laryngeal cancer in the United Kingdom.

Download Full-text

Reconstruction of the larynx with unipedicled sternohyoid myofascial flap following open extended vertical partial laryngectomy

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20185309 ◽

2018 ◽

Vol 5 (1) ◽

pp. 231

Author(s):

Ramil K. Yagudin ◽

Kamil F. Yagudin

Keyword(s):

Significant Risk ◽

Extent Of Resection ◽

Glottic Cancer ◽

Partial Laryngectomy ◽

Laryngeal Function ◽

Protective Function ◽

Simple Modification ◽

Mucosal Defect ◽

Laryngeal Mucosa ◽

Ideal Technique

<p class="abstract">The extent of resection during open vertical partial laryngectomy may vary considerably and even an experienced surgeon may encounter difficulties in reconstructing the larynx to preserve laryngeal function and to prevent stenosis. Different local flaps were proposed for reconstruction; however, the ideal technique is still under development. A simple modification to the technique originally described by Calcaterra (1983) is presented. The unipedicled sternohyoid myofascial flap consists of the unsplit sternohyoid muscle with all three overlying fasciae harvested as a whole. The flap is rotated 90° and horizontally sutured in position to supply the necessary bulk to the entire neocord to produce a functional voice. Completely filling the mucosal defect USMF-flap allows laryngeal structures to maintain their native position and retain protective function of the larynx. The thick multilayered fascia covering facilitates rapid epithelization and prevents excessive granulation and secondary stenosis. The technique is indicated in glottic cancer patients treated by open extended vertical partial laryngectomy when the laryngeal mucosa defect is too extensive for primary closure and poses significant risk of developing postoperative stenosis.</p>

Download Full-text

Laryngeal framework reconstruction using titanium mesh in glottic cancer after frontolateral vertical partial laryngectomy

The Laryngoscope ◽

10.1002/lary.21103 ◽

2010 ◽

Vol 120 (11) ◽

pp. 2197-2202 ◽

Cited By ~ 2

Author(s):

Xue-Kui Liu ◽

Quan Zhang ◽

Quan Li ◽

Wei-Wei Liu ◽

Hao Li ◽

...

Keyword(s):

Glottic Cancer ◽

Partial Laryngectomy ◽

Titanium Mesh

Download Full-text

FRONTOLATERAL PARTIAL LARYNGECTOMY AS SALVAGE SURGERY FOR RADIATION FAILURES IN EARLY GLOTTIC CANCER

Japanese jornal of Head and Neck Cancer ◽

10.5981/jjhnc1974.26.422 ◽

2000 ◽

Vol 26 (3) ◽

pp. 422-425

Author(s):

Hirishi NISHINO

Keyword(s):

Salvage Surgery ◽

Glottic Cancer ◽

Partial Laryngectomy ◽

Early Glottic Cancer

Download Full-text

Vertical partial frontolateral laryngectomy with simultaneous pedunculated sternothyroid muscle flap reconstruction of the vocal fold – surgical procedure and treatment outcomes

Otolaryngologia Polska ◽

10.5604/01.3001.0011.5938 ◽

2018 ◽

Vol 72 (1) ◽

pp. 23-29

Author(s):

Olga Jurek-Matusiak ◽

Piotr Wójtowicz ◽

Tomasz Szafarowski ◽

Antoni Krzeski

Keyword(s):

Treatment Outcomes ◽

Vocal Fold ◽

Muscle Flap ◽

Good Method ◽

Intermediate Stage ◽

Glottic Cancer ◽

Partial Laryngectomy ◽

Flap Reconstruction ◽

Tumor Spread ◽

Male Patients

Purpose of the study: The aim of the study was to present the treatment outcomes after vertical partial laryngectomy with or without pedunculated sternothyroid muscle flap reconstruction following the resection of neoplasm-infiltrated vocal fold. The procedure was used in a patient with glottic cancer. Oncological outcomes, morphology of neo-vocal fold and the act of swallowing were evaluated. Material and methods: 45 patients with T1-T2 glottic cancer were subjected to vertical partial laryngectomy with 26 patients undergoing a procedure with pedunculated sternothyroid muscle flap reconstruction and the remaining 19 patients undergoing a procedure without such a reconstruction. Two female and 43 male patients aged 35-82 years (mean age of 62.5 years) were enrolled in the study. Local tumor spread and the condition of reconstructed vocal fold were assessed in sequential videofiberoscopy examination conducted each month after surgery whereas the regional spread was assessed in ultrasound scans. Postoperative aspiration was graded according to the Pearson’s scale. Results: Six patients experienced local recurrence while 2 patients experienced regional recurrence of the tumor. The pedunculated sternothyroid muscle flap neo-fold was structurally resemblant of the non-affected vocal fold. Episodic, daily dysphagia was observed in 1 patient while normal act of swallowing with no Pearson’s scale symptoms was observed in the remaining 44 patients. No necrosis of pedunculated flap was observed. Conclusions: Vertical partial laryngectomy with or without pedunculated sternothyroid muscle flap reconstruction is a good method for the treatment of low- or intermediate-stage glottic cancer, especially when endoscopic access to the tumor is limited and when CO2 laser cannot be used. No significant functional disorders were observed in operated larynges.

Download Full-text