Extended partial laryngectomy with functional preservation using the rotational crico-thyrotracheopexy

Area of Science:

• Otolaryngology
• Head and Neck Surgery
• Surgical Oncology

Background:

• Advanced glottic tumors involving commissures and subglottic regions pose oncological and functional challenges.
• Traditional conservation surgeries have limitations in resection extent and functional outcomes.
• Extended vertical hemilaryngectomy is oncologically optimal but often necessitates total laryngectomy due to reconstruction limitations.

Purpose of the Study:

• To evaluate the efficacy of single-stage extended vertical partial laryngectomy with rotational crico-thyrotracheopexy for advanced glottic tumors.
• To assess the oncological safety and functional outcomes, including airway, voice, and swallowing.

Main Methods:

• Eight patients with vocal fold malignancy and subglottic extension underwent extended vertical partial laryngectomy with rotational crico-thyrotracheopexy.
• Functional outcomes were assessed using objective and subjective tests.

Main Results:

• All patients achieved tumor-free margins histologically.
• Successful decannulation within two weeks was observed in all patients.
• Patients maintained a stable airway, reported socially acceptable voice, and enabled oral feeding in seven cases.

Conclusions:

• Rotational crico-thyrotracheopexy is an effective single-stage reconstruction for large laryngeal defects after extended vertical hemilaryngectomy.
• This technique is suitable for advanced unilateral glottic tumors with supra/subglottic invasion.
• It achieves adequate airway, acceptable voice, and safe swallowing without compromising oncological outcomes.