Vertical Laryngectomy Research Articles

喉頭部分摘出術 遠隔成績からみた適応の検討と新再建法の紹介

The five year survival rates of 55 patients with laryngeal cancer who were treated with partial laryngectomy were 90.2, 73.4 and 0% for glottic, supraglottic and subglottic cancers, respectively.Fourteen cases of recurrence or death due to cancer were reported. The interval between partial laryngectomy and recurrence varied from 6 months to l3 years and 8 months. Eight of the 14 patients lived for five years or more after total laryngectomy.The survival rates of the different T classes show glottic T2 cancer could be treated with partial laryngectomy. Patients with recurrence after radiation treatment are also good candidates for partial laryngectomy.A new method of reconstruction after vertical laryngectomy using a sternocleidomastoid musculocutaneous flap was described.

Imbrication Reconstruction following Partial Laryngectomy

Experience over a 16-year period with 38 patients who underwent partial laryngectomy with imbrication reconstruction is reviewed. We have found this technique to be an expeditious and highly successful means of eradicating T1 or T2 glottic cancer. The use of the patient's own full-thickness, adjacent normal tissue with imbrication of cartilage produces an adequate airway, an almost normal-appearing larynx, and a remarkable posttreatment voice quality, better results than from most cordectomies or vertical hemilaryngectomies. It is valuable as a salvage procedure after full-course radiation. Imbrication laryngoplasty is an alternative and a preferred modality for treatment of young people with early glottic carcinoma for whom the possible carcinogenic properties of radiation must be considered. The survival results are comparable with the more extensive vertical laryngectomies.

Partial laryngectomy following irradiation

Partial laryngectomy after full course of irradiation was performed in 65 patients as a salvage for residual tumors and local recurrences. The results are reviewed and compared to results obtained by primary operation. It appears that in glottic lesions excellent results by vertical laryngectomy may be obtained without increased complication rate due to irradiation. In supraglottic tumors horizontal laryngectomy is accompanied by increased postoperative morbidity and severely impaired function to such a degree that total laryngectomy is the operation of choice for irradiation failures in supraglottic recurrences.

Analysis of surgical therapy for epidermoid carcinoma of the laryngeal glottis.

Four hundred sixty-three patients with glottic carcinoma were treated by surgical techniques with or without preoperative irradiation. Two hundred eighty-one had hemilaryngectomy and 182 total laryngectomy procedures. The overall cure rate for the hemilaryngectomy group was 91 percent and 80 percent for the total laryngectomy group, with an overall cure rate of 87 percent. Our observations support the fact that Stage I glottic carcinoma has slightly better prognosis when treated by hemilaryngectomy. Stage II and III lesions have a significant improvement in cure rate and survival when treated with combined preoperative irradiation and partiall vertical laryngectomy or total laryngectomy than by irradiation alone.

PARTIAL VERTICAL LARYNGECTOMY IN CANCER OF THE LARYNX.

PARTIAL VERTICAL LARYNGECTOMY IN CANCER OF THE LARYNX.