MANAGEMENT OF BILATERAL GLOTTIC TUMORS

Objective: To compare the rates of cure and complication and the time to decannulation and deglutition in patients undergoing resection of b ilateral glottic tumors. Design: A 22-year, nonrandomized, prospective , retrospective analysis. Setting: Two academic tertiary care referral centers. Participants: Seventy-two patients with bilateral glottic ca rcinoma were treated using bilateral hemilaryngectomy. Depending on th e size of the tumor and the extent of thyroid cartilage resection, pat ients underwent 1 of 3 methods of reconstruction: group 1, placement o f an anterior commissure stent (34 patients); group 2, epiglottic lary ngoplasty (15 patients); and group 3, staged posterior thyroid alar tr ansposition laryngoplasty (23 patients). Intervention: Resection and r econstruction of 72 larynges with bilateral glottic tumors using the b ilateral hemilaryngectomy procedures. Main Outcome Measures: Acceptabl e rates of cure and complication, intervals to decannulation and deglu tition, and quality of speech. Results: High rates of tumor control an d cure, low rates of recurrence and complication, acceptable time to d ecannulation and deglutition, and adequate quality and intelligibility of speech. Conclusions: Bilateral vocal cord carcinoma can be treated surgically with a high degree of tumor control and cure. The use of a ll 3 methods maintained laryngeal function with regard to tracheal dec annulation, oral alimentation, and speech intelligibility.