LARYNGEAL RECONSTRUCTION AND SURVIVAL AFTER FUNCTION-SPARING LARYNGECTOMY FOR SELECTED T3 AND T4 LESIONS

Most patients lost their vocal ability after ablative surgery for the laryngeal cancer. Total laryngectomy has a history of over 100 years, hence many surgeons are accustomed to the en bloc organ resection and the loss of ability for communication after surgery. The recent advanc e of surgery introduces the concept and technique of radical cure and functional preservation of the cancer-afflicted-organ at same setting. For lesions of late T categories (T3, T4), the maintenance of normal function after wide resection to ensure radicality demands a special t echnique to repair the crippled larynx. For this purpose a local osteo muscular flap was designed to reconstruct a functioning larynx. The su rgical manoeuvre was described and the result proved to be successful. The outcome of 138 patients with T3 and T4 laryngeal carcinomas follo wing conservation laryngectomy was analyzed. The five-year survival ra te was 69% for supraglottic type and 75% for glottic type. The quality of life was much improved.