Hemicricoidectomy for voice rehabilitation following hemilaryngectomy withipsilateral arytenoid removal

The purpose of this article is to describe an approach to reconstruction of the larynx after vertical partial laryngectomy with removal of the ipsilat eral arytenoid cartilage. This method addresses the problem of postoperativ e posterior glottal incompetence (aphonia with or without aspiration). The technique involves resection of the ipsilateral half of the cricoid cartila ge, use of an inferiorly based strap muscle flap for vocal fold reconstruct ion, and placement of a customized stent. This technique may be used at the time of the primary cancer extirpation or as a secondary rehabilitative pr ocedure. Generally, patients who have undergone this procedure have had min imal postoperative breathiness with good phonatory and airway function. We recommend this reconstructive technique for patients with large posterior d efects following hemilaryngectomy.