SUPRA-CRICOID PARTIAL LARYNGECTOMY: EVALUATION OF THE TECHNIQUE AND FUNCTIONAL RESULTS | ||||
The Egyptian Journal of Surgery | ||||
Volume 22, Issue 4, October 2003, Page 375-382 PDF (332.1 K) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/ejsur.2003.374252 | ||||
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Authors | ||||
Ahmed Helmy1; Hatem Aboul Kassem* 1; Magdy El-Sherbiny1; Ayman Amin1; Soliman El-Shakhs2; Sameh ElBosraty3; Yasser Khalil4 | ||||
1National Cancer Institute, Cairo University | ||||
2Surgical Oncology Dept., Minoufiya University | ||||
3E.N.T. Dept., Cairo University | ||||
4E.N.T. Dept., Minoufiya University | ||||
Abstract | ||||
Introduction: Cancer of the larynx is a disease of central importance in head and neck surgery, due to its impact on human dignity and self presentation. Total laryngectomy deprives the patient permenantly from functions of the larynx. Purpose: The aim of this study is to evaluate the technique of supra-cricoid laryngectomy as a method of reconstruction of the larynx after resection, and study the results as regards laryngeal functions and control of cancer. Patients and Methods: Twenty one patients with squamous cell carcinoma of the glottis and/ or supraglottis underwent this procedure during the period from January 1999 till December 2000 at the National Cancer Institute, Kasr El-Eini and Minoufiya University Hospitals. Supra-cricoid partial laryngectomy was done in 21 patients. The mean age of the patients was 57.8 years; twenty were males and one was female. Reconstructive techniques included were crico-hyoido-epiglottpexy (CHEP) in 13 patients, and crico-hyoidopexy (CHP) in 7 patients. In one patient supracricoid laryngectomy was planned but during surgery there was a major subglottic extension of the tumor, so total laryngectomy was done and it was excluded from the study. Evaluation of deglutition, phonation, time of decannulation and nasogastric tube removal occurred. The minimum follow up period was 2 years. Results: All patients except one resumed physiologic deglutition and none required permanent tracheostomy. Swallowing was excellent, only 4 patients assumed a certain posture during meals. The average period for decanulation and nasogastric tube removal was 16.35 and 20 days; respectively. Phonation was good enough for easy communication with others. Tumor recurrence occurred in three patients. One patient underwent total laryngectomy due to serious aspiration and pneumonia. Conclusion: For properly selected patients with supra-glottic and/or glottic carcinoma, supracricoid laryngectomy is a reasonable alternative to horizontal laryngectomy and total laryngectomy. | ||||
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