Modified subtotal laryngectomy with cricohyoidoepiglottopexy - Long term results in 81 patients

Background. Standard treatment of early glottic carcinoma is radiotherapy, but involvement of the anterior commissure leads to a reduced cure rate.(1) We investigated retrospectively whether our modified subtotal laryngectomy had improved results for early glottic carcinomas involving the anterior c ommissure, without causing excessive disability to laryngeal functions. Methods. Eighty-one patients with T1 or T2 glottic carcinoma involving the anterior commissure were reviewed. Follow-up was at least 3 years. Speech w as assessed by subjective evaluation and a computer-assisted voice analysis device. Results. Three-year overall survival rate and 3- and 5-year actuarial survi val rates were, respectively, 90.1%, 95%, and 90.8%, with no difference bet ween the different T stages involved (p > 0.46). The local recurrence rate was 7.4%. Speech recovered in all patients and was evaluated as satisfactor y in 86% of cases. Conclusion. For early glottic carcinomas involving the anterior commissure, subtotal laryngectomies appear to be more effective than radiotherapy, and our modified technique simplifies the procedure. (C) 1999 John Wiley & Son s, Inc.