[Voice function of the platysma skin and sternohyoid muscle composite flap for reconstructing hemilaryngeal defects after vertical partial laryngectomy: a prospective cohort study].

Objective: To evaluate the voice outcomes of of the platysma skin and sternohyoid muscle composite flap in reconstructing hemilaryngealdefects following vertical partial laryngectomy (VPL). Methods: This study enrolled 26 patients with T2-T3 glottic carcinoma treated in the Otorhinolaryngology department of Sun Yat-sen Memorial Hospital, Sun Yat-sen University, from December 2021 to September 2024.There were 24 males and 2 females, with an age range of 41-75 (69.2±9.2) years. All patients underwent VPL with platysma-sternohyoid muscle composite flap reconstruction (composite flap group). Postoperative assessments included oncologic outcomes, stroboscopy, aerodynamic testing, and subjective voice evaluation. Patients who underwent sternohyoid muscle flaps reconstruction during the same period were selected as the control group, consisting of 23 males and 0 females, aged 41-79 (60.0±9.3) years. Statistical analysis was performed using independent samples t-test, Mann-Whitney U tests, or chi-square tests. Results: Among the 26 patients in the composite flap group, the 2-year overall survival rate was 100.00%, and the disease-free survival rate was 95.83%. The fundamental frequency (F0) in the composite flap group was significantly lower than that in the sternohyoid muscle flap group [139.4 (118.8, 172.0) Hz vs. 188 (143.8, 274.3) Hz, F=137.5,P=0.001], whereas, the maximum phonation time (MPT) was longer [8.4 (6.2, 11.0) s vs. 5.0 (4.0, 8.3) s, F=159.5,P=0.005]. The composite flap group showed better breathiness (B) scores (P=0.086) as well as more favorable laryngeal morphology and higher rates of detectable flap vibrational wave. Conclusion: The short-term postoperative voice quality of patients who underwent platysma skin-sternohyoid muscle composite flap reconstruction for VPL-related hemilaryngeal defects is significantly superior to those who received sternohyoid muscle flap reconstruction.