[Anatomic and functional results in fronto-laterally laryngectomized patients]

The present work reports the experience acquired on 33 males who had undergone fronto-lateral laryngectomy at least three years before. The patients were divided into 4 groups according to cord neoplastic extension: 1) in 9 subjects the neoplasm was localized to the anterior half or two-thirds of the vocal cord; 2) in 9 others the entire vocal cord was involved; 3) in 8 the tumor extended forward to the median line; that is to the anterior commissure; 4) in 7 either the ventricle (4 cases) or the subglottis zone (3) were involved. In 30 cases (90%) complete clinical healing was achieved; for 14 survival has exceeded the conventional 5-year limit. Two of the three recurrences were remedied by total laryngectomy for which follow-up has proved favorable for over 5 years. In regard to functional results both phonatory and respiratory results have proved satisfactory. In regard to the latter, due to insufficient endolaryngeal calibration of the scar tissue, it proved impossible to remove the tracheal cannula in three cases. Based on the results obtained the validity of the fronto-lateral laryngectomy in terms of oncology and functional results is underlined. The authors fully agree with the caution generally taken in terms of indications. However, at the same time, they feel that careful clinical-radiological evaluation, supported by intraoperative findings as well as extemporaneous testing, makes it possible to rely on this form of surgery in cases of unilateral cord tumours of different extensions, although naturally within the limitations of oncological radicality.