title: Subtotal supracricoid laryngectomy: changing in indications, surgical techniques and use of new surgical devices.
abstract: OBJECTIVE
  The aim of this study is to evaluate the evolution of supracricoid partial laryngectomy (SCPL) in indications, surgical techniques and outcomes through last decades.
  
  
  METHODS
  A retrospective analysis of 146 patients affected by laryngeal cancer treated with SCPL was carried on. We defined: (1) group A, 100 patients treated by cold instruments between 1995 and 2004; (2) group B, 46 patients treated by harmonic scalpel between 2005 and 2010. Complications rate, and functional and oncological results were documented and a comparison between the two groups was made; histopathological analysis of surgical margins was evaluated and correlated with local incidence of recurrence.
  
  
  RESULTS
  Significant differences in age mean-value (p=0.02), T classification (p=0.007), and in indication for more advanced-staged patients were found in group B (p=0.001). Surgical procedure was shorter in group B (p<0.001), with shorter swallowing recovery (p=0.003). Oncological outcomes did not report any significant differences. Group B showed a higher incidence of post- operative arytenoid edema (p=0.03) associated with a lower rate of pneumonia (p=0.038). Despite a higher rate of close or positive-margins found in group B no higher incidence of local-recurrence was reported (p=0.02) compared to group A.
  
  
  CONCLUSIONS
  We documented changing in indications and surgical technique for SCPL because of the development of modern diagnostic techniques and the introduction of low-thermal injury device allowing a more challenging tumor excision as well as with a shorter swallowing recovery in our series.
authors.affiliation: First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Via Largo Brambilla 3, Florence, Italy. Electronic address: mannelli.giuditta@gmail.com.
authors.forename: Giuditta
authors.initials: G
authors.lastname: Mannelli
authors.affiliation: First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Via Largo Brambilla 3, Florence, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Meccariello
authors.affiliation: First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Via Largo Brambilla 3, Florence, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Deganello
authors.affiliation: First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Via Largo Brambilla 3, Florence, Italy.
authors.forename: Francesca Romana
authors.initials: FR
authors.lastname: Fiorini
authors.affiliation: Department of Radiotherapy, University of Florence, Viale G.B. Morgagni, 85, Florence, Italy.
authors.forename: Fabiola
authors.initials: F
authors.lastname: Paiar
authors.affiliation: First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Via Largo Brambilla 3, Florence, Italy.
authors.forename: Oreste
authors.initials: O
authors.lastname: Gallo
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D007825:Laryngectomy / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016879:Salvage Therapy; D000077195:Squamous Cell Carcinoma of Head and Neck; D016896:Treatment Outcome; D055815:Young Adult