Extended supracricoid laryngectomy with excision of both arytenoids: the modified reconstructive laryngectomy

Abstract

Conclusion: Modified reconstructive laryngectomy (MRL) with excision of both arytenoid cartilages will expand the range of indications for conservative surgery in the management of cancer of the larynx. Objective: The present work describes a modification of the standard reconstructive laryngectomy procedure, in order to address problems related to aspiration, and to improve functional results. Patients and methods: The study was conducted in Cairo University Hospital. MRL was performed on 14 patients who were scheduled for total laryngectomy. This technique allows for preservation of the superior laryngeal nerves, by fashioning folds of the pharyngeal mucosa to replace the arytenoids. This is followed by reconstruction of the airway through elevation and attachment of the remaining tracheal rings and/or cricoid to the hyoid bone and epiglottis. Results: MRL was successful in all of the 14 patients included in this preliminary study. All of the patients maintained comprehensible speech, and only one required a speaking type of tracheotomy tube.