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Total Laryngectomy With En Bloc Resection of the Overlying Cervical Skin

Andrea Gallo, MD, PhD; Rossana Moi, MD; Marilia Simonelli, MD; Domenico Vitolo, MD; Maria Luisa Fiorella, MD; Vincenzo Marvaso, MD; Valentina Manciocco, MD; Marco de Vincentiis, MD

Arch Otolaryngol Head Neck Surg. 2001;127:786-789.

Objective  To evaluate the effectiveness of extended total laryngectomy for the treatment of recurrences of laryngeal cancer.

Design  We conducted a retrospective clinical study of patients who had undergone extended total laryngectomy and were seen over a 15-year period. The follow-up period ranged from 3 to 15 years.

Setting  Academic tertiary referral medical center.

Patients  We observed 15 patients who were affected by a recurrence of laryngeal cancer that extended to the overlying soft tissue. All patients were male. The mean age was 61.5 years. Thirteen patients had previously undergone partial laryngeal surgery, and 2 patients had undergone radiation therapy, without success.

Intervention  All patients underwent total laryngectomy extending to the soft tissue, including the overlying skin.

Results  Five of the 15 patients died of local recurrence, and 1 patient died of massive postoperative hemorrhaging. An actuarial survival rate of 60% was observed at 5 years.

Conclusion  Total laryngectomy extending to the soft tissues seems to be an effective procedure for treating local recurrences of laryngeal cancer after partial laryngectomy or failure of radiation therapy.

From the Departments of Otolaryngology (Drs Gallo, Moi, Marvaso, Manciocco, and de Vincentiis) and Experimental Medicine and Pathology (Dr Vitolo), "La Sapienza" University–Rome, and the Speech and Swallowing Rehabilitation Service, Santa Lucia Hospital (Dr Simonelli), Rome, Italy.

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