Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2009
Endoscopic partial supraglottic laryngectomies: techniques and results.
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Remacle Marc, Lawson Georges, Hantzakos Anastasios, Jamart Jacques
Аннотация
OBJECTIVE: The aim of this study was to evaluate long-term results of endoscopic surgery for supraglottic carcinoma.
STUDY DESIGN: Case series with chart review.
SETTING: Tertiary care university hospital.
SUBJECTS AND METHODS: From 1992 to 2004, 45 patients diagnosed with supraglottic squamous cell carcinoma (two Tis, nine T1N0, 27 T2N0, two T2N1, one T2N2, four T3N0) underwent different types of endoscopic supraglottic laryngectomies according to the European Laryngological Society (ELS) classification: three limited excision (type I); 27 medial without resection of the preepiglottic space (type IIb); one medial with resection of the preepiglottic space (type IIIa); three medial with resection of the preepiglottic space (type IIIb); nine lateral (type IVa); two lateral (type IVb).
RESULTS: Overall survival was 93 +/- 4 percent (SE) after three years and 89 +/- 6 percent (SE) after five years. The median follow-up is 3.7 years. Patients with clinically N0 necks were found to have positive nodes in eight (19%) cases. Two cases of postoperative hemorrhage were controlled by electrocautery. All of the patients without previous treatment for larynx cancer regained swallowing function within five days to three weeks after surgery. Mean duration of hospitalization was 12.5 days.
CONCLUSION: Endoscopic partial laryngectomies, as defined by the ELS classification, for selected supraglottic squamous cell carcinoma proved to be an excellent alternative to radiotherapy and open neck surgery.
STUDY DESIGN: Case series with chart review.
SETTING: Tertiary care university hospital.
SUBJECTS AND METHODS: From 1992 to 2004, 45 patients diagnosed with supraglottic squamous cell carcinoma (two Tis, nine T1N0, 27 T2N0, two T2N1, one T2N2, four T3N0) underwent different types of endoscopic supraglottic laryngectomies according to the European Laryngological Society (ELS) classification: three limited excision (type I); 27 medial without resection of the preepiglottic space (type IIb); one medial with resection of the preepiglottic space (type IIIa); three medial with resection of the preepiglottic space (type IIIb); nine lateral (type IVa); two lateral (type IVb).
RESULTS: Overall survival was 93 +/- 4 percent (SE) after three years and 89 +/- 6 percent (SE) after five years. The median follow-up is 3.7 years. Patients with clinically N0 necks were found to have positive nodes in eight (19%) cases. Two cases of postoperative hemorrhage were controlled by electrocautery. All of the patients without previous treatment for larynx cancer regained swallowing function within five days to three weeks after surgery. Mean duration of hospitalization was 12.5 days.
CONCLUSION: Endoscopic partial laryngectomies, as defined by the ELS classification, for selected supraglottic squamous cell carcinoma proved to be an excellent alternative to radiotherapy and open neck surgery.