The Application of Epiglottic Laryngoplasty after Partial Laryngectomy

Abstract

Objectives:

Observe the applied value of epiglottis in laryngeal function reconstruction after partial laryngectomy.

Methods:

From April 1997 to December 2008, there were 295 patients with laryngeal carcinomas who were operated on in our department. There were 40 patients who had partial laryngectomy and laryngeal function was reconstructed using epiglottis with or without other materials. The 40 cases were followed up and the oncologic and functional results were retrospectively analyzed. We calculated the 3- and 5-year tumor-free survival rates and evaluated the rehabilitation of laryngeal function.

Results:

The 3- and 5-year tumor-free survival rates were 82.9% and 75.7%, respectively. All of the patients with supraglottic carcinoma had tumor-free survival; in the 3 patients with subglottic carcinomas, only 1 patient had tumor-free survival for 5 years; in the 34 patients with glottic carcinomas, 6 patients died, and 1 patient with local recurrence had a total laryngectomy. The total decannulation rate was 90%. Thirty-nine patients rehabilitated normal peroral feeding. The mean time of removal of the nasogastric tube was 15.7 days. In the 40 cases, voice quality was good in 6 patients with a little hoarseness, 2 were worse, having only a whispered voice, and the others were moderate; the rate of vocal satisfaction was 95%.

Conclusions:

Using the epiglottis with or without other materials to reconstruct laryngeal function after partial laryngectomy is a useful alternative to total laryngectomy in laryngeal cancers, especially in selected advanced cases which improve the quality of life. The epiglottis is one of the ideal materials in laryngoplasty after partial laryngectomy.