Abstract
Extra-mucosal laryngectomy for the treatment of radiation-induced non-functional larynx
Highlights
The normal human larynx has three major functions: phonation, breathing and airway protection
The procedure is simple and allows for total conservation of the pharyngeal mucosa with the main advantage being the absence of post-operative fistula
We report a case of nonfunctional larynx-induced chronic aspiration complicated by bilateral lingual paralysis
Summary
The normal human larynx has three major functions: phonation, breathing and airway protection. Total laryngectomy and tracheal diversion are the most definitive performed procedures to manage patients with nonfunctional larynx and chronic aspiration. A 54-year-old, female Caucasian was diagnosed in 2008 for squamous cell carcinoma of the supraglottic larynx and unilateral left sided vocal fold immobility, initially staged as cT3cN1cM0 She underwent chemo-radiotherapy (total dose of 70 Gy combined with 3 cycles of Cisplatin 100mg/m2). Due to the persistence and pejoration of chronic aspiration with the incidence of complicated pneumonia, inability of oral ingestion and failure of all the therapies applied to manage this situation, the decision to perform a total laryngectomy as a definitive procedure was taken. In order to reduce as much as possible the incidence of post-operative fistula, an extra-mucosal laryngectomy was performed The principal of this new surgical procedure is to conserve the totality of the pharyngeal mucosa and avoid any opening of the hypopharyngeal tube. The follow-up at 10 months showed progressive and continued subjective improvement of oral feeding
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