THE SIGNIFICANCE OF PRE-EPIGLOTTIC SPACE INVASION IN SUPRAGLOTTIC LARYNGEAL CARCINOMAS

It is widely accepted that tumoral invasion of the pre-epiglottic spac e (PES) has a significant prognostic importance in supraglottic laryng eal carcinomas. The lymphatics of the supraglottic larynx drain to cer vical lymph nodes via the PES. Since the supraglottic larynx is an emb ryological unit that contains the PES, malignant lesions of this regio n must be resected with en bloc surgery, including the PES. Tumors wit h PES invasion are already considered to be T3 in TNM staging. The pur pose of this study was to review the clinical experience we have had w ith these tumors at Ankara University. The study comprised 150 patient s with squamous cell carcinomas of the supraglottic larynx treated wit h either partial or total laryngectomies. Findings suggested that PES invasion occurred at early stages of supraglottic tumor progression. S uprahyoid epiglottic lesions behaved less aggressively than tumors ori ginating from other supraglottic subsites and did not invade the PES u ntil advanced stages. PES invasion was not considered to be a signific ant prognostic factor because the majority of the supraglottic lesions studied demonstrated PES invasion regardless of cervical lymph node m etastases. Analysis of oncological and functional results revealed tha t en bloc resection of the supraglottis with the PES was facilitated b y preservation of the hyoid bone.