Oncological and functional results by horizontal glottectomy in laryngeal carcinomas

The aim of this study is to describe the indications, surgical technique and results of horizontal glottectomy in laryngeal carcinomas.

Twenty patients suffering from differentiated glottal carcinoma (15 T1b and 5 T1a) were treated between 1985 and 1994. A classic horizontal glottectomy, with some modifications, not extended to the ventricular fold or to the arytenoid, was performed in every patient. All patients followed a postoperative rehabilitative program. Time of feeding tube removal, decannulation and voice production were considered.

No local recurrence was recorded in any of the patients, however follow up on 4 cases was only three years. No postoperative radiotherapy was used. Two patients died from cardiovascular causes. Post-operative average times were: discharge from hospital after 10.5 days; feeding tube removal after 7 days; decannulation after 9.5 days. No major pulmonary complications nor laryngeal stenosis following surgery was recorded. In all patients adequate voice production was achieved.

Our results show that horizontal glottectomy is a safe procedure in the treatment of laryngeal cancer. Local control of disease, provided case selection is very accurate, can reach 100%. Rapid and excellent laryngeal function may thus be obtained and the voice production is adequate in every patient.