SUPRACRICOID PARTIAL LARYNGECTOMIES IN THE ELDERLY - MORTALITY, COMPLICATIONS, AND FUNCTIONAL OUTCOME

A review of the postoperative course, complications, and functional ou tcome of 69 elderly patients (older than 65 years of age) consecutivel y managed with a supracricoid partial laryngectomy between 1977 and 19 93 is presented. The tumors were glottic and supraglottic in origin in 53 and 16 patients, respectively. A cricohyoidoepiglottopexy, a trach eo-cricohyoidoepiglottopexy, and a cricohyoidopexy were performed in 4 8, five, and 16 patients, respectively. Immediate laryngeal, cervical, and medical complications were noted in 5.8%, 10.2%, and 10.2% of pat ients, respectively. Supracricoid partial laryngectomies never resulte d in perioperative or postoperative death. The 5-year actuarial surviv al and local control estimates were 68%, and 93.9%, respectively. Late surgical complications included laryngocele, laryngeal stenosis, and pneumonia hom aspiration-related death in 4.3%, 4.3%, and 1.4% of pati ents, respectively. Completion total laryngectomy, permanent gastrosto my, and permanent tracheostomy were requested in 1.4%, 1.4%, and 2.9% of patients, respectively. Overall a 92.8% laryngeal preservation rate was achieved. Univariate analysis of the potential correlation of dif ferent factors with the mortality incidence and causes, the incidence and type of the various complications, and the incidence for postopera tive aspiration is presented.