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Functional results after total cricoidectomy with medial femoral condyle free flap reconstruction

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Abstract

Our goal was to describe a laryngeal-preserving single-stage procedure for the treatment of low-grade chondrosarcomas of the larynx: a total cricoidectomy with medial femoral condyle flap reconstruction. The study was designed as a case series of three consecutive patients with low-grade chondrosarcomas of the cricoid cartilage lamina, diameter 4.4, 5.2, 3.8 cm, respectively, who underwent total cricoidectomy in 2012. Single-staged reconstruction of the defect with medial femoral condyle flap including the periosteum and thin underlying cortical layer of the bone was conducted. Oncologic and functional results were observed during 3 years of follow-up. No evidence of tumor recurrence was detected during follow-up. One month after surgery, all patients were able to tolerate a soft diet and to speak satisfactorily. None of the patients reported aspiration after surgery nor experienced aspiration-related problems, which was confirmed by means of the Leipzig–Pearson scale. The speech ability was good, maximum phonation time was 14, 18, 21 s, respectively, and the voice handicap index scores ranged from 24 to 36 and had improved noticeably at 1, 3 and 6 months follow-up. Two patients were ultimately decannulated, and one female still has a tracheostomy; however, she is able to keep the tracheostoma closed for most of the time, maintaining good phonatory and swallowing functions. Total cricoidectomy with reconstruction by means of medial femoral condyle flap may replace the total laryngectomy in large low-grade chondrosarcomas of the cricoid cartilage.

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Authors and Affiliations

  1. Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Przybyszewskiego 49, 60593, Poznan, Poland

    Jacek Banaszewski, Małgorzata Wierzbicka, Maciej Pabiszczak, Tomasz Pastusiak & Witold Szyfter

  2. Department of Oral and Maxillofacial Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria

    Alexander Gaggl

  3. Private Hospital Maria Hilf, Klagenfurt, Austria

    Heinz Buerger

Authors
  1. Jacek Banaszewski
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  2. Alexander Gaggl
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  3. Heinz Buerger
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  4. Małgorzata Wierzbicka
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  5. Maciej Pabiszczak
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  6. Tomasz Pastusiak
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  7. Witold Szyfter
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Corresponding author

Correspondence to Jacek Banaszewski.

Ethics declarations

We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.

Patient received a written invitation to participate in answering questionnaires and for undergoing functional tests.

Informed consent was obtained prior to operation.

As this is a retrospective study, it was considered that no ethical approval was necessary.

Additional information

The work was done in Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Poland.

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Banaszewski, J., Gaggl, A., Buerger, H. et al. Functional results after total cricoidectomy with medial femoral condyle free flap reconstruction. Eur Arch Otorhinolaryngol 273, 3869–3874 (2016). https://doi.org/10.1007/s00405-016-4017-2

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  • DOI: https://doi.org/10.1007/s00405-016-4017-2

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