Total cricoidectomy in the treatment of laryngeal chondrosarcomas.
OBJECTIVE
Our goal was to describe a total cricoidectomy, a laryngeal-preserving procedure for the treatment of low-grade chondrosarcomas of the larynx. These extremely rare cartilaginous tumors arise in the cricoid cartilage in most cases. Although these are slow-growing and rarely metastasizing tumors, large chondrosarcomas of cricoid cartilage are generally treated with total laryngectomy. An oncologically radical but function-preserving approach would therefore be preferable.


METHODS
Case series.


METHODS
Three consecutive patients with low-grade chondrosarcomas of the larynx underwent total cricoidectomy from 1996 to 2004. An end-to-end anastomosis between the remaining larynx and the trachea was performed to restore the continuity of airways. In all cases the laryngeal lumen was stented using a Montgomery T-tube. Oncologic and functional results were observed during at least 6 years of follow-up.


RESULTS
No evidence of tumor recurrence was detected during follow-up. One month after surgery, all patients were able to tolerate a soft diet and to speak satisfactorily. One patient was ultimately decannulated, and two patients still have a tracheostomy. However, even nondecannulated patients were able to keep the tracheostoma closed for most of the time, maintaining good phonatory and swallowing functions.


CONCLUSIONS
Total cricoidectomy with thyrotracheopexy may avoid the need for total laryngectomy in low-grade chondrosarcomas of the cricoid cartilage.
Department of Sensorial Organs, Otorhinolaryngology Section, Sapienza University of Rome, Rome, Italy.
Marco
M
de Vincentiis
Antonio
A
Greco
Massimo
M
Fusconi
Giulio
G
Pagliuca
Salvatore
S
Martellucci
Andrea
A
Gallo
D000714:Anastomosis, Surgical / Q000379:methods; D002813:Chondrosarcoma / Q000473:pathology / Q000601:surgery*; D003413:Cricoid Cartilage / Q000473:pathology / Q000601:surgery*; D003679:Deglutition / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D010699:Phonation / Q000502:physiology; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology; D013018:Sound Spectrography; D013957:Thyroid Cartilage / Q000601:surgery; D014132:Trachea / Q000601:surgery; D014139:Tracheostomy