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Salvage supracricoid laryngectomy after failed radiotherapy and partial laryngectomy

Published online by Cambridge University Press:  30 December 2014

M Nakayama ,
S Miyamoto ,
S Okabe  and
M Okamoto
M Nakayama*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Kitasato University School of Medicine, Sagamihara, Japan
S Miyamoto
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Kitasato University School of Medicine, Sagamihara, Japan
S Okabe
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Kitasato University School of Medicine, Sagamihara, Japan
M Okamoto
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Kitasato University School of Medicine, Sagamihara, Japan
*
Address for correspondence: Dr M Nakayama, Department of Otorhinolaryngology – Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa 252-0374, Japan Fax:+81–42–778–8441 E-mail: meijin@med.kitasato-u.ac.jp
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Abstract

Background:

A case of salvage supracricoid laryngectomy with cricohyoidoepiglottopexy after failed radiation therapy and vertical partial laryngectomy had successful oncological and functional outcomes. This is the first reported application of salvage supracricoid laryngectomy with cricohyoidoepiglottopexy after the failure of two major treatments.

Case report:

A 65-year-old man was referred for salvage supracricoid laryngectomy with cricohyoidoepiglottopexy. The right recurrent hemilarynx was successfully resected. After pexis, the right lobe of the thyroid gland was repositioned to overlap and reinforce the pexis gap and fill the devoid portion of the strap muscular closure. Multiple scattered foci (recurrent tumour–node–metastasis stage T2) were identified around the arytenoid cartilage and beneath the musculocutaneous flap. Four years after supracricoid laryngectomy with cricohyoidoepiglottopexy, the patient's recovery was following a favourable course and he had satisfactory laryngeal function.

Conclusion:

Appropriate case selection and proficient surgical skills were essential for a successful outcome. Head and neck surgeons should not be afraid to adopt functional preservation open surgical procedures in well-selected and well-motivated patients. A requirement for more challenging surgical procedures and meticulous rehabilitation processes should not exclude appropriate treatments from a surgeon's repertoire.

Keywords

Laryngeal CancerOrgan Preservation
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 1 , January 2015 , pp. 101 - 105
Copyright
Copyright © JLO (1984) Limited 2014 

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