Comparison of long-term functional results between standard supracricoid laryngectomy and modified technique with sternohyoid muscle

Selçuk Güneş,Kadir Serkan Orhan,Bora Başaran,Mehmet Çelik,Erkan Kıyak

doi:10.1016/j.bjorl.2018.02.007

Selçuk Güneş, Kadir Serkan Orhan + Show 3 more

Open Access

https://doi.org/10.1016/j.bjorl.2018.02.007

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Abstract

IntroductionLaryngeal cancer is the most common cancer of the upper respiratory tract. The main methods of treatment included surgery (partial laryngectomy and total laryngectomy) and radiation therapy. Laryngeal dysfunction is seen after both treatment modalities. ObjectiveThe aim of the study is to compare postoperative functional results of the standard supracricoid partial laryngectomy technique and a modified supracricoid partial laryngectomy technique using the sternohyoid muscle. MethodsIn total, 29 male patients (average years 58.20±9.00 years; range 41–79 years) with laryngeal squamous cell carcinoma who underwent supra cricoid partial laryngectomy were included. The patients were divided into two groups in terms of the surgical techniques. In Group A, all patients underwent standard supracricoid partial laryngectomy technique between January 2007 and November 2011. In Group B, all patients underwent modified supracricoid partial laryngectomy between August 2010 and November 2011. Fiberoptic endoscopic evaluation of swallowing test, short version of the voice handicap index scores, and the MD Anderson dysphagia inventory, the time of oral feeding and the decanulation of the patients after surgery of each groups were compared. ResultsThe mean maximum phonation time was 8.68±4.21s in Group A and 15.24±6.16s in Group B (p>0.05). The S/Z (s/s) ratio was 1.23±0.35 in Group A and 1.08±0.26 in Group B (p>0.05); the voice handicap index averages were 9.86±4.77 in Group A and 12.42±12.54 in Group B (p>0.05); the fiberoptic endoscopic evaluation of swallowing test averages were calculated as 12.73±3.08 in Group A and 13.64±1.49 in Group B (p>0.05). In the MD Anderson dysphagia inventory, evaluation of swallowing, the emotional, physical, and functional scores were 29.21±4.11, 32.21±6.85, and 20.14±2.17 in the Group B, and 29.20±2.54, 32.4±4.79, and 19±1.92 in Group A, respectively. ConclusionAlthough there is no statistical difference in functional outcome comparisons, if rules are adhered to in preoperative patient selection, modified supracricoid partial laryngectomy can be applied safely and meaningful gains can be achieved in functional outcomes.

Highlights

Laryngeal cancer is the most common cancer of the upper respiratory tract
Supracricoid partial laryngectomy (SCPL), which is an alternative technique to total laryngectomy, was first described by Meyer and Rieder in 1959.1 The aim of this technique is to remove the tumor without using permanent tracheostomy and to preserve swallowing and speech functions.[2,3]
We explored the comparison of the functional results, feeding time, decanulation time, and complications of the standard SCPL (SSCPL) and the modified SCPL (MSCPL) using the sternohyoid muscle

Summary

Introduction

Laryngeal cancer is the most common cancer of the upper respiratory tract. The main methods of treatment included surgery (partial laryngectomy and total laryngectomy) and radiation therapy. Methods: In total, 29 male patients (average years 58.20 ± 9.00 years; range 41---79 years) with laryngeal squamous cell carcinoma who underwent supra cricoid partial laryngectomy were included. In Group A, all patients underwent standard supracricoid partial laryngectomy technique between January 2007 and November 2011. In Group B, all patients underwent modified supracricoid partial laryngectomy between August 2010 and November 2011. Fiberoptic endoscopic evaluation of swallowing test, short version of the voice handicap index scores, and the MD Anderson dysphagia inventory, the time of oral feeding and the decanulation of the patients after surgery of each groups were compared. Supracricoid partial laryngectomy (SCPL), which is an alternative technique to total laryngectomy, was first described by Meyer and Rieder in 1959.1 The aim of this technique is to remove the tumor without using permanent tracheostomy and to preserve swallowing and speech functions.[2,3]

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