Oncological and functional outcomes of supracricoid partial laryngectomy

Abstract

Objective: The aim of this study is to review the oncological outcomes of T1-T4 glottic or supraglottic tumor patients who underwent supracricoid partial laryngectomy in our clinic.

Material and Methods: A total of 43 patients with laryngeal squamous cell carcinoma who underwent supracricoid partial laryngectomy between January 2014 and December 2016 in the Otorhinolaryngology Department of Istinye University Hospital were retrospectively analyzed. Postoperative data of these patients regarding surgical margin, nasogastric feeding tube removal time, decannulation time, postoperative radiotherapy, local regional recurrence, and distant metastases were recorded.

Results: Cricohyoidoepiglotopexy was applied to 16 patients by preserving both arytenoids and applied to 7 patients with a single arytenoid; Cricohyoidopexy was applied to 14 patients with both arytenoids preserved, and 6 patients were treated with a single arytenoid.The five-year survival was compared for Cricohyoidopexy/Cricohyoidoepiglotopexy with single arytenoid to double arytenoid preservation and found to be 80%-76% (p=0.56). The mean 5-year survival was 88% in the post-operative radiotherapy group, and 86% in the non- radiotherapy group. The study compared patients with Cricohyoidopexy/Cricohyoidoepiglotopexy with a single arytenoid to those with double arytenoid preservation; the mean decannulation time was 54.23±34.12 to 35.62±27.08 (p=0.05). Postoperative radiotherapy prolonged the decannulation time (51.16±38.5 versus 32.68±20.1; p=0.043). The duration of nasogastric tube placement in the Cricohyoidopexy/Cricohyoidoepiglotopexy with a single arytenoid group was 50.3±14.3 and double arytenoid preservation was 35.17±32.9 (p=0.088). Nasogastric tube removal time was 53.29±50.2 in the post-operative radiotherapy group and was 30.24±16.8 in patients who did not receive post-operative radiotherapy (p=0.040).

Conclusion: Supracricoid partial laryngectomy with Cricohyoidoepiglotopexy and Cricohyoidopexy had satisfactory oncological outcomes, and laryngeal function was preserved by rebuilding the neolarynx.