2007 Volume 19 Issue 2 Pages 120-124
We performed laryngeal functional surgeries on four cases with supraglottic carcinomas. The procedures consisted of two horizontal partial laryngectomies, one subtotal laryngectomy with cricohyoidopexy, and one subtotal laryngectomy with tracheocricohyoidoepiglottopexy. In all four cases, the tracheostomy tube was removed after the operation and all were successful in deglutition. Swallowing function was almost normal in two cases and the other two cases, whose aryepiglottic folds had been resected, could tolerate a soft diet. While three cases had a slight aspiration on fluoroscopic pharyngogram examination, only two cases without aryepiglottic folds had subjective symptoms of aspiration. This suggests that there is an important relationship between the preservation of aryepiglottic folds and postoperative swallowing function.
The pathological findings were : squamous cell carcinoma in two cases, basaloid squamous cell carcinoma in one and mucoepidermoid carcinoma in one. Surgical resection is recommended for basaloid squamous cell carcinomas and mucoepidermoid carcinomas as they are radiation resistant. One case had a local recurrence after chemoradiotherapy and three cases had locally advanced tumors (pT3 in two cases and pT4a in one), that were not expected to be cured completely by radiotherapy.
Laryngeal functional surgery was chosen over radiotherapy in cases that exhibited pathologically radiation-resistance, radiation-failure, and locally advanced laryngeal tumor growth.
