title: Laryngeal reconstruction with a sternohyoid muscle flap after supracricoid laryngectomy: postoperative respiratory and swallowing evaluation.
abstract: OBJECTIVE
  To compare postoperative respiratory and swallowing functions between patients who underwent classic supracricoid laryngectomy (SCL) and those who underwent SCL with laryngeal reconstruction using the sternohyoid muscle.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  National cancer center.
  
  
  METHODS
  Forty-four patients who consecutively underwent SCL for laryngeal squamous cell carcinoma from December 2009 to March 2011 were included. Postoperative parameters including the mean tracheostomy decannulation time, tracheostomy decannulation rate at 6 months, mean nasogastric tube (NGT) removal time, degree of dysphagia at 3 months, and survival time after surgery were evaluated.
  
  
  RESULTS
  Twenty-one patients underwent classic SCL (group A), and 23 underwent SCL with laryngeal reconstruction (group B). After a median follow-up period of 37 months (range, 3-44 months), group A had a significantly longer mean decannulation time (120.05 ± 109.38 days vs 33.43 ± 22.60 days, respectively; P < .01) and NGT removal time (37.30 ± 29.97 days vs 17.22 ± 10.95 days, respectively; P < .01) than group B. Swallowing function after 6 months was significantly better in group B than in group A (P = .004). The decannulation rate after 6 months was significantly higher in group B than in group A (95.7% vs 66.7%, respectively; P = .036). The 3-year disease-free survival rate was not significantly different between group A and group B (95.2% vs 95.7%, respectively; P = .961).
  
  
  CONCLUSIONS
  Laryngeal reconstruction using a sternohyoid muscle flap seems to improve quality of life in the early postoperative period after SCL.
authors.affiliation: Department of Surgery, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Department of Head and Neck Surgery, Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China wangxlcams@163.com.
authors.forename: Xiao-lei
authors.initials: XL
authors.lastname: Wang
authors.affiliation: Department of Head and Neck Surgery, Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Zhen-gang
authors.initials: ZG
authors.lastname: Xu
authors.affiliation: Department of Head and Neck Surgery, Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Yue-huang
authors.initials: YH
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D003413:Cricoid Cartilage; D003679:Deglutition; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000379:methods*; D058753:Laryngoplasty / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009334:Neck Muscles / Q000637:transplantation*; D011184:Postoperative Period; D011446:Prospective Studies; D020127:Recovery of Function; D012119:Respiration; D013524:Surgical Flaps
keywords: quality of life; respiration; supracricoid partial laryngectomy; survival; swallowing