Abstract
A retrospective review of 19 patients treated by horizontal partial laryngectomy at our hospital was accomplished for the period of 1979-1998. The mean age at diagnosis was 64 years, with a range of 52 to 78 years. The distribution of TN-stage (UICC1987) was as follows: T1-one, T2-12, T3-five, T4-one and N0-11, N1-three, N2a-one, N2b-one, and N2c-three. Four patients had received radiotherapy to the neck including the larynx with the dosage ranging from 42Gy to 70Gy. Sixteen patients had standard supraglottic laryngectomy and the remaining three had extended resection including the arytenoid or the base of tongue or the vocal cord. No patients received postoperative radiotherapy. Follow-up was conducted until death or for a minimum of 911 days. The mean follow-up was 1, 885 days.
Primary disease control was achieved in 100% of the patients. Two patients never attempted to swallow after surgery because of early postoperative mortality from severe aspiration pneumonia or cerebral infarction, and the remaining 17 patients were successful in deglutition. None of these patients developed pneumonia and all were successfully decannulated. The average durations of cannulation and of feeding through the nasogastric tube were 29 days (10-92 days) and 34 days (12-108 days). Most prolonged dysphagia was seen in the one whose arytenoids were resected. Chest radiographs and white blood cell counts showed no influence on the respiratory tract due to long-term latent aspiration, in spite of slight aspirations on pharyngogram in 57% (5/7) of the patients. The 5-year crude survival rate and cause specific survival rate were 77%, 100%, respectively. There was no significant difference between the partial laryngectomy group and the radical radiation group (n=81). The causes of death relevant to the respiratory system consisted of 36% (4/11), one of which was severe aspiration pneumonia (78-year-old patient with heart disease).
From the results it was suggested that horizontal partial laryngectomy is useful in tumor control and retaining the laryngeal function in the strictly selected cases.
