Survival and functional results of Pearson's near-total laryngectomy for larynx and pyriform sinus carcinoma

Background. Current treatment for most T3 and T4 transglottic and pyriform sinus carcinomas is total laryngectomy or total laryngectomy with partial p haryngectomy. Voice rehabilitation usually requires the use of a tracheoeso phageal puncture (TEP). Pearson's near-total laryngectomy (NTL) is an optio n for voice preservation in selected cases with no invasion of the interary thenoid space and limited invasion of the subglottis. The purpose of this s tudy is to report the functional and survival results of 42 consecutive pat ients who underwent NTL from 1988 to 1995. Patients and Methods. The patients were 40 men and two women, with a median age of 58 years. All patients had squamous cell carcinoma. There were 37 l arynx and five pyriform sinus tumors. T3 stage tumor represented 85.7% of t he cases. Results. There were complications in 13 patients (28.9%). Vocal quality was considered good in 83.3% of the cases. To date, eight patients presented t umor recurrences: two local, two in the neck, and four distant. The 5-year actuarial overall survival rates were of 81.7% in larynx carcinoma and 66.6 % in pyriform sinus carcinoma. Conclusions. In selected transglottic and pyriform sinus carcinomas, NTL ca n be carried out with acceptable morbidity and a high potential of voice pr eservation and tumor control. (C) 2000 John Wiley & Sons, Inc.