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Updated: May 20, 2026
Learning Modern Laryngeal Surgery in a Dissection Laboratory
Published on: March 18, 2020
Salvage open partial horizontal laryngectomy: a comprehensive systematic review of oncological and functional
Andy Bertolin1, Alberto Grassetto2, Marco Lionello1
1Otorhinolaryngology Unit, Vittorio Veneto Hospital, Vittorio Veneto, Italy.
Objective:
To evaluate the oncological and functional outcomes of salvage open partial horizontal laryngectomy (OPHL) following failure of transoral laser microsurgery (TOLMS) (chemo)radiotherapy [(C)RT].
Methods:
A comprehensive systematic review was conducted, analysing survival rates (overall survival [OS], disease-specific survival [DSS], and local control [LC]), laryngeal preservation, and functional recovery (decannulation and swallowing) in the salvage setting.
Results:
Salvage OPHL offers oncological outcomes comparable to total laryngectomy (TL) in strictly selected patients. Meta-analyses report 5-year OS rates of 71-83% and LC around 87%. Outcomes are significantly superior for post-TOLMS recurrences compared to post-(C)RT failures. In the post-TOLMS setting, organ preservation reaches 95.3%. Conversely, irradiated tissues are prone to higher morbidity, including chronic oedema, chondronecrosis, and pexy rupture. While functional recovery is substantially longer after RT - with decannulation and nasogastric feeding tube removal times often doubling - the final success rate remains high, with over 90% of patients regaining oral feeding and airway patency within one year.
Conclusions:
Salvage OPHL is a powerful organ-preservation tool. Success depends on rigorous patient selection, accurate restaging (addressing frequent clinical understaging), and the preservation of at least one functional cricoarytenoid unit. While functionally demanding, it provides a superior quality of life compared to TL by avoiding a permanent tracheostoma and maintaining laryngeal voice.
