Extended fronto-lateral laryngectomy with simultaneous reconstruction by means of a mucochondral nasal septum flap

As treatment for laryngeal cancers the extended fronto-lateral laryngectomy allows tumor to be removed that involves the glottis with the vestibule of the larynx. Since 1979 we have performed 417 extended fronto-lateral laryn gectomies with simultaneous reconstruction of the anterior part of the lary nx using a mucoperichondral flap from the anterior septum. This operation w as indicated for stage T1b cancer (175 cases), stage T2 tumor (231 tumors) and T3 extended operations with epiglottectomy (11 cases). For the total nu mber of 417 patients operated on, 19 cases during the 5-year period of foll owing had local recurrences that required total laryngectomy. In 11 cases, metastases to the cervical lymph nodes required surgical neck dissection. I n the remaining 387 cases, a normal air passage and a large laryngeal lumen were found. In 15 cases graft rotation into the larynx made respiration an d phonation difficult but without dyspnea occurring. Follow-up to a maximum of 18 years showed that the oncological and functional results after this surgical procedures are encouraging.