Paraglottic space in supracricoid laryngectomy.
BACKGROUND
Paraglottic space (PGS) is a connective tissue compartment of the larynx and is important in the extension of laryngeal cancer. It communicates with the preepiglottic space superiorly and with the extralaryngeal region inferiorly through the gap within the cricothyroid membrane. Transglottic cancer of the larynx, which spreads within PGS, is characterized by a high incidence of laryngeal skeleton invasion and of cervical metastasis. Determining the correct stage of transglottic cancer of the larynx is difficult, leading to therapeutic failure of partial laryngectomy in some cases.


OBJECTIVE
To clinically confirm a pathologically complete resection of PGS from the piriform sinus mucosa by supracricoid partial laryngectomy in laryngeal cancers involving PGS.


METHODS
Eight patients with transglottic cancer whose cancer was confirmed clinically and pathologically at stages T2b or higher underwent supracricoid partial laryngectomy. During supracricoid partial laryngectomy, we performed a sharp dissection of PGS from the piriform sinus mucosa to obtain a complete resection margin while preserving the piriform sinus mucosa. Microscopic evaluation of the specimens was made for the invasion of PGS and the safe margin distance from the piriform sinus mucosa.


RESULTS
Pathological cancer invasion of PGS was confirmed in 7 of 8 patients and a sufficient pathological margin from tumor invasion to the piriform sinus mucosa was obtained. The average safety margin was 10.3 mm.


CONCLUSIONS
Supracricoid partial laryngectomy could be considered a safe surgical modality for cancers not extending to PGS.
Kim
Min-Sik
MS
Department of Otolaryngology-Head and Neck Surgery, Kangnam St Mary's Hospital, The Catholic University of Korea, Seoul, Korea 137-040. entkms@cmc.cuk.ac.kr
Sun
Dong-Il
DI
Park
Kyung-Ho
KH
Cho
Kwang-Jae
KJ
Park
Young-Hak
YH
Cho
Seung-Ho
SH
D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D007830:Larynx / Q000473:pathology; D008297:Male; D008875:Middle Aged