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Updated: Feb 20, 2026

Learning Modern Laryngeal Surgery in a Dissection Laboratory
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Open Maximal Mucosa-Sparing Functional Total Laryngectomy.

Pavel Dulguerov1, Naif H Alotaibi1, Stephanie Lambert1

  • 1Department of Oto-Rhino-Laryngology - Head and Neck Surgery, Geneva University Hospitals (HUG), Geneva, Switzerland.

Frontiers in Surgery
|October 28, 2017
PubMed
Summary

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Maximal mucosal-sparing total laryngectomy (MMSTL) offers a minimally invasive open approach for voice preservation after radiation. This technique resulted in a low fistula rate and functional voice outcomes in a pilot study.

Area of Science:

  • Otolaryngology
  • Head and Neck Surgery
  • Surgical Oncology

Background:

  • Total laryngectomy post-chemoradiotherapy has high fistula rates, necessitating flap reconstruction.
  • Transoral robotic surgery inspired minimally invasive open techniques for functional total laryngectomy.

Purpose of the Study:

  • To present a minimally invasive open approach for functional total laryngectomy.
  • To evaluate the complication and functional outcomes of this technique.

Main Methods:

  • Retrospective study of 10 patients undergoing open maximal mucosal-sparing functional total laryngectomy (MMSTL) between 2014-2016.
  • Detailed description of the surgical technique.
  • Review of postoperative complications and functional outcomes.
Keywords:
aspirationcomplicationsflap reconstructionroboticssurgical techniqueswallowingtotal laryngectomy

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Main Results:

  • No pedicled flaps were used in the 10 patients.
  • A low fistula incidence of 10% (1 patient) was observed.
  • All patients achieved oral diet resumption and functional tracheoesophageal voice.

Conclusions:

  • Maximal mucosal-sparing functional total laryngectomy (MMSTL) is a viable robotic-free, minimally invasive open technique.
  • MMSTL demonstrates a minimal incidence of complications for functional total laryngectomy.