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Published on: March 18, 2020
Supracricoid laryngectomy: oncologic validity and functional safety.
Kwang Jae Cho1, Young Hoon Joo, Dong Il Sun
1Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul, 137-701, Korea.
Summary
Supracricoid laryngectomy (SCL) is a viable oncologic treatment for advanced laryngeal cancer and as a salvage procedure. Postoperative swallowing rehabilitation is crucial to prevent complications like aspiration pneumonia.
Area of Science:
- Otolaryngology
- Surgical Oncology
- Laryngeal Cancer Research
Background:
- Supracricoid laryngectomy (SCL) is a laryngeal-sparing surgical technique.
- Its role in managing locally advanced endolaryngeal cancers and as a salvage procedure requires further elucidation.
- Maintaining laryngeal physiology post-SCL is critical for patient outcomes.
Purpose of the Study:
- To assess the oncologic validity of SCL for advanced endolaryngeal cancers.
- To evaluate SCL as a salvage procedure for recurrent laryngeal cancer.
- To determine the safety and functional outcomes of SCL, including laryngeal physiology preservation.
Main Methods:
- Retrospective review of medical records from 114 patients who underwent SCL.
- Analysis of factors influencing patient survival, decannulation time, and nasogastric tube removal.
- Investigation of postoperative complications, focusing on pulmonary issues and swallowing function.
Main Results:
- SCL demonstrated oncologic validity for locally advanced and salvage cases, with no significant survival difference based on tumor resection extent or prior treatment.
- Adjuvant radiation or chemoradiation post-SCL was associated with significantly lower survival rates.
- Decannulation and nasogastric tube removal were successful in most patients (mean 18.4 and 26.1 days, respectively).
- Oral feeding resumption was delayed in patients undergoing cricohyoidopexy, extended procedures, or salvage surgery.
- Aspiration pneumonia was the most frequent postoperative complication.
Conclusions:
- SCL is a feasible surgical option for locally advanced laryngeal cancers and salvage treatment.
- Effective postoperative swallowing rehabilitation is essential, especially after cricohyoidopexy, extended procedures, and salvage surgery, to mitigate aspiration pneumonia risk.
