Oncologic and functional results of near-total laryngectomy.
OBJECTIVE
To report the oncologic and functional outcome of patients undergoing near-total laryngectomy.


METHODS
A retrospective analysis was carried out from 1991 through 1998.


RESULTS
Eighty-seven patients underwent near-total laryngectomy. The Kaplan-Meier overall survival, cause-specific survival, and relapse-free survival estimates at 5 years were 48.2%, 75.8%, and 72.4%, respectively. Univariate analysis revealed prognosis significance for location, stage, and pathologic cervical lymph node status. Five percent of the patients developed local recurrence, 16% recurrence in cervical lymph nodes, and 10% distant metastasis. Pharyngocutaneous fistula was the most frequent complication (48%). Seventy-seven percent of cases achieved voice preservation. Symptomatic aspiration was noted in 12.3% of cases.


CONCLUSIONS
Near-total laryngectomy can be a successful surgical procedure for selected patients; it does not replace total laryngectomy but reduces its indications. Voice preservation can be achieved in most cases.


CONCLUSIONS
Near-total laryngectomy enhances the speech rehabilitation options for the laryngectomy patient by adding a physiologic, nonprosthetic tissue technique.
Department of Otolaryngology, La Paz Hospital, Autonomous University, Madrid, Spain. bernaldezm@seorl.net
Ricardo
R
Bernáldez
Marta
M
García-Pallarés
Eduardo
E
Morera
Luis
L
Lassaletta
Antonio
A
Del Palacio
Javier
J
Gavilán
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D009367:Neoplasm Staging; D010610:Pharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014832:Voice Disorders / Q000209:etiology / Q000517:prevention & control