The Pearson method of "near total" laryngectomy: a radical surgical procedure with preservation of laryngeal phonatory function

Abstract

Patients with advanced T3 and T4 laryngeal and hypopharyngeal carcinoma need surgical treatment--total laryngectomy. Excision of the larynx affects enormously the quality of patient's life. Near total laryngectomy appeared about twenty years ago, and was accepted worldwide during the last decade of the twentieth century. Two years ago we started performing this operative procedure. Although we still don't have great experiance, first results are satisfying. We point to the importance of this procedure especially in developing countries, where phonatory protheses are expensive, patients' education of esophageal speech is not satisfactory and number of those who were successfully trained is small. The aim of this paper was to introduce near total laryngectomy as a surgical procedure which improves quality of life of patients with advanced stages of laryngeal and hypopharyngeal carcinoma. The original procedure described by Pearson was very complicated to understand, so we accepted Monux procedure which is easier. The resection of the laryngeal structures corresponds to those in total laryngectomy, but we spare a small part of cricoid cartilage and whole or 2/3 of the healthy vocal cord. A number of arguments, presented in this paper, speak in favor of near total laryngectomy. This technique has the same oncological results as total laryngectomy, but much better functional results and quality of life in patients with laryngeal and some hypopharyngeal carcinomas.