Feasibility of subtotal laryngectomy based on whole-organ examination
K. T. Robbins and L. Michaels
Subtotal (near-total) laryngectomy has recently been advocated to eradicate
large laryngeal tumors. The operation, which preserves the cricoarytenoid
joint and adjacent vocal fold, is based on the premise that many T3 and T4
tumors can be resected without complete sacrifice of the phonatory
mechanism. The purpose of this study was to verify or disprove the
assumption by examining sections of whole-organ laryngeal specimens.
Twenty-four of the 64 specimens analyzed were determined to be resectable
by subtotal laryngectomy. Twenty-two other specimens could have been
resected by a more conventional conservation technique such as
hemilaryngectomy or supraglottic laryngectomy. This study supports the
concept of subtotal laryngectomy for selected large tumors. Guidelines for
determining the suitability of the technique are suggested.
