THE TREATMENT OF PRIMARY RECURRENCE FOLLOWING LARYNGECTOMY FOR LARYNGEAL CARCINOMA

Of the 397 patients undergoing total laryngectomy for squamous cell ca rcinoma by Professor P. M. Stell between 1963 and 1991, 73 are known t o have suffered a local recurrence. Of these, 17 were treated by radio therapy and/or further surgery. Secondary surgery was reserved for sel ected cases of peristomal and pharyngeal recurrence: of the 35 peristo mal recurrences, eight were treated surgically. Previous reports of re currence after total laryngectomy have focused on the problem of peris tomal recurrence. Patients with pharyngeal recurrences can also be tre ated satisfactorily with microvascular surgical reconstruction techniq ues. Though rarely curative, secondary total pharyngectomy can be high ly palliative and results in little additional morbidity.