Laryngeal function-preserving of frontolateral vertical partial laryngectomy (FLVPL) for selected T4a glottic cancer with thyroid cartilage invasion adherence to the anterior commissure: an innovative attempt

• Published in: European archives of oto-rhino-laryngology Vol. 279; no. 12; pp. 5735 - 5740
• Main Authors: Yan, Honghong, Wu, Di, Mai, Jun-hao, Zhao, Zheng, Xu, Pengfei, Liao, Lieqiang, Lin, Hongsheng, Zhang, Xin-rui, Liu, Xue-Kui
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2022
• Subjects: Carcinoma, Squamous Cell - pathology; Glottis - pathology; Glottis - surgery; Head and Neck Surgery; Humans; Laryngeal Neoplasms - pathology; Laryngectomy - methods; Laryngology; Medicine; Medicine & Public Health; Neurosurgery; Otorhinolaryngology; Retrospective Studies; Thyroid Cartilage - pathology; Thyroid Cartilage - surgery; Titanium; Tongue Neoplasms - pathology; T4a glottic cancer; Titanium mesh; Laryngeal framework reconstruction
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-022-07459-8

Objective To evaluate the feasibility and efficacy in selected T4a glottic cancer (thyroid cartilage invasion adherence to the anterior commissure) treated with frontolateral vertical partial laryngectomy (FLVPL) and laryngeal framework reconstruction using titanium mesh. Methods Six patients with the limited T4a glottic cancer with thyroid cartilage destruction adherence to the anterior commissure, underwent FLVPL from 2009 to 2016 in Sun Yat-Sen University Cancer Center. All patients were followed up postoperatively. Results All patients comprised radical tumor resection and favorable functional outcomes, and no aspiration and laryngeal stenosis were observed. According to postoperative pathology, four patients should go through postsurgical radiotherapy with a mean dose of 66 Gy. But one of them refused to undergo postoperative radiotherapy, who observed local recurrence in postcricoid area underwent total laryngectomy (TL) and ipsilateral selected neck dissection in post-surgery two year. During follow-up period, all patients were still alive, and five patients without local recurrence and distant metastases. Conclusion FLVPL and laryngeal framework reconstruction using titanium mesh is one viable surgical procedure to obtain adequate oncologic and functional outcomes.