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Published on: March 18, 2020
Oncologic and functional results of near-total laryngectomy
Ricardo Bernáldez1, Marta García-Pallarés, Eduardo Morera
1Department of Otolaryngology, La Paz Hospital, Autonomous University, Madrid, Spain. bernaldezm@seorl.net
Objective:
To report the oncologic and functional outcome of patients undergoing near-total laryngectomy.
Study Design And Setting:
A retrospective analysis was carried out from 1991 through 1998.
Results:
Eighty-seven patients underwent near-total laryngectomy. The Kaplan-Meier overall survival, cause-specific survival, and relapse-free survival estimates at 5 years were 48.2%, 75.8%, and 72.4%, respectively. Univariate analysis revealed prognosis significance for location, stage, and pathologic cervical lymph node status. Five percent of the patients developed local recurrence, 16% recurrence in cervical lymph nodes, and 10% distant metastasis. Pharyngocutaneous fistula was the most frequent complication (48%). Seventy-seven percent of cases achieved voice preservation. Symptomatic aspiration was noted in 12.3% of cases.
Conclusion:
Near-total laryngectomy can be a successful surgical procedure for selected patients; it does not replace total laryngectomy but reduces its indications. Voice preservation can be achieved in most cases.
Significance:
Near-total laryngectomy enhances the speech rehabilitation options for the laryngectomy patient by adding a physiologic, nonprosthetic tissue technique.
