SUPRACRICOID PARTIAL LARYNGECTOMIES - ONCOLOGIC AND FUNCTIONAL RESULTS

Background. The authors present their study on oncologic and functiona l results of supracricoid partial laryngectomies (SPL) performed on 14 9 patients between January 1984 and December 1995. Methods. Cricohyoid opexy (CHP) was carried out on 98 patients and cricohyoidoepiglottopex y (CHEP) on 51 patients. The patients were divided into two groups. Th e first group included those operated on between January 1984 and Dece mber 1992 and who therefore had a minimum follow-up period of 3 years. The second group included those operated on after December 1992 and w ho therefore had a follow-up period of less than 3 years. The statisti cal evaluation of this second group was carried out using an actuarial method according to Kaplan-Meier. Results. In the first group, surviv al rate (regarding disease-related deaths) was 94% (95/101), whereas i n the second group, survival rate was 95%. There were 9 recurrences in the 149 patients (6.71%), 8 of which occurred after CHP (6 for tumor [T] and 2 for node [N]) and 1 (for T) after CHEF. Three of the 6 recur rences for T after CHP occurred in the hypopharynx, 2 in the peristoma l area, and 1 in the arytenoid area. The only recurrence for T after C HEF occurred in the paraglottic area. Decannulation was carried out in 85.7% of CHP patients (84/98) and in 98% of CHEF patients (50/51). Th e nasogastric tube was kept in position for an average of 28 days (ran ge, 15-90 days) in the CHP patients and 15 days (range, 9-90 days) in the CHEF patients. Swallowing was excellent; only a small number of pa tients (n = 21) were forced to assume a particular posture during meal s. Phoniatric controls performed on 104 patients also showed adequate speech recovery. Conclusions. If the indications are applied scrupulou sly, CHEF is a valid alternative to partial laryngeal surgery and CHP is a possible alternative to total laryngectomy in the treatment of gl ottic and supraglottic tumors. (C) 1998 John Wiley & Sons, Inc.