Modified subtotal laryngectomy with cricohyoidoepiglottopexy--long term results in 81 patients

Head Neck. 1999 Mar;21(2):95-103. doi: 10.1002/(sici)1097-0347(199903)21:2<95::aid-hed1>3.0.co;2-f.

Abstract

Background: Standard treatment of early glottic carcinoma is radiotherapy, but involvement of the anterior commissure leads to a reduced cure rate. We investigated retrospectively whether our modified subtotal laryngectomy had improved results for early glottic carcinomas involving the anterior commissure, without causing excessive disability to laryngeal functions.

Methods: Eighty-one patients with T1 or T2 glottic carcinoma involving the anterior commissure were reviewed. Follow-up was at least 3 years. Speech was assessed by subjective evaluation and a computer-assisted voice analysis device.

Results: Three-year overall survival rate and 3- and 5-year actuarial survival rates were, respectively, 90.1%, 95%, and 90.8%, with no difference between the different T stages involved (p > 0.46). The local recurrence rate was 7.4%. Speech recovered in all patients and was evaluated as satisfactory in 86% of cases.

Conclusion: For early glottic carcinomas involving the anterior commissure, subtotal laryngectomies appear to be more effective than radiotherapy, and our modified technique simplifies the procedure.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cricoid Cartilage / surgery*
  • Female
  • Glottis / surgery*
  • Humans
  • Hyoid Bone / surgery*
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / surgery*
  • Laryngectomy / methods*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Neoplasms, Second Primary
  • Postoperative Complications
  • Retrospective Studies
  • Survival Rate