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Repair with sternohyoid muscle fascia after subtotal laryngectomy

Published online by Cambridge University Press:  22 May 2009

P Dong*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Shanghai First People's Hospital, Shanghai Jiao Tong University, China
X Li
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Shanghai First People's Hospital, Shanghai Jiao Tong University, China
G Wang
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Shanghai First People's Hospital, Shanghai Jiao Tong University, China
X Chen
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Shanghai First People's Hospital, Shanghai Jiao Tong University, China
J Xie
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Shanghai First People's Hospital, Shanghai Jiao Tong University, China
T Nakashima
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
*
Address for correspondence: Prof Pin Dong, Department of Otolaryngology-Head and Neck Surgery, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai 200080, China. Fax: +86 21 63240825 E-mail: [email protected]

Abstract

Background:

The subtotal laryngectomy procedure enables the patient to avoid some of the serious consequences of total laryngectomy without having to relinquish oncological effectiveness. However, the important complication of aspiration may still seriously affect some patients. Many methods of reconstruction have been described in an attempt to avoid or minimise this complication.

Methods:

Thirty-nine patients (15 with supraglottic laryngeal cancer and 24 with hypopharyngeal cancer) who had undergone subtotal laryngectomy between 2000 and 2006 were included in this study. In all patients, a sternohyoid muscle flap has been used for primary, one-stage reconstruction of laryngopharyngeal defects, following resection of advanced stage lesions. Patients' times to oral intake and decannulation, their speech function and their post-operative complications were reviewed.

Results:

The patients' three-year overall survival rate was 46.1 per cent. Their mean time to oral intake was 14 days. Twenty-six patients were decannulated (66.7 per cent). Almost all patients regained their speech function post-operatively, although their voice quality was not as good as before surgery.

Conclusions:

Sternohyoid muscle fascia reconstruction leads to optimal repair of subtotal laryngectomy defects and restored laryngeal function.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2009

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References

1Chevalier, D, Piquet, JJ. Subtotal laryngectomy with cricohyoidopexy for supraglottic carcinoma. Review of 61 cases. Am J Surg 1994;168:472–3CrossRefGoogle ScholarPubMed
2Laccourreye, H, Laccourreye, O, Weinstein, G, Menard, M, Brasnu, D. Supracricoid laryngectomy with cricohyoidopexy: a partial laryngeal procedure for selected supraglottic and transglottic carcinomas. Laryngoscope 1990;100:735–41CrossRefGoogle ScholarPubMed
3DeSanto, LW, Pearson, BW, Olsen, KD. Utility of near-total laryngectomy for supraglottic, pharyngeal, base-of-tongue, and other cancer. Ann Otol Rhinol Laryngol 1989;98:27CrossRefGoogle Scholar
4Bielamowicz, S, Berke, GS. An improved method of medialization laryngoplasty uses a three-sided thyroplasty window. Laryngoscope 1995;105:537–9Google Scholar
5Crampette, L, Garrel, R, Gardiner, Q et al. Modified subtotal laryngectomy with cricohyoidoepiglottopexy – long term results in 81 patients. Head Neck 1999;21:95103Google Scholar
6Gavilán, J, Herranz, J, Prim, J, Rabanal, I. Speech results and complications of near-total laryngectomy. Ann Otol Rhinol Laryngol 1996;105:729–33CrossRefGoogle ScholarPubMed
7Lima, RA, Freitas, EQ, Kligerman, J, Paiva, FP, Dias, FL. Near-total laryngectomy for treatment of advanced laryngeal cancer. Am J Surg 1997;174:490–1CrossRefGoogle ScholarPubMed
8Dong, P, Jiang, Y, Wang, T. Supraglottic laryngectomy with or without one arytenoid in epiglottic carcinoma. A report of 40 cases [in Chinese]. Chung Hua Chung Liu Tsa Chih 1998;20:231–2Google ScholarPubMed
9Rojananin, S, Suphaphongs, N, Ballantyne, AJ. The infrahyoid musculocutaneous flap in head and neck reconstruction. Am J Surg 1991;162:400–3Google Scholar
10Mello, FV, Mamede, RC, Velludo, MA. Tracheal neovascularization: a method involving mobilization of a complete tracheal neovascularized segment using a sternohyoid muscle flap. Laryngoscope 1996;106:81–5Google Scholar
11Lu, X, Dong, P. The use of platysmal myocutaneous flaps in laryngeal reconstruction. Lin Chuang Erh Pi Yen Hou Ko Tsa Chih 1997;11:56–8Google Scholar
12Wang, RC, Puig, CM, Brown, DJ. Strap muscle neurovascular supply. Laryngoscope 1998;108:973–6CrossRefGoogle ScholarPubMed
13Majoufre, C, Faucher, A. The infrahyoid musculocutaneous flap. Anatomic bases and the results of a preliminary experience in cervicofacial oncology. Rev Stomatol Chir Maxillofac 1994;95:319–24Google ScholarPubMed