Supracricoid partial laryngectomies after radiation failure: a multi-institutional series.

BACKGROUND: Radiation therapy (RT) is one of the gold standard treatments for early laryngeal cancer, and total laryngectomy is still the most applied surgical procedure after failure. Selected recurrences can be managed by supracricoid partial laryngectomies (SCPLs). METHODS: A multi-institutional retrospective analysis was carried out in 78 consecutive patients treated by SCPLs for the recurrence of glottic-supraglottic cancer after RT. Cricohyoidoepiglottopexy was performed in 62, and cricohyoidopexy (CHP) in 16 cases. RESULTS: Disease-free survival at 3 and 5 years were 95.5%. Early and late postoperative complications occurred in 27% and 17.9% of cases. Decannulation and satisfactory swallowing were achieved in 97.4% of cases. CONCLUSIONS: SCPLs represent effective surgical organ-preservation strategies in the treatment of selected recurrences after RT failure, resulting in a good local control as well as functional recovery with acceptable morbidity, despite a complication rate which is not negligible.

Cervical bronchogenic cyst: asymptomatic neck mass in an adult male.

Bronchogenic cysts are rare congenital malformations of ventral foregut development. They are usually located in the mediastinum and intrapulmonary regions. Localization in the cervical area is unusual and the majority of cases reported have been found in the pediatric population: the literature reports few cases in adults. We describe a 57-year-old male who presented an asymptomatic right lateral neck mass. Diagnostic studies included chest X-ray, pharyngo-esophagus double-contrast X-ray, computed tomography (CT), and bronchoscopy. The mass was excised through a transverse right cervical skin incision. The right lateral neck mass of the patient was identified as a bronchogenic cyst. The embryology, the presentation, the pathological and radiological evaluation, treatment of the cyst and a review of the English literature are reported in this paper. Cervical bronchogenic cysts are usually diagnosed in the pediatric population; these lesions are rare in adults. We suggest that the clinical observation of an asymptomatic lateral neck mass in an adult should include the possibility of a bronchogenic cyst in the differential diagnosis. Surgical excision is the elective treatment for this tumor, in order to prevent complications including infection, compression symptoms, malignant transformation, and the rare but fatal air embolism.

Supracricoid laryngectomies: long-term oncological and functional results.

CONCLUSIONS: Our results confirm that supracricoid laryngectomies (SL) are reliable techniques for glottosupraglottic tumors, even for selected T3 and T4 cases, if the indications are correct. These surgical techniques allow a good quality of life with the preservation of the larynx. OBJECTIVE: SL with cricohyoidoepiglottopexy (CHEP) and cricohyoidopexy (CHP) have been popular over the last 20 years for the treatment of the glottic and/or supraglottic squamous cell carcinoma due to demonstrated good oncological and functional results. We report our experience with these techniques, with special focus on long-term oncological and functional results. PATIENTS AND METHODS: We retrospectively reviewed 206 patients who had undergone SL with CHEP or CHP technique between 1987 and 1998 for glottosupraglottic squamous cell carcinoma in our department. The long-term results for 206 patients with T1-T4 laryngeal carcinomas treated with SL are reported: 90.8% CHEP and 9.2% CHP. The mean follow-up was 62 months. RESULTS: Oncological results: the 5-year actuarial disease-free survival was 85%; the 5-year determinate actuarial survival was 88.3%. Functional results: organ preservation rate was 97%. Phonation was assessed according to the GRBAS scale.