Issue N# 5 - 2017
Reconstruction after hemilaryngopharyngectomy with hemicricoid resection: Indications, surgical technique and functional results
Authors : Chabrillac E, Woisard-Bassols V, Sarini J. (Toulouse)
Ref. : Rev Laryngol Otol Rhinol. 2017;138,5:211-214.
Article published in french
Downloadable PDF document french
Introduction: In 1997, Urken et al published a novel method of laryngo-pharyngeal reconstruction after resection of half of the cricoid cartilage, using an antebrachial free flap and a costal cartilage graft. This surgical technique would allow the preservation of the larynx with satisfactory functional outcomes, by accurately reconstructing the piriform sinus and the vocal cord. We hereby detail the indications, surgical technique, data of the literature and a case from our experience illustrating the functional outcomes that can be obtained. Discussion: The alteration of autonomy and quality of life is mainly due to swallowing disorders, related to the lack of glotto-sus-glottic closure. Respiratory disorders are added, often requiring a prolonged tracheostomy. The voice is often satisfying but requires an external pressure to medialize the new vocal cord. Conclusion: This surgical technique can provide satisfactory functional outcomes in selected cases: Ideally lesions of the upper part of the laryngopharyngeal wall, in a patient in good general condition, having no history of cervical radiotherapy, not eligible for an organ preservation protocol, preferably for the treatment of tumors with little or no radiosensitivity. Used inappropriately, it can provide a functional disability that is significantly greater than total laryngectomy.
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