Partial laryngectomies: when the problem is the pexy.

Area of Science:

• Otolaryngology
• Surgical Oncology
• Laryngeal Pathology

Background:

• Pexy is a surgical technique used in partial laryngectomies.
• Complications can arise post-operatively, impacting patient recovery.
• Rupture or detachment of the pexy line is a recognized, though infrequent, complication.

Purpose of the Study:

• To analyze complications associated with pexy.
• To identify clinical manifestations suggesting pexy line rupture/detachment.
• To determine optimal diagnostic techniques and treatments for pexy rupture.

Main Methods:

• Retrospective chart review of patients with oncological laryngeal pathologies.
• Study conducted at a tertiary university referral center (University Hospital of Modena).
• Analysis of medical records from May 2003 to March 2012, identifying 10 cases of pexy rupture.

Main Results:

• Clinical manifestations included dysphagia, altered hypopharyngeal/laryngeal sensitivity, fever, infection, wound diastasis, bleeding, dysphonia, and aspiration pneumonia.
• Diagnosis was achieved through endoscopic evaluation, radiological imaging, or intraoperative findings during revision surgery.
• Surgical treatment combined with swallowing rehabilitation led to progressive functional recovery.

Conclusions:

• Pexy line rupture is a post-operative complication of partial laryngectomies.
• Specific clinical signs can indicate pexy rupture, facilitating early diagnosis.
• Prompt diagnosis and treatment, including surgical intervention and rehabilitation, are crucial for functional recovery.