抄録
Supracricoid laryngectomy with cricohyoidoepiglottopexy (CHEP) involves the resection of the entire thyroid cartilage and paraglottic space. The cricoid cartilage, the hyoid bone, most of the epiglottis and arytenoids are preserved. Laryngeal reconstruction is achieved by suturing the cricoid cartilage and the hyoid bone. This procedure, mainly indicated for cases of late T2, selected T3 and T4 glottic carcinoma, provides radical resection and laryngeal preservation without permanent tracheostomy. We performed this surgery for 22 cases as a primary treatment or as a salvage surgery for cases where radiation treatment failed. Oncologic and functional results are satisfactory. CHEP is considered to be useful as a laryngeal function preserving treatment for locally advanced laryngeal cancer.
We also experienced successful laryngeal reconstruction by impaction of the cricoid and the tongue base after extended supracricoid laryngectomy. With a supracricoid laryngectomy, conservation of the hyoid bone is considered essential, and it is contraindicated if tumor infiltrates the hyoid bone. An extended supracricoid laryngectomy was performed on a patient with supraglottic cancer infiltrating the pre-epiglottic space and reaching to the hyoid bone. The larynx was reconstructed by suturing the cricoid cartilage and tongue base. This patient's phonatory and swallowing functions were conserved and the tracheal stoma was closed. While more patients must be studied, conservation of laryngeal function may be possible even when the hyoid bone and tongue base are excised in the course of a supracricoid laryngectomy, thus extending surgical indications.
