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Subtotal laryngectomy with myomucosal shunt

Published online by Cambridge University Press:  29 June 2007

H. R. Chandrachud ,
M. K. Chaurasia  and
K. P. Sinha
H. R. Chandrachud*
Affiliation:
Consultant in Otolaryngology; Department of Otolaryngology, Gartnavel General Hospital, Glasgow.
M. K. Chaurasia
Affiliation:
Registrar in Otolaryngology; Department of Otolaryngology, Gartnavel General Hospital, Glasgow.
K. P. Sinha
Affiliation:
Erstwhile Registrar in Otolaryngology; Department of Otolaryngology, Gartnavel General Hospital, Glasgow.
*
H. R. Chandrachud, F.R.C.S., Department of Otolaryngology, Gartnavel General Hospital, Glasgow G12.
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Abstract

This is a modified subtotal laryngectomy. On the tumour-free side of the larynx, some posterior structures, with their neurovascular supply are preserved. The endolaryngeal mucosa is tubed in continuity with the trachea below and projects into the pharynx above. Thus a myomucosal shunt is formed. Air is directed into it by finger occlusion of the tracheal stoma.

The voice production is highly satisfactory. Aspiration is prevented by constriction of the thyroarytenoid muscle which provides a valved upper end of the tube.

The possibility of leaving tumour in the laryngeal remnant is eliminated by careful selection of patients, and re-confirmation of tumour extent intra-operatively and a frozen section.

Eleven such operations have been performed since October 1983 for squamous cell carcinoma, some previously irradiated. None of the patients had local recurrence. Only one had an aspiration problem which later resolved. All acquired a satisfactory voice

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 103 , Issue 5 , May 1989 , pp. 504 - 507
Copyright
Copyright © JLO (1984) Limited 1989

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