Supracricoid laryngectomy as salvage surgery after failure of radiation therapy

Abstract

Supracricoid laryngectomy can be an alternative in selected patients with a local recurrence after radiotherapy when endoscopic treatment or more conservative external approaches are not indicated. In this study, we reviewed our experience in patients who underwent salvage supracricoid laryngectomies for local recurrence following radiotherapy. Between 1997 and 2005, salvage supracricoid laryngectomy was performed in nine consecutive patients. The primary tumour was located in the glottis in eight cases and in the supraglottis in one case. The reconstruction method consisted of a cricohyoidoepiglottopexy in six cases and a cricohyoidopexy in three. One patient died of a complication associated to salvage treatment and another died as a consequence of a new recurrence of the laryngeal tumour. All patients were decannulated and recovered the ability to swallow. The mean cannulation and nasogastric feeding tube times were 11 and 27 days, respectively. The mean hospitalisation time was 34 days. Six patients had wound healing complications, all of which were solved without further surgery. Laryngeal function was preserved in 78% of the patients treated. In conclusion, supracricoid laryngectomy is an effective technique as salvage treatment in selected cases of local recurrence after radiotherapy and it can be an alternative to total laryngectomy when other methods of salvage conservation laryngeal surgery are not indicated.