Staged laryngeal reconstruction with a prefabricated flap for radiation recurrent glottic carcinoma

Laryngoscope. 2016 May;126(5):1061-70. doi: 10.1002/lary.25593. Epub 2015 Nov 6.

Abstract

Objectives/hypothesis: Although salvage total laryngectomy remains the definitive approach to recurrent/persistent glottic cancer following failed radiation therapy for favorable early-stage disease, it comes at the price of a permanent laryngostome and an impact on quality of life. We describe a three-stage method of laryngeal reconstruction for salvage partial laryngectomy to address the unique challenges of operating on radiation recurrent/persistent cancer.

Study design: This was a single-surgeon retrospective case series of patients who underwent a three-stage laryngeal reconstruction for salvage partial laryngectomy.

Methods: We performed a comprehensive review of the clinical, pathologic, and radiologic files of all patients who underwent a three-stage laryngeal reconstruction for salvage partial laryngectomy.

Results: Seven male patients underwent a three-stage laryngeal reconstruction following open partial salvage laryngectomy. The average follow-up time since salvage surgery was 55 months. All patients were without evidence of recurrence and demonstrated satisfactory functional outcomes.

Conclusion: Staged reconstruction provides a more controlled assessment of wound healing and valuable pathologic information regarding the specific disease virulence and adequacy of the margins.

Level of evidence: 4. Laryngoscope, 126:1061-1070, 2016.

Keywords: Head and neck surgery; laryngeal cancer; reconstruction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carcinoma / radiotherapy
  • Carcinoma / surgery*
  • Follow-Up Studies
  • Glottis / surgery*
  • Humans
  • Laryngeal Neoplasms / radiotherapy
  • Laryngeal Neoplasms / surgery*
  • Laryngectomy / methods*
  • Laryngoplasty / methods
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / etiology
  • Neoplasm Recurrence, Local / surgery*
  • Retrospective Studies
  • Salvage Therapy / methods*
  • Surgical Flaps*
  • Treatment Outcome