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- Title
Is There Still a Role for Salvage Supracricoid Partial Laryngectomy with Cricohyoidoepiglottopexy?
- Authors
Nakayama, Meijin; Okamoto, Tabito; Seino, Yutomo; Okamoto, Makito; Miyamoto, Shunsuke; Matsuki, Takashi
- Abstract
Objective: A history of radiation therapy is known to be a major risk factor promoting postsurgical complications. By comparing the clinical outcomes of supracricoid partial laryngectomy with cricohyoidoepiglottopexy (SCPL‐CHEP) in radiated and nonradiated patients, we investigated the usefulness of salvage SCPL‐CHEP. Method: Among 61 patients who received SCPL‐CHEP between 1997 and 2010, 25 (41%) had received radiation therapy preoperatively and 36 (59%) had not. Staging error, wound infection, accuracy of surgical margin determination, acquired laryngeal function, and prognosis were compared between the two groups. Results: Staging error occurred in 5 out of 25 (20%) irradiated and 13 out of 36 (36%) nonirradiated patients. Wound infection developed in 11 out of 25 (44%) irradiated and 5 out of 36 (14%) nonirradiated patients. Delayed wound infection (eg, infection appearing more than 1 month after an uneventful postsurgical course) was identified in 4 patients with a radiation dose over 65 Gy. Intraoperative margin study demonstrated dysplastic or positive margin in 13 out of 25 (52%) irradiated and 9 out of 36 (25%) nonirradiated patients. Swallowing function (ability to eat out) was acquired in 23 out of 25 (92%) irradiated and 32 out of 36 (89%) nonirradiated patients. Five‐year overall survival rates were 83% in both groups. Conclusion: Risk of infection was significantly higher in irradiated patients; delayed infection should be appropriately managed. Functional and oncological results were stable regardless of radiation history. When salvage SCPL‐CHEP is the only option to save a functioning larynx, head and neck surgeons are encouraged to take reasonable risks in performing SCPL‐CHEP.
- Subjects
LARYNGECTOMY; RADIOTHERAPY; SALVAGE therapy
- Publication
Otolaryngology-Head & Neck Surgery, 2011, Vol 145, pP68
- ISSN
0194-5998
- Publication type
Abstract
- DOI
10.1177/0194599811416318a90