Surgical Treatment of Supraglottic Cancer and Reconstructive Techniques with Tongue Flap

Background:

During the recent 10 years, we improved the surgical technique of supraglottic cancer and introduced the tongue flap to facilitate the reconstruction. Here we summarized our clinical experience in the treatment of supraglottic cancer and the follow-up of survival.

Methods:

Medical files of 184 patients, who underwent surgery in our department between 2008 and 2012, were retrospectively reviewed.

Supraglottic horizontal laryngectomy and total laryngectomy were performed. The tongue flap or sternohyoid myofascial flap were used for repairing defects.

The tongue flap was prepared by separating the space between the base of the tongue and hyoid bone. The whole flap could be retracted inferiorly to the superior margin of thyroid cartilage without tension, thus the laryngeal cavity could be enclosed directly.

Survival rates were then analyzed by the Kaplan-Meier method.

Results:

Patients receiving conservation laryngeal surgery accounted for 75.5% (139/184) of all cases. The 3-year and 5-year survival rate of all cases was 84.2% and 70.7%, respectively. Moreover, the log-rank test demonstrated that cervical lymph node metastasis, primary tumor staging, and clinical TNM staging were significantly associated with prognosis of patients. Dysphagia was observed in no case and speech function was maintained in those undergoing a partial laryngectomy.

Conclusion:

Adequate pre-operative evaluation, individualized treatment, and comprehensive application of flaps for repairment are critical to precise tumor excision and reconstruction of laryngeal function.

Publication History

Publication Date:
23 April 2019 (online)