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Partial Laryngectomy With Imbrication Laryngoplasty for Glottic Carcinoma
Gady Har-El, MD;
Randy C. Paniello, MD;
Elliot Abemayor, MD;
Dale H. Rice, MD;
Christopher Rassekh, MD
Arch Otolaryngol Head Neck Surg. 2003;129:66-71.
Background Treatment options for unilateral glottic carcinoma include radiation therapy, partial laryngectomy, and endoscopic cordectomy. We used partial laryngectomy with imbrication laryngoplasty (PLIL) for definitive treatment with curative intent in a select group of patients.
Study Design Retrospective multicenter review of 24 patients treated with PLIL. Data collection included demographics, tumor characteristics, time to decannulation, time to oral food intake, local control, survival, voice result as judged by the physician, voice result as judged by the patient, and patient satisfaction.
Setting Five academic medical centers.
Methods PLIL includes a composite resection of the entire vocal fold, with its ligament, muscle, adjacent paraglottic tissues, and the adjacent block of thyroid cartilage. A neocord is reconstructed by imbricating the remaining thyroid cartilage strips and covering them with a false vocal fold flap.
Results A total of 24 patients (T1, n = 13; T2, n = 10; and T3, n = 1) underwent PLIL. Median time to decannulation was 4 days, and median time to oral food intake was 5 days. Clear margins were achieved in 23 patients (96%). Follow-up ranged from 1 to 11 years (median duration of follow-up, 5.5 years). In the patients who had clear margins at the initial surgery, the rate of overall disease control was 100%. Voice quality was judged by the physician as good or excellent in 100% of the patients who underwent PLIL, and as better than typical hemilaryngectomy in 23 patients (96%). Twenty-three patients (96%) were satisfied with their voice quality.
Conclusions PLIL provides us with a single modality curative approach to unilateral glottic carcinoma. It also provides rapid recovery of oral and/or nasal airway and swallowing, excellent voice quality, and a disease-control rate similar to or better than other treatment modalities.
From the Departments of Otolaryngology, State University of New York–Downstate Medical Center, Brooklyn (Dr Har-El), Washington University, St Louis, Mo (Dr Paniello), University of Southern California, Los Angeles (Dr Rice), and West Virginia University, Morgantown (Dr Rassekh), and the Division of Head and Neck Surgery, University of California, Los Angeles (Dr Abemayor).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Cordectomy With Imbrication Laryngoplasty
Luna-Ortiz
Arch Otolaryngol Head Neck Surg 2005;131:280-280.
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