Supracricoid Laryngectomy Outcomes: The Johns Hopkins Experience
Objective: To report the oncologic and functional results from our experience in performing supracricoid laryngectomy (SCL) for selected patients with laryngeal cancer. Study Design: Retrospective chart review. Methods: Twenty‐four consecutive patients who underwent SCL for laryngeal cancer in our i...
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| Veröffentlicht in: | The Laryngoscope 2007-01, Vol.117 (1), p.129-132 |
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| creator | Farrag, Tarik Y. Koch, Wayne M. Cummings, Charles W. Goldenberg, David Abou-Jaoude, Peter M. Califano, Joseph A. Flint, Paul W. Webster, Kimberly Tufano, Ralph P. |
| description | Objective: To report the oncologic and functional results from our experience in performing supracricoid laryngectomy (SCL) for selected patients with laryngeal cancer.
Study Design: Retrospective chart review.
Methods: Twenty‐four consecutive patients who underwent SCL for laryngeal cancer in our institution from December 2000 to March 2006 have been reviewed. Reports of the site and extent of tumor, type of reconstruction, preoperative or postoperative radiotherapy, and the final histopathologic examination were reviewed. In addition, the reports of the preoperative examination, inpatient course, and postoperative follow‐up were reviewed.
Results: A total of 24 patients were involved in the study; 19 had tumors involving the glottic region, and 5 patients had tumors involving both the glottic and supraglottic regions (transglottic). Ten patients had their SCL for postradiotherapy recurrence/persistence of disease. Eighteen patients underwent reconstruction through cricohyoidoepiglottopexy (CHEP), whereas six patients had cricohyoidopexy (CHP). Eleven patients had an arytenoid cartilage resected; 8 of 11 had CHEP, and 3 of 11 had CHP. All patients had a tracheostomy and percutaneous endoscopic gastrostomy (PEG) tube placement performed at the same time as the SCL. The median hospital stay period was 6 days. Twenty‐three of 24 had successful tracheostomy tube decannulation, with a median time to decannulation of 37 days. The median time to removal of the PEG tube was 70 days. The complications with SCL were postoperative wound infection in two patients (SCL/CHP) and the need for completion total laryngectomy secondary to intractable aspiration in one patient with SCL/CHP. One patient with SCL/CHEP had a ruptured pexy and subsequently underwent a second reconstruction with successful tracheostomy and PEG tube removal. One of 24 patients is still PEG tube dependant, and he had postoperative radiotherapy. Fifteen patients underwent concurrent neck dissection. None of the patients had any local or regional recurrence, with a median follow‐up period of 3 years. All final surgical margins were negative for tumor invasion. Three patients had postoperative radiotherapy, two patients because of nodal metastases in the excised lymph nodes and one because of perineural invasion on final histopathologic examination of the SCL specimen. There were no perioperative deaths.
Conclusion: SCL with CHEP or CHP represents an effective technique that can be taught and effectiv |
| doi_str_mv | 10.1097/01.mlg.0000247660.47625.02 |
| format | Article |
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Study Design: Retrospective chart review.
Methods: Twenty‐four consecutive patients who underwent SCL for laryngeal cancer in our institution from December 2000 to March 2006 have been reviewed. Reports of the site and extent of tumor, type of reconstruction, preoperative or postoperative radiotherapy, and the final histopathologic examination were reviewed. In addition, the reports of the preoperative examination, inpatient course, and postoperative follow‐up were reviewed.
Results: A total of 24 patients were involved in the study; 19 had tumors involving the glottic region, and 5 patients had tumors involving both the glottic and supraglottic regions (transglottic). Ten patients had their SCL for postradiotherapy recurrence/persistence of disease. Eighteen patients underwent reconstruction through cricohyoidoepiglottopexy (CHEP), whereas six patients had cricohyoidopexy (CHP). Eleven patients had an arytenoid cartilage resected; 8 of 11 had CHEP, and 3 of 11 had CHP. All patients had a tracheostomy and percutaneous endoscopic gastrostomy (PEG) tube placement performed at the same time as the SCL. The median hospital stay period was 6 days. Twenty‐three of 24 had successful tracheostomy tube decannulation, with a median time to decannulation of 37 days. The median time to removal of the PEG tube was 70 days. The complications with SCL were postoperative wound infection in two patients (SCL/CHP) and the need for completion total laryngectomy secondary to intractable aspiration in one patient with SCL/CHP. One patient with SCL/CHEP had a ruptured pexy and subsequently underwent a second reconstruction with successful tracheostomy and PEG tube removal. One of 24 patients is still PEG tube dependant, and he had postoperative radiotherapy. Fifteen patients underwent concurrent neck dissection. None of the patients had any local or regional recurrence, with a median follow‐up period of 3 years. All final surgical margins were negative for tumor invasion. Three patients had postoperative radiotherapy, two patients because of nodal metastases in the excised lymph nodes and one because of perineural invasion on final histopathologic examination of the SCL specimen. There were no perioperative deaths.
Conclusion: SCL with CHEP or CHP represents an effective technique that can be taught and effectively used to avoid a total laryngectomy while maintaining physiologic speech and swallowing in selected patients with advanced stage primary laryngeal cancer or recurrent/persistent laryngeal cancer after radiotherapy. There is a good functional recovery with acceptable morbidity and an excellent oncologic outcome when strict selection criteria are applied and a formal swallowing rehabilitation program is followed.</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1097/01.mlg.0000247660.47625.02</identifier><identifier>PMID: 17202941</identifier><identifier>CODEN: LARYA8</identifier><language>eng</language><publisher>Hoboken, NJ: John Wiley & Sons, Inc</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Carcinoma, Squamous Cell - surgery ; Cricoid Cartilage - surgery ; Female ; Gastrostomy ; Humans ; laryngeal cancer ; Laryngeal Neoplasms - surgery ; Laryngectomy - methods ; Male ; Medical sciences ; Middle Aged ; Otorhinolaryngology. Stomatology ; Partial laryngectomy ; Retrospective Studies ; Tracheostomy ; Treatment Outcome ; Tumors ; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology</subject><ispartof>The Laryngoscope, 2007-01, Vol.117 (1), p.129-132</ispartof><rights>Copyright © 2007 The Triological Society</rights><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5143-6ac63e5b44799a46113d6dc0d0e78be3e5816ceade29a768b3c3db5766698f883</citedby><cites>FETCH-LOGICAL-c5143-6ac63e5b44799a46113d6dc0d0e78be3e5816ceade29a768b3c3db5766698f883</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1097%2F01.mlg.0000247660.47625.02$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1097%2F01.mlg.0000247660.47625.02$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,4012,27910,27911,27912,45561,45562</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18439856$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17202941$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Farrag, Tarik Y.</creatorcontrib><creatorcontrib>Koch, Wayne M.</creatorcontrib><creatorcontrib>Cummings, Charles W.</creatorcontrib><creatorcontrib>Goldenberg, David</creatorcontrib><creatorcontrib>Abou-Jaoude, Peter M.</creatorcontrib><creatorcontrib>Califano, Joseph A.</creatorcontrib><creatorcontrib>Flint, Paul W.</creatorcontrib><creatorcontrib>Webster, Kimberly</creatorcontrib><creatorcontrib>Tufano, Ralph P.</creatorcontrib><title>Supracricoid Laryngectomy Outcomes: The Johns Hopkins Experience</title><title>The Laryngoscope</title><addtitle>The Laryngoscope</addtitle><description>Objective: To report the oncologic and functional results from our experience in performing supracricoid laryngectomy (SCL) for selected patients with laryngeal cancer.
Study Design: Retrospective chart review.
Methods: Twenty‐four consecutive patients who underwent SCL for laryngeal cancer in our institution from December 2000 to March 2006 have been reviewed. Reports of the site and extent of tumor, type of reconstruction, preoperative or postoperative radiotherapy, and the final histopathologic examination were reviewed. In addition, the reports of the preoperative examination, inpatient course, and postoperative follow‐up were reviewed.
Results: A total of 24 patients were involved in the study; 19 had tumors involving the glottic region, and 5 patients had tumors involving both the glottic and supraglottic regions (transglottic). Ten patients had their SCL for postradiotherapy recurrence/persistence of disease. Eighteen patients underwent reconstruction through cricohyoidoepiglottopexy (CHEP), whereas six patients had cricohyoidopexy (CHP). Eleven patients had an arytenoid cartilage resected; 8 of 11 had CHEP, and 3 of 11 had CHP. All patients had a tracheostomy and percutaneous endoscopic gastrostomy (PEG) tube placement performed at the same time as the SCL. The median hospital stay period was 6 days. Twenty‐three of 24 had successful tracheostomy tube decannulation, with a median time to decannulation of 37 days. The median time to removal of the PEG tube was 70 days. The complications with SCL were postoperative wound infection in two patients (SCL/CHP) and the need for completion total laryngectomy secondary to intractable aspiration in one patient with SCL/CHP. One patient with SCL/CHEP had a ruptured pexy and subsequently underwent a second reconstruction with successful tracheostomy and PEG tube removal. One of 24 patients is still PEG tube dependant, and he had postoperative radiotherapy. Fifteen patients underwent concurrent neck dissection. None of the patients had any local or regional recurrence, with a median follow‐up period of 3 years. All final surgical margins were negative for tumor invasion. Three patients had postoperative radiotherapy, two patients because of nodal metastases in the excised lymph nodes and one because of perineural invasion on final histopathologic examination of the SCL specimen. There were no perioperative deaths.
Conclusion: SCL with CHEP or CHP represents an effective technique that can be taught and effectively used to avoid a total laryngectomy while maintaining physiologic speech and swallowing in selected patients with advanced stage primary laryngeal cancer or recurrent/persistent laryngeal cancer after radiotherapy. There is a good functional recovery with acceptable morbidity and an excellent oncologic outcome when strict selection criteria are applied and a formal swallowing rehabilitation program is followed.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Squamous Cell - surgery</subject><subject>Cricoid Cartilage - surgery</subject><subject>Female</subject><subject>Gastrostomy</subject><subject>Humans</subject><subject>laryngeal cancer</subject><subject>Laryngeal Neoplasms - surgery</subject><subject>Laryngectomy - methods</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Otorhinolaryngology. Stomatology</subject><subject>Partial laryngectomy</subject><subject>Retrospective Studies</subject><subject>Tracheostomy</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVkEtvEzEURi0EoqHwF9AICXYz-P3oijZqG1BEJRoErCyP56Y1nRd2RjT_vm4TkTVe-C7uuZ99D0LvCK4INuojJlXX3lQ4H8qVlLjKNxUVps_QjAhGSm6MeI5muc9KLejPI_Qqpd8YE8UEfomOiKKYGk5m6NP1NEbnY_BDaIqli9v-Bvxm6LbF1bTxQwfppFjdQvFluO1TsRjGu5Dr-f0IMUDv4TV6sXZtgjf7eoy-X5yv5otyeXX5eX66LL0gnJXSeclA1JwrYxyXhLBGNh43GJSuIbc0kR5cA9Q4JXXNPGtqkbeTRq-1Zsfowy53jMOfCdLGdiF5aFvXwzAlKzUznGuawZMd6OOQUoS1HWPo8mKWYPvoz2Jisz978Gef_Fn8OPx2_8pUd9AcRvfCMvB-D7jkXbuOrvchHTjNmdFCZu5ix_0NLWz_4wt2efrtlxCcEIUJZTmo3AWFtIH7f0Eu3lmpmBL2x9dLu7o-m68UM3bBHgBOU5xj</recordid><startdate>200701</startdate><enddate>200701</enddate><creator>Farrag, Tarik Y.</creator><creator>Koch, Wayne M.</creator><creator>Cummings, Charles W.</creator><creator>Goldenberg, David</creator><creator>Abou-Jaoude, Peter M.</creator><creator>Califano, Joseph A.</creator><creator>Flint, Paul W.</creator><creator>Webster, Kimberly</creator><creator>Tufano, Ralph P.</creator><general>John Wiley & Sons, Inc</general><general>Wiley-Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>8BM</scope></search><sort><creationdate>200701</creationdate><title>Supracricoid Laryngectomy Outcomes: The Johns Hopkins Experience</title><author>Farrag, Tarik Y. ; Koch, Wayne M. ; Cummings, Charles W. ; Goldenberg, David ; Abou-Jaoude, Peter M. ; Califano, Joseph A. ; Flint, Paul W. ; Webster, Kimberly ; Tufano, Ralph P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5143-6ac63e5b44799a46113d6dc0d0e78be3e5816ceade29a768b3c3db5766698f883</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Carcinoma, Squamous Cell - surgery</topic><topic>Cricoid Cartilage - surgery</topic><topic>Female</topic><topic>Gastrostomy</topic><topic>Humans</topic><topic>laryngeal cancer</topic><topic>Laryngeal Neoplasms - surgery</topic><topic>Laryngectomy - methods</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Otorhinolaryngology. Stomatology</topic><topic>Partial laryngectomy</topic><topic>Retrospective Studies</topic><topic>Tracheostomy</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Farrag, Tarik Y.</creatorcontrib><creatorcontrib>Koch, Wayne M.</creatorcontrib><creatorcontrib>Cummings, Charles W.</creatorcontrib><creatorcontrib>Goldenberg, David</creatorcontrib><creatorcontrib>Abou-Jaoude, Peter M.</creatorcontrib><creatorcontrib>Califano, Joseph A.</creatorcontrib><creatorcontrib>Flint, Paul W.</creatorcontrib><creatorcontrib>Webster, Kimberly</creatorcontrib><creatorcontrib>Tufano, Ralph P.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>ComDisDome</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Farrag, Tarik Y.</au><au>Koch, Wayne M.</au><au>Cummings, Charles W.</au><au>Goldenberg, David</au><au>Abou-Jaoude, Peter M.</au><au>Califano, Joseph A.</au><au>Flint, Paul W.</au><au>Webster, Kimberly</au><au>Tufano, Ralph P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Supracricoid Laryngectomy Outcomes: The Johns Hopkins Experience</atitle><jtitle>The Laryngoscope</jtitle><addtitle>The Laryngoscope</addtitle><date>2007-01</date><risdate>2007</risdate><volume>117</volume><issue>1</issue><spage>129</spage><epage>132</epage><pages>129-132</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><coden>LARYA8</coden><abstract>Objective: To report the oncologic and functional results from our experience in performing supracricoid laryngectomy (SCL) for selected patients with laryngeal cancer.
Study Design: Retrospective chart review.
Methods: Twenty‐four consecutive patients who underwent SCL for laryngeal cancer in our institution from December 2000 to March 2006 have been reviewed. Reports of the site and extent of tumor, type of reconstruction, preoperative or postoperative radiotherapy, and the final histopathologic examination were reviewed. In addition, the reports of the preoperative examination, inpatient course, and postoperative follow‐up were reviewed.
Results: A total of 24 patients were involved in the study; 19 had tumors involving the glottic region, and 5 patients had tumors involving both the glottic and supraglottic regions (transglottic). Ten patients had their SCL for postradiotherapy recurrence/persistence of disease. Eighteen patients underwent reconstruction through cricohyoidoepiglottopexy (CHEP), whereas six patients had cricohyoidopexy (CHP). Eleven patients had an arytenoid cartilage resected; 8 of 11 had CHEP, and 3 of 11 had CHP. All patients had a tracheostomy and percutaneous endoscopic gastrostomy (PEG) tube placement performed at the same time as the SCL. The median hospital stay period was 6 days. Twenty‐three of 24 had successful tracheostomy tube decannulation, with a median time to decannulation of 37 days. The median time to removal of the PEG tube was 70 days. The complications with SCL were postoperative wound infection in two patients (SCL/CHP) and the need for completion total laryngectomy secondary to intractable aspiration in one patient with SCL/CHP. One patient with SCL/CHEP had a ruptured pexy and subsequently underwent a second reconstruction with successful tracheostomy and PEG tube removal. One of 24 patients is still PEG tube dependant, and he had postoperative radiotherapy. Fifteen patients underwent concurrent neck dissection. None of the patients had any local or regional recurrence, with a median follow‐up period of 3 years. All final surgical margins were negative for tumor invasion. Three patients had postoperative radiotherapy, two patients because of nodal metastases in the excised lymph nodes and one because of perineural invasion on final histopathologic examination of the SCL specimen. There were no perioperative deaths.
Conclusion: SCL with CHEP or CHP represents an effective technique that can be taught and effectively used to avoid a total laryngectomy while maintaining physiologic speech and swallowing in selected patients with advanced stage primary laryngeal cancer or recurrent/persistent laryngeal cancer after radiotherapy. There is a good functional recovery with acceptable morbidity and an excellent oncologic outcome when strict selection criteria are applied and a formal swallowing rehabilitation program is followed.</abstract><cop>Hoboken, NJ</cop><pub>John Wiley & Sons, Inc</pub><pmid>17202941</pmid><doi>10.1097/01.mlg.0000247660.47625.02</doi><tpages>4</tpages></addata></record> |
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| subjects | Adult Aged Biological and medical sciences Carcinoma, Squamous Cell - surgery Cricoid Cartilage - surgery Female Gastrostomy Humans laryngeal cancer Laryngeal Neoplasms - surgery Laryngectomy - methods Male Medical sciences Middle Aged Otorhinolaryngology. Stomatology Partial laryngectomy Retrospective Studies Tracheostomy Treatment Outcome Tumors Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology |
| title | Supracricoid Laryngectomy Outcomes: The Johns Hopkins Experience |
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