[Clinical evaluation on second stage reconstruction for laryngostenosis after partial laryngectomy for laryngeal cancer patients].
OBJECTIVE
To present a new method of decannulation for laryngostenosis patients after partial laryngectomy and extended partial laryngectomy, and restoration of the essential functions of larynx and normal neck appearance.


METHODS
Nineteen cases of laryngostenosis after partial laryngectomy and extended partial laryngectomy were treated with second stage reconstruction. The patients had been treated by vertical laryngectomy (6/19) using extended vertical laryngectomy (11/19) and frontolateral laryngectomy (2/19). Among these patients, second stage reconstruction of larynx was performed by using rotary door myocutaneous flap (17/19). Stemohyoideus flap (1/19) and sternocleidomastoid flap (1/19).


RESULTS
Three and five year-survival rates were 91.7% (11/12) and 3/5, respectively. Over-all decannulation rate was 84.2% (16/19), but 94.1% (16/17) in patients with rotary door myocutaneous flap and 0% (0/2) in both patients with sternohyoideus flap and sternocleidomastoid flap. There were 3 decannulation failures (15.8%). All patients resumed acceptable voice, 94.7% (18/19) enjoyed satisfactory phonation, but 5.3% (1/19) showed severe hoarseness. All except 2 patients returned normal swallow function. The latter 2 patients experienced mild abnormal swallow during eating fluid food in early stage of surgery, but had normal swallow function after 1-2 weeks.


CONCLUSIONS
Functional laryngectomy is a radical operation in selected cases with advanced laryngeal cancer. The second stage reconstruction with bi-pedical rotary door myocutaneous flaps can help decannulation in patients who developed laryngostenosis after partial laryngectomy and extended partial laryngectomy, and restore the essential function of larynx and normal neck appearance.
Zhao
S
S
Department of Otorhinolaryngology, Changzheng Hospital, Second Miltiary Medical University, Shanghai 200003, China. zhaoshw@citiz.net
Ye
Q
Q
Xie
Y
Y
Wu
J
J
Wang
H
H
Lang
J
J
Sun
B
B
Tian
S
S
Sun
A
A
D000328:Adult; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000009:adverse effects; D007829:Laryngostenosis / Q000209:etiology / Q000601:surgery*; D007830:Larynx / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D013524:Surgical Flaps