Corniculate-cuneiform flap for reconstruction in the extended vertical partial laryngectomy

Area of Science:

• Otolaryngology
• Head and Neck Surgery
• Surgical Oncology

Background:

• Extended vertical partial laryngectomy necessitates arytenoid cartilage removal, increasing the risk of postoperative aspiration due to impaired laryngeal closure.
• Existing reconstructive techniques for this defect have limitations.

Purpose of the Study:

• To evaluate the efficacy of a local, mucosally based corniculate-cuneiform flap for reconstruction after extended vertical partial laryngectomy.
• To assess functional outcomes, including swallowing, voice quality, and tumor recurrence, following this reconstructive approach.

Main Methods:

• A retrospective review of five patients who underwent extended vertical partial laryngectomy with corniculate-cuneiform flap reconstruction.
• Assessment of decannulation status, long-term aspiration, voice quality, and tumor recurrence rates.
• Minimum follow-up of 3 years.

Main Results:

• All five patients were successfully decannulated.
• No long-term aspiration was observed in any patient.
• Patients maintained socially acceptable voice quality.
• No tumor recurrence was noted during the follow-up period.
• Preliminary data indicate potential efficacy in previously irradiated patients.

Conclusions:

• The corniculate-cuneiform flap is an effective reconstructive method for extended vertical partial laryngectomy.
• This technique successfully addresses postoperative aspiration and voice quality concerns.
• The flap shows promise for use in patients with prior radiation therapy.