[Fronto-lateral laryngectomy using a combined endolaryngeal external approach]

Area of Science:

• Otolaryngology
• Surgical Oncology
• Laryngeal Cancer Research

Background:

• Functional laryngectomies can lead to significant post-operative sequelae.
• Existing surgical methods may not always preserve laryngeal function optimally.
• Carcinoma of the anterior commissure and vocal cords presents unique surgical challenges.

Purpose of the Study:

• To present a novel surgical technique combining internal and external approaches for laryngeal neoplasms.
• To minimize functional deficits following subtotal or conservative laryngectomies.
• To improve oncological radicalness and functional outcomes for specific laryngeal cancer types.

Main Methods:

• A combined endolaryngeal and external surgical approach is detailed.
• Suspension microlaryngoscopy facilitates precise delimitation of the laryngeal neoplasm.
• The technique involves coordinated internal and external dissections for en bloc tumor removal, including thyroid cartilage.
• Specific steps include thyroid membrane and epiglottis sectioning, and cricothyroid membrane incision.

Main Results:

• The described method allows for precise tumor boundary delineation and radical resection.
• It enables both internal and external sections to be performed under visual control.
• The technique aims to maintain endolaryngeal diameters, preserving function.
• It is particularly suitable for T1 and T2 N0 M0 cordo-commissure carcinomas, including those previously treated with radiotherapy.

Conclusions:

• The combined internal-external approach offers a viable solution for specific laryngeal cancers.
• This technique addresses the need for oncological radicalness while mitigating functional sequelae.
• It provides a potentially improved surgical option for previously irradiated patients with cordo-commissure carcinoma.