[Supracricoid partial laryngectomy as salvage for recurrent carcinoma of the larynx initially treated by vertical partial hemilaryngectomy. Case report].
OBJECTIVE
We undertook this study to report the possibility of salvage of vertical partial hemilaryngectomy with imbrication laryngoplasty (PVHLIL) to supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP) in a patient with recurrent glottic carcinoma.


METHODS
A 68-year-old patient with recurrent glottic squamous cell carcinoma (T1aN0) was treated with imbricated partial laryngectomy. Transoperative histopathological report demonstrated vocal cord free surgical margins anterior at 1 cm and 0.4 cm posterior. The patient was evaluated trimonthly and at 16-month follow-up presented with tumor activity on the posterior third of the left false vocal cord, close to the arytenoids, which still conserved mobility. Biopsy was performed and confirmed recurrence of squamous cell carcinoma. SCPL with CHEP was performed with a satisfactory postoperative evolution with tracheotomy decannulation at day 7. Physiological phonation and retirement of nasogastric tube were accomplished at day 15, as well as reinitiation of oral feeding. Histopathological report showed a moderately differentiated squamous cell carcinoma. Functional evaluation with PVHLIL is a clear voice alteration; however, patients do not require permanent tracheostomy, and a close to normal biopsicosocial integration after SCPL + CHEP is possible.


CONCLUSIONS
PVHLIL is an excellent treatment option for selected glottic tumors staged T1 or T2. Close follow-up must be given to allow the possibility of organ conservation either with radiotherapy or surgery. When recurrence occurs, SCPL + CHEP must be considered according to the established criteria for this procedure. Total laryngectomy must be considered as the last option, with the only purpose being a normal quality of life.
Luna-Ortiz
Kuauhyama
K
Departamento de Cirugía de Cabeza y Cuello, Instituto Nacional de Cancerología, México, D.F. kuauhyama@starmedia.com
Nuñez-Valencia
Ethel Ruth
ER
Carmona-Luna
Tania
T
D000368:Aged; D001193:Arytenoid Cartilage / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D003413:Cricoid Cartilage / Q000601:surgery; D055154:Dysphonia / Q000517:prevention & control; D004825:Epiglottis / Q000601:surgery; D005500:Follow-Up Studies; D005931:Glottis / Q000601:surgery; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011788:Quality of Life; D016879:Salvage Therapy / Q000379:methods; D014833:Voice Quality