[Three-quarter laryngectomy. Our experience: indications, surgical technique, results]

Three-quarter laryngectomy is regarded as a supraglottic laryngectomy which has been extended on one side to the glottic plane. Indications are those for supraglottic laryngectomy at the vestibular level and of cordectomy extended to the arytenoid at the glottic level (undamaged lower paraglottic space, preserved motility). Surgical technique includes total removal of the laryngeal vestibule together with the hyoid bone, pre-epiglottic space and one supracricoid hemilarynx (vocal cord, arytenoid, medial wall of the entrance of the pyriform fossa) through an internal, subperichondrial approach. Reconstruction of a new cord on the hemilaryngectomy side is through a triangular strip of the exterior thyroid perichondrium. From 1975 to 1989 44 patients underwent a three-quarter laryngectomy in the authors' department. Functional results were positive in all cases. The oncological results were as follows: 6 recurrences (3 local, 2 locoregional lymph node recurrences and 1 distant metastasis) and 4 primary secondary tumors. 9 patients expired (6 of T, 2 of secondary tumor, 1 of other causes). The actuarial 5-year survival rate for the tumor was 79%.