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Management of bilateral glottic tumors
1Department of Otolaryngology, Mount Sinai Medical Center, New York, NY 10029, USA.
Objective:
To compare the rates of cure and complication and the time to decannulation and deglutition in patients undergoing resection of bilateral glottic tumors.
Design:
A 22-year, nonrandomized, prospective, retrospective analysis.
Setting:
Two academic tertiary care referral centers.
Participants:
Seventy-two patients with bilateral glottic carcinoma were treated using bilateral hemilaryngectomy. Depending on the size of the tumor and the extent of thyroid cartilage resection, patients underwent 1 of 3 methods of reconstruction: group 1, placement of an anterior commissure stent (34 patients); group 2, epiglottic laryngoplasty (15 patients); and group 3, staged posterior thyroid alar transposition laryngoplasty (23 patients).
Intervention:
Resection and reconstruction of 72 larynges with bilateral glottic tumors using the bilateral hemilaryngectomy procedures.
Main Outcome Measures:
Acceptable rates of cure and complication, intervals to decannulation and deglutition, and quality of speech.
Results:
High rates of tumor control and cure, low rates of recurrence and complication, acceptable time to decannulation and deglutition, and adequate quality and intelligibility of speech.
Conclusions:
Bilateral vocal cord carcinoma can be treated surgically with a high degree of tumor control and cure. The use of all 3 methods maintained laryngeal function with regard to tracheal decannulation, oral alimentation, and speech intelligibility.