title: Functional results after total cricoidectomy with medial femoral condyle free flap reconstruction.
abstract: Our goal was to describe a laryngeal-preserving single-stage procedure for the treatment of low-grade chondrosarcomas of the larynx: a total cricoidectomy with medial femoral condyle flap reconstruction. The study was designed as a case series of three consecutive patients with low-grade chondrosarcomas of the cricoid cartilage lamina, diameter 4.4, 5.2, 3.8 cm, respectively, who underwent total cricoidectomy in 2012. Single-staged reconstruction of the defect with medial femoral condyle flap including the periosteum and thin underlying cortical layer of the bone was conducted. Oncologic and functional results were observed during 3 years of follow-up. 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. None of the patients reported aspiration after surgery nor experienced aspiration-related problems, which was confirmed by means of the Leipzig-Pearson scale. The speech ability was good, maximum phonation time was 14, 18, 21 s, respectively, and the voice handicap index scores ranged from 24 to 36 and had improved noticeably at 1, 3 and 6 months follow-up. Two patients were ultimately decannulated, and one female still has a tracheostomy; however, she is able to keep the tracheostoma closed for most of the time, maintaining good phonatory and swallowing functions. Total cricoidectomy with reconstruction by means of medial femoral condyle flap may replace the total laryngectomy in large low-grade chondrosarcomas of the cricoid cartilage.
authors.affiliation: Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Przybyszewskiego 49, 60593, Poznan, Poland. bananana@poczta.onet.pl.
authors.forename: Jacek
authors.initials: J
authors.lastname: Banaszewski
authors.affiliation: Department of Oral and Maxillofacial Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Gaggl
authors.affiliation: Private Hospital Maria Hilf, Klagenfurt, Austria.
authors.forename: Heinz
authors.initials: H
authors.lastname: Buerger
authors.affiliation: Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Przybyszewskiego 49, 60593, Poznan, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Wierzbicka
authors.affiliation: Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Przybyszewskiego 49, 60593, Poznan, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Pabiszczak
authors.affiliation: Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Przybyszewskiego 49, 60593, Poznan, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Pastusiak
authors.affiliation: Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Przybyszewskiego 49, 60593, Poznan, Poland.
authors.forename: Witold
authors.initials: W
authors.lastname: Szyfter
mesh_terms: D002813:Chondrosarcoma / Q000601:surgery*; D003413:Cricoid Cartilage / Q000601:surgery*; D003679:Deglutition; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010699:Phonation; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D014139:Tracheostomy; D016896:Treatment Outcome
keywords: Chondrosarcoma; Cricoidectomy; Free flap; Laryngeal reconstruction