Survival and life quality evaluation on advanced laryngeal cancer treated with modified supracricoid partial laryngectomy / 中国耳鼻咽喉头颈外科

OBJECTIVE To evaluate the survival and functional outcomes of advanced laryngeal squamous cell carcinoma after modified supracricoid partial laryngectomy(SCPL).METHODS We selected 65 laryngeal cancer patients treated with modified supracricoid partial laryngectomy from 2002 to 2015 in our hospital.Among them,62 cases were males,3 cases were females with an age ranged from 35 to 80 years(median age 58 years)There were 26 cases with T2 stage,32 cases with T3 stage and 7 cases with T4 stage.We selected 120 laryngeal cancer patients treated with vertical partial laryngectomy at the same period as control.Then we evaluated the functional outcomes of modified supracricoid partial laryngectomy group compared with vertical partial hemilaryngectomy group.RESULTS The 5-year cumulative survival rate and decannulation rate were 82.3％ and 98.3％ for supracricoid laryngectomy group respectively.Decannulation ratewas 86.1％ for vertical partial hemilaryngectomy group(P＜0.05).However,there was no significant difference between supracricoid partial laryngectomy group and vertical partial laryngectomy group in pronunciation evaluation and abnormal deglutition.CONCLUSION Modified supracricoid partial laryngectomy is a good choice for local advanced laryngeal squamous cell carcinoma.

Supracricoid partial laryngectomy in recurrent or advanced laryngeal cancer / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Advanced or recurrent laryngeal cancers after chemoradiotherapy were mainly treated by total laryngectomy because of inadequate surgical margin, multifocal recurrent site, and delayed diagnosis. Recently, voice preservation through conservative laryngeal surgery in case of advanced or recurrent laryngeal cancer with strict application of surgical indication became possible. In this study, authors studied the usefulness of surpracricoid partial laryngectomy (SCPL) for advanced or recurrent laryngeal cancers is discussed. MATERIALS AND METHOD: Twenty-five laryngeal cancer cases of cricohyoido-epiglottopexy (CHEP) or cricohyoidopexy (CHP) from May 1996 through April 2001 were analysed retrospectively. In recurrent cases after radiotherapy, there were 8 cases with glottic T1, 6 with T2, 3 with T3, one with T4, one with supraglottic T2 and T3. In advanced cases without radiotherapy, there were 3 cases with glottic T3 and 2 with supraglottic T3. Evaluation of oncological and functional results were conducted. The mean follow-up period was 29.1 months. RESULTS: Local recurrence occurred in 1 patient (4.3%) and cricoid perichondritis in 5 patients (21.7%), laryngocutaneous fistula in 1 patient (4.3%) after the operation. Four patients (17.3%) had to be treated with completion laryngectomy. Voice function was preserved in 19 patients (82.7%). CONCLUSION: Our experience with supracricoid partial laryngectomy with CHEP or CHP suggests that this technique can be a valuable alternative to the total laryngectomy in the recurrent or advanced laryngeal cancer.

Evaluation of the Voice Parameters Following Supracricoid Partial Laryngectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Conservation laryngeal surgery is designed to remove the cancer mass completely while preserving the physiologic functions of the larynx. Recently, the supracricoid partial laryngectomy (SCPL) has broadened the spectrum of reliable techniques available to conservation laryngeal surgeons. Much research has been devoted to the surgical technique and oncological results of SCPL, but only a few signi6cant objective reports of the phonatory results are available presently. This study was designed to analyze the phonatory results achieved after SCPL for laryngeal cancer. MATERIALS AND METHODS: Selected characteristics of the speech and voice were compared in 25 patients who had undergone SCPL and 10 normal adult laryngeal (NAL) speakers. Durational and frequency features were analyzed with the CSL and the MDVP. RESULTS: SCPL speech proved comparable to NAL speech at the average fundamental frequency. SCPL spech and voice were statistically less efficient than NAL speech in jitter, shimmer, harmonics-to-noise ratio, mean airflow rate, maximal phonation time, and subglottic pressure (p<0.01). The completion of an arytenoid cartilage resection and/or anterior cricoid cartilage removal did not statistically modify the durational and frequency features of SCPL speakers (p <0.01). CONCLUSION: The voice parameters of SCPL speakers were different from those of the NAL speakers, but patients were thought to be allowed social interaction.

Evaluation of the Swallowing after Supracricoid Partial Laryngectomy with Modified Barium Swallow / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Supracricoid partial laryngectomy is popular due to its satisfactory oncological and functional outcomes in selected laryngeal cancers. Their postoperative management is now well codified, but functional failures still persist. The aims of this study were to analyze the deglutition modification induced by these intervention and to plan a better rehabilitation program of swallowing. MATERIALS AND METHOD: For the evaluation of swallowing function, the swallowing analysis was performed by following the videofluoroscopic evaluation using the modified barium swallow (Logemann, 1983) in 14 laryngeal cancer patients. RESULTS: Asymptomatic aspiration was observed in 4 patients (28.6%), especially in patients with the extended procedures (p=0.032) and delayed decannulation (p=0.035). Aspiration was associated with faulty backward tilting of epiglottis and inadequate movement of the base of tongue (p<0.05). CONCLUSIONS: In planning the swallowing rehabilitation program after supracricoid partial laryngectomy, recuperation of proper epiglottic movement, which is promoted by exercise of backward tongue movement, is the most important concern.

Comparison of Vocal Function before and after Supracricoid Partial Laryngectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Supracricoid partial laryngectomy (SCPL), one of the conservative techniques for supraglottic laryngectomy, can be used to control advanced laryngeal cancers extending to paraglottic space, thyroid cartilage with or without epiglottis and preepiglottic space. This procedure can preserve physiologically phonatory and swallowing function, and achieve similar local control rates as total laryngectomy but voice quality is somewhat less efficient than that of normal speakers. Authors evaluated prospectively speech and voice parameters for efficiency of phonation in patients treated with SCPL for recurrent laryngeal carcinoma after primary radiotherapy. MATERIALS AND METHODS: Authors compared 5 male patients who underwent SCPL with 8 normal subjects of the same age. RESULTS: No significant difference of phonatory function was found between subjects before or 3 to 6 months after the operation. However, MPT, C/B, jitter and shimmer were significantly different between the normal and post-operative 3 months group (p<0.05) and jitter and shimmer between the normal and post-operative 6 months group (p<0.05). CONCLUSION: All patients complained of breathy voice but could not breathe through the oro-nasal airway and swallow without aspiration within 2 to 3 months after SCPL. In conclusion, SCPL is a recommendable procedure in selected cases of laryngeal cancer which can not be controlled by vertical partial laryngectomy or supraglottic laryngectomy.