Aortic homograft reconstruction of partial laryngectomy defects: a new technique.
OBJECTIVE
Wide-field transcervical partial laryngectomy often precludes tracheotomy decannulation. It is done infrequently today, primarily because of the popularity of chemotherapy-radiotherapy treatment regimens and limited enthusiasm for using transcervical partial laryngectomy after failed radiotherapy. We sought to identify a new reconstructive technique that would provide an alternative to total laryngectomy in as many patients as possible.


METHODS
We performed a retrospective examination of 15 patients who underwent single-stage wide-field transcervical partial laryngectomy with cryopreserved aortic homograft reconstruction. Eight of the 15 patients had previously undergone failed radiotherapy. At least 40% of the cricoid circumference was resected in 8 patients.


RESULTS
All 15 patients had their tracheotomy tube removed and have laryngeal phonation, and 14 of the 15 resumed oral intake. There were no major surgical complications.


CONCLUSIONS
Use of aortic homografts is a new, reliable, and versatile reconstructive option for performing conservation laryngeal cancer surgery that allows for airway, swallowing, and voice preservation.
Department of Surgery, Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation Boston, Massachusetts 02114, USA.
Steven M
SM
Zeitels
John C
JC
Wain
Anca M
AM
Barbu
Paul C
PC
Bryson
James A
JA
Burns
D001011:Aorta / Q000637:transplantation*; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000601:surgery*; D003413:Cricoid Cartilage / Q000601:surgery; D003679:Deglutition; D006801:Humans; D007822:Laryngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013584:Sarcoma, Synovial / Q000532:radiotherapy / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D013065:Speech Intelligibility; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014833:Voice Quality