Extended supracricoid laryngectomy with excision of both arytenoids: the modified reconstructive laryngectomy.
CONCLUSIONS
Modified reconstructive laryngectomy (MRL) with excision of both arytenoid cartilages will expand the range of indications for conservative surgery in the management of cancer of the larynx.


OBJECTIVE
The present work describes a modification of the standard reconstructive laryngectomy procedure, in order to address problems related to aspiration, and to improve functional results.


METHODS
The study was conducted in Cairo University Hospital. MRL was performed on 14 patients who were scheduled for total laryngectomy. This technique allows for preservation of the superior laryngeal nerves, by fashioning folds of the pharyngeal mucosa to replace the arytenoids. This is followed by reconstruction of the airway through elevation and attachment of the remaining tracheal rings and/or cricoid to the hyoid bone and epiglottis.


RESULTS
MRL was successful in all of the 14 patients included in this preliminary study. All of the patients maintained comprehensible speech, and only one required a speaking type of tracheotomy tube.
Rifai
Mohamed
M
Head and Neck Surgery, Kasr El Aini Hospital, Medical School, Cairo University, Cairo, Egypt. rifai29@gmail.com
D000328:Adult; D000714:Anastomosis, Surgical; D001193:Arytenoid Cartilage / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D003413:Cricoid Cartilage / Q000601:surgery*; D005260:Female; D006801:Humans; D006928:Hyoid Bone / Q000601:surgery; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery; D007825:Laryngectomy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications; D053120:Respiratory Aspiration / Q000453:epidemiology / Q000209:etiology; D013060:Speech; D014132:Trachea / Q000601:surgery; D014833:Voice Quality