[Vertical partial laryngectomy and its reconstruction methods].
In the past ten years, we performed vertical partial laryngectomy in 25 patients with glottic carcinomas. These included two T1 cases, seven T2 cases, six T3 cases, and ten post-irradiation recurrent cases. Three types of reconstructive surgery were performed in 24 patients which included 14 patients reconstructed by superior based sternohyoid muscle flap covered with A-E fold or free oral mucosa flap, 7 patients by epiglottic flap, and 3 patients by free fat graft. Most patients healed well post-operatively. Only two post-irradiated patients suffered from fistula due to poor healing, one of whom was found necrosis of sternohyoid muscle flap. In three of those reconstructed by sternohyoid flap, more granulation tissues were noted in the glottis. Transient aspiration was noted in all those reconstructed by epiglottic flaps and some of those by sternohyoid muscle flaps. Later, however, all patients get satisfied with phonation post-operatively. Seventeen patients were followed over year and one T3 patients suffered from recurrence six months after surgery. We concluded that superior based sternohyoid muscle flap covered with free oral mucosa for reconstruction of glottis after ventrical partial laryngectomy was a safe and effective method except for post-irradiated patient. Reconstruction with epiglottic flap might be better for such post-irradiated patients. More satisfactory reconstructive method still deserves further investigation.
Department of Otolaryngology, National Yang-Ming Medical College, Taipei Veterans General Hospital.
H C
HC
Tsai
S Y
SY
Chang
D000328:Adult; D000368:Aged; D005260:Female; D005931:Glottis / Q000601:surgery*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013524:Surgical Flaps