The impact of total laryngectomy for very old patients

Abstract

We present two very old patients aged over 90 years with laryngeal squamous cell carcinoma who underwent total laryngectomy. The first case was a 91-year-old female with cT2N0M0 laryngeal squamous cell carcinoma. She was staying in a geriatric health services facility and had an ECOG-PS of 1 even though she used a wheelchair after fracturing her femur. Emergency tracheostomy was performed when stridor was detected during her first visit to our hospital. Total laryngectomy was performed 34 days after admission, and she returned to the same facility 57 days after admission without postoperative complications. The second case was a 91-year-old male with cT3N0M0 laryngeal squamous cell carcinoma who also had chronic heart failure and atrial fibrillation. ECOG-PS had worsened to 2 during his stay at a previous hospital. He underwent emergency tracheostomy soon after transferring to our hospital. We then performed a total laryngectomy 14 days after the tracheostomy. He was discharged 45 days after admission although sudden heart failure required additional medication.