Issue N# 2 - 1999
Subtotal laryngectomy with reconstruction - a personal series of 100 patients operated between 1990 and 1997
Authors : G. Bolot, M. Poupart, Ph. Zrounba, F. Herlemont, J. C. Pignat (Lyon)
Ref. : Rev Laryngol Otol Rhinol 1999;120,2:93-96.
Article published in french
Described by Majer and Rieder, modified by Piquet, subtotal laryngectomy with cricohyoidoepiglottopexy (CHEP) allowed to treat intralaryngeal carcinoma with preservation of speech and swallowing. Some modifications were proposed to the procedure to simplify it and to improve functional results. Most important one is the one proposed by Guerrier. In the refined procedure we describe, we didn't do any pexy to concerved as near as possible from normality morphology and physiology of pharyngolaryngeal unit. Dynamics is preserved by keeping jointly the laryngotracheal tract. In addition, we avoid doing a tracheotomy. We present the functional outcome of 100 patients treated between 1990 and 1997 : oral feeding was initiated at the 6th day postoperative, delay to achieve proper swallowing was 11.5 days and median hospitalization duration was 18 days (14 days for non tracheotomized group). The comfort of patients without trachetomy was greatly increased with a low risk of pneumonia. Such a procedure could be applied every time a laryngeal reconstruction had to be done (partial laryngectomy, laryngeal trauma).