Supracricoid partial laryngectomy with cricohyoidoepiglottopexy and cricohyoidopexy for glottic and supraglottic carcinomas

Objectives: To review the patients operated in our department with supracri coid partial laryngectomy with either cricohyoidoepiglottopexy (CHEP) (59 c ases) or cricohyoidopexy (CHP) (10 cases) technique, for primary or recurre nt glottosupraglottic squamous cell carcinoma and compare the technique wit h other surgical or conservative approaches for treatment of laryngeal carc inoma. Methods: From hospital charts, we retrospectively reviewed 69 patien ts who had undergone supracricoid partial laryngectomy with the CUFF or CHP technique between 1983 and 1996 for primary or recurrent glottosupraglotti c squamous cell carcinoma in our department. Statistical evaluation of onco logical and functional results were conducted. Results were compared with o ther surgical and conservative treatment for glottosupraglottic carcinoma o f the larynx that were published previously in the literature, Results: Six ty-nine patients had CHEF or CHP for glottosupraglottic carcinoma of the la rynx. Thirteen percent of the patients received adjuvant radiotherapy, Mini mum follow-up was 2 years or until death. Five-year actuarial survival (Kap lan-Meier method) was 68%. Global local control was achieved in 84% of case s. Among previously untreated patients (n = 54), local control rate was 94. 5%, After 1 year, 92.7% of patients achieved normal swallowing and respirat ion. Salvage total laryngectomy had to be performed in four patients (5.7%) for persistent aspiration and in five patients (7.2%), who were previously treated with radiotherapy, for local recurrence. No permanent tracheostomy or gastrostomy was required. Conclusions: Our experience with supracricoid partial laryngectomy with either CHP or CHEF suggests that this technique is a valuable alternative to radiotherapy for T2-T4 glottosupraglottic carc inomas, particularly those with extension and invasion of the anterior comm issure. It allows for preservation of a good laryngeal function without, al tering the long-term survival, keeping total laryngectomy as a salvage proc edure.