Luna-Ortiz K, Núñez-Valencia ER, Carmona-Luna T

Language: Spanish
References: 22
Page: 333-337
PDF size: 106.31 Kb.

ABSTRACT

Objective: We undertook this study to report the possibility of salvage of partial vertical hemilaryngectomy with imbrication laryngoplasty (PVHLIL) to a supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP) in a patient with recurrent glottic carcinoma.
Clinical case: A 68-year-old patient with a recurrent glottic squamous cell carcinoma (T1a N0) was treated with an imbricated partial laryngectomy. Transoperative histopathological report demonstrated vocal cord free surgical margins anterior at 1 cm and 0.4 cm posterior. The patient was evaluated trimonthly and at 16-month follow-up presented with tumoral activity on the posterior third of the left false vocal cord, close to the arythenoid, which still conserved mobility. Biopsy was performed and confirmed recurrence of squamous cell carcinoma. SCPL with CHEP was performed with a satisfactory postoperative evolution with tracheotomy decannulation at day 7. Physiological aspects of phonation and retirement of nasogastric tube were accomplished at day 15, as well as a return to oral feeding. Histopathological report showed a moderately differentiated squamous cell carcinoma. Functional evaluation with PVHLIL is a clear voice alteration; however, patients do not require permanent tracheostomy and a close to normal biopsychosocial integration after SCPL + CHEP is possible.
Conclusions: PVHLIL is an excellent treatment option for selected glottic tumors staged T1 or T2. Close follow-up must be given to allow the possibility of organ conservation either with radiotherapy or surgery. When recurrence occurs, SCPL + CHEP must be considered according to the established criteria for this procedure. Total laryngectomy must be considered as the last option, with the only purpose being a normal quality of life.

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