Supracricoid Laryngectomy with Cricohyoidoepiglottopexy: A Partial Laryngeal Procedure for Glottic Carcinoma

TLDR

The procedure is indicated for glottic carcinomas that extend beyond the membranous portion of the true vocal cord or limit true vocal cord mobility, offering a useful alternative to radiotherapy, partial vertical laryngectomy, and total laryngectomy. The partial horizontal supracricoid laryngectomy with cricohyoidoepiglottopexy removes the entire thyroid cartilage and paraglottic space while preserving the cricoid cartilage, hyoid bone, most of the epiglottis, and at least one arytenoid cartilage. In 36 patients treated between 1974 and 1986, all achieved physiologic deglutition and phonation without permanent tracheotomy, with an 86.5 % 3‑year actuarial survival and a 5.5 % local recurrence rate.

Abstract

The partial horizontal supracricoid laryngectomy with cricohyoidoepiglottopexy consists of resection of the whole thyroid cartilage and paraglottic space. The cricoid cartilage, the hyoid bone, most of the epiglottis, and at least one arytenoid cartilage are conserved. Thirty-six patients with squamous cell carcinoma of the glottis who underwent this procedure from 1974 through 1986 are presented. All 36 recovered physiologic deglutition and phonation. None required a permanent tracheotomy. The 3-year actuarial survival rate was 86.5%. The local recurrence rate was 5.5%. The indications for the procedure are carcinomas of the glottis that 1) spread beyond the confines of the membranous portion of the true vocal cord or 2) present with limitation of true vocal cord mobility. The procedure is presented as a useful alternative to radiotherapy, partial vertical laryngectomy, and total laryngectomy in select cases of glottic carcinoma.