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Isoprognostic functional CT map for open partial horizontal laryngectomy.

Andy Bertolin1, Chiara Varago1, Michelangelo Salemi2

  • 1Otolaryngology Unit, Vittorio Veneto Hospital, Vittorio Veneto, Treviso, Italy.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
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PubMed
Summary

Tumor location in the larynx impacts outcomes after open partial horizontal laryngectomy (OPHL). Anterior supraglottic or posterior glottic involvement predicts longer recovery and higher complication risks.

Keywords:
Computerized tomographyDecannulationFunctional outcomeMapOpen partial horizontal laryngectomy

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Area of Science:

  • Otolaryngology
  • Head and Neck Surgery
  • Radiology

Background:

  • Open partial horizontal laryngectomy (OPHL) is a laryngeal cancer treatment.
  • Predicting functional outcomes after OPHL is crucial for patient management.
  • Identifying specific tumor subsites linked to outcomes can refine surgical planning.

Purpose of the Study:

  • To create a radiological map of laryngeal subsites.
  • To correlate tumor involvement in these subsites with functional outcomes post-OPHL.
  • To predict patient functional recovery based on tumor location.

Main Methods:

  • Retrospective analysis of 96 glottic squamous cell carcinoma patients.
  • Contrast-enhanced neck CT scans for radiological staging.
  • Development of a radiological risk map based on functional outcomes (decannulation, feeding tube removal, complications, hospital stay).

Main Results:

  • Anterior supraglottic tumor involvement correlated with longer nasogastric feeding tube (NFT) dependence and hospital stay (p=0.003).
  • Posterior glottic tumor involvement negatively impacted decannulation time and increased postoperative complication likelihood (p=0.000 and p=0.002).

Conclusions:

  • Tumors confined to the anterior glottis with minimal sub/supraglottic extension yield the best functional outcomes.
  • Preservation of the suprahyoid epiglottis and arytenoids is associated with favorable results.
  • Radiological mapping of laryngeal subsites aids in predicting functional outcomes after OPHL.