title: [CHEP with the total removal of the arytenoid on the tumor-bearing side].
abstract: A supracricoid laryngectomy with cricohyoidoepiglottopexy (CHEP) consists of the resection of the whole thyroid cartilage and paraglottic space, while preserving the cricoid cartilage, the hyoid bone, most of the epiglottis and the arytenoids. Laryngeal reconstruction is achieved be suturing the cricoid cartilage and the hyoid bone. This procedure is mainly indicated for large T2 glottic carcinomas and provides a complete resection and laryngeal preservation without requiring a permanent tracheostomy. Although bilateral arytenoids are usually preserved to ensure better laryngeal function after CHEP, we unavoidably had to remove the arytenoid on the tumor-bearing side during a complete resection performed in a 56-year-old male with a rT2 tumor who had undergone radiation and demonstrated impaired vocal fold motion. Despite the resection of one arytenoid, the final laryngeal function proved to be satisfactory. CHEP should be utilized as an alternative surgical modality for conventional vertical partial laryngectomies or total laryngectomies. CHEP with the total removal of the arytenoid on the tumor-bearing side may be a useful laryngeal preservation procedure for the treatment of patients with glottic carcinoma associated with an impaired vocal fold motion or a fixed vocal fold.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Shiotani
authors.forename: Koji
authors.initials: K
authors.lastname: Araki
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Moro
authors.forename: Asako
authors.initials: A
authors.lastname: Ikeda
authors.forename: Keisuke
authors.initials: K
authors.lastname: Okubo
authors.forename: Koichiro
authors.initials: K
authors.lastname: Saito
authors.forename: Kaoru
authors.initials: K
authors.lastname: Ogawa
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D044964:Cervicoplasty / Q000379:methods; D003413:Cricoid Cartilage / Q000601:surgery*; D004825:Epiglottis / Q000601:surgery*; D005931:Glottis; D006801:Humans; D006928:Hyoid Bone / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013957:Thyroid Cartilage / Q000601:surgery*