방사선조사후 재발한 후두암에서 상윤상후두부분절제술의 의의

Abstract

Background and Objectives: Recurrent laryngeal cancer after radiotherapy was mainly treated by total laryngectomy because of multifocal recurrent site, delayed diagnosis and inaccurate surgical margin, etc. Recently, it is possible to preserve voice function through conservative laryngeal surgery in case of radiation failed laryngeal cancer with strict application of indication. In this study, authors studied the curability of surpracricoid partial laryngectomy for radiation failed laryngeal cancers. Materials and Methods: We analyzed retrospectively 18 radiation failed laryngeal cancer patients who were treated with supracricoid partial laryngectomy with cricohyoidopiglottopexy (CHEP) or cricohyoidopexy (CHP), from May 1996 through September 2000. Their recurrent TNM stage were T1 in 7 patients, T2 in 7 patients, T3 in 3 patients, T4 in 1 patient. Evaluation of oncological and functional results were conducted. Mean follow-up period was 22 months. Results: Local recurrence occured in 1 patient (6%) and cricoid perichondritis in 5 patients (28%), pharyngocutaneous fistula in 1 patient (6%) after operation. Four patients (22%) had to be treated with completion laryngectomy. Voice function were preserved in 14 patients (78%). Conclusion: Our experience with supracricoid partial laryngectomy with CHEP or CHP suggests that this technique can be a valuable alternative to total laryngectomy in radiation failed laryngeal cancer. (J Clinical Otolaryngol 2000;11:280-285)