Laryngeal reconstruction with mucoperiosteum valve following vertical partial laryngectomy for vocal function

Xuelin WANG; Chaofeng XIE; Qinqing HU; Huaisheng YU; Yanzhen YANG; Huaijie LIN; Yingfang CHEN

ABSTRACT

BACKGROUND:

Although the sternohyoid muscular valves are traditionally used as reparative material for functional reconstruction after partial laryngectomy, the late-term results are not so satisfactory.

OBJECTIVE:

To investigate the efficacy of using external layer mucoperiosteum valve of thyroid cartilage to repair the wound surface and reconstruct vocal function.

DESIGN:

A self-controlled observational trial using the patients as subjects.

SETTING:

Department of otolaryngology of a municipal hospital.

PARTICIPANTS:

A total of 57 patients with laryngocarcinoma were selected from the Department of Otolaryngology, Shantou Second People' s Hospital, from June 1998 to May 2004. Among them, there were 56 men and 1 woman who were aged 37 to 78 years with the average age of 60. 38 years and whose disease duration was two months to one year with the average of five months.

METHODS:

In the 57 patients with laryngocarcinoma, their external layer mucoperiosteum valves of thyroid cartilages in the affected side were preserved and inverted into laryngeal cavities, which were used to cover the wound surface and rebuild the vocal fold.MAIN OUTCOME

MEASURES:

The final outcome indices changes in the symtoms and function and Karnofsky scores before and after treatment. Risk indices adverse events and side effects.

RESULTS:

The operations on the 57 patients were successful. The incidence of respiratory tract obstruction and hoarseness in the patients before operation was 38.9% and 98. 1%, but 1.9% and 96. 3% after treatment. Karnofsky score was 40 and 70 before and after treatment, respectively. No complications of pharyngeal stricture occurred in the near and long term.

CONCLUSION:

Vertical partial laryngectomy and laryngeal reconstruction with mucoperiosteum valve are easy to operate. The recovery of the wound surface is good, phonation efficacy is satisfacory, and respiratory function is not affected. The treatment has low incidence of complications and satisfactory long-term results.