Glottic Reconstruction and Wound Rehabilitation: Procedures in Partial Laryngectomy

Abstract

Historically, partial laryngectomy was a multiphased technique, and often the wound included an intentional laryngostome. In the days preceding biotherapy, the laryngostome added an increased measure of safety, as well as assistance in rehabilitating the larynx. As the one-stage procedure was developed, the concept of rehabilitation of the glottis was dropped. Techniques are presented here to emphasize the advantages of rehabilitation of the glottis, in a single-stage operation associated with partial laryngectomy. These include basic resurfacing of the wound and the formation of an artificial vocal cord structure to enhance voice production, thereby permitting extension of partial laryngectomy to the maximum degree of subtotal resection. This procedure is not presented as competitive to irradiation, where cure and function are excellent in the vast majority of early superficial cancers. It is intended to augment, and not supplant, the standard partial laryngectomy where rehabilitation of the wound or cord has been ignored.