Supracricoid laryngectomy: oncologic validity and functional safety.
The objectives of this study are to elucidate the oncologic validity of the supracricoid laryngectomy (SCL) for locally advanced endolaryngeal cancers and as a salvage procedure, and to determine its safety in maintaining laryngeal physiology. The medical records of 114 patients that underwent SCL were reviewed. We examined whether the extended procedures, salvage procedure, adjuvant treatment, and type of reconstruction were associated with patient survival and the mean time of decannulation and nasogastric tube removal. Postoperative complications were investigated. There was no significant difference in survival according to the extent of the resection of the primary tumors and the presence or absence of previous treatment. However, the survival of patients that received radiation or concurrent chemoradiation after SCL was significantly lower than that of patients without any adjuvant treatment. Decannulation and nasogastric tube removal was possible for all except for two patients, and the mean time required was 18.4 and 26.1 days, respectively. The interval to starting oral feeding was significantly increased in cases that underwent cricohyoidopexy, an extended procedure, and salvage surgery compared to their counterparts. Pulmonary complications, particularly aspiration pneumonia, were the most common postoperative complications. The results of this study suggest that SCL was feasible for locally advanced laryngeal cancers and as a salvage procedure. Active and effective postoperative swallowing rehabilitation, particularly in cases that underwent cricohyoidopexy, an extended procedure, and salvage surgery, is needed to prevent aspiration pneumonia.
Cho
Kwang Jae
KJ
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul, 137-701, Korea.
Joo
Young Hoon
YH
Sun
Dong Il
DI
Kim
Min Sik
MS
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003413:Cricoid Cartilage / Q000601:surgery*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016879:Salvage Therapy; D012509:Sarcoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome