[Patient selection for near-total laryngectomy and oncologic results].
OBJECTIVE
We reviewed preoperative, perioperative, and postoperative findings and the survival data to determine which patients may be appropriate for near-total laryngectomy.


METHODS
We reviewed hospital records of 20 patients (all males; mean age 56.6 years; range 35 to 73 years) who underwent near-total laryngectomy. Indications for patient selection for near-total laryngectomy and survival data were evaluated in comparison with literature reports.


RESULTS
The site of the tumor was the sinus pyriformis in two, and the larynx in 18 patients. Thirteen patients had T3, seven patients had T2 tumors. The lesions were localized in the sinus pyriformis in two patients with T2 tumors. The locoregional control rate at the end of two years was 75%; two- and three-year survival rates were 81.2% and 64.2%, respectively.


CONCLUSIONS
Following a detailed and meticulous investigation in the preoperative period, near-total laryngectomy seems to be appropriate in selected patients with advanced laryngeal and hypopharyngeal tumors in which partial laryngectomy procedures are not considered. It may both provide cure and preserve phonation. It may also be considered for functional purposes in patients whose pulmonary functions are insufficient for partial laryngectomy, in those in whom food aspiration is inevitable after partial laryngectomy, and in those suffering from lifelong food aspiration due to neurologic causes, and for oncologic reasons in patients who develop local recurrences after partial laryngectomy.
Osmangazi Universitesi Tip Fakültesi, Kulak Burun Boğaz Hastaliklari Anabilim Dali, Eskişehir, Turkey. ozudogru@ogu.edu.tr
Erkan
E
Ozüdoğru
Emre
E
Cingi
Hamdi
H
Cakli
M Cem
MC
Keçik
Cemal
C
Cingi
M Kezban
MK
Gürbüz
D000328:Adult; D000368:Aged; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D007825:Laryngectomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality*; D018579:Patient Selection; D016019:Survival Analysis; D014421:Turkey / Q000453:epidemiology