1. Digital Library at SDUAHER
2. SDUAHER FACULTY PUBLICATION
3. Otorhinolaryngology (ENT)

Title:	Near-Total Laryngectomy in Advanced Laryngeal and Pyriform Cancers
Authors:	Sultan A. Pradhan, FRCS, MS, FACS, FCPS; Anil K. D’Cruz, MS, DNB; Prathamesh S. Pai, MS, DNB, DORL; Azeem Mohiyuddin, MS
Issue Date:	Feb-2002
Publisher:	Wiley
Description:	Objective: To demonstrate the oncologic and physiological safety of near-total laryngectomy (NTL), its success in voice conservation, and its versatility for use in extensive resections that necessitate pharyngoplasty, and even in post-radiation recurrences. Study: In this study of 137 cases of NTL for cancer of the larynx (45 cases) and pyriform (92 cases), 86.9% were stage T3/T4 and 60.6% were N . A total of 8.8% had extended pharyngeal resections necessitating patch pharyngoplasty (ENTLP). In 10.9% cases, NTL was used as salvage of post-radiation failures. Concurrent neck dissection was performed in 99 cases. Results: A total of 70.1% was alive and diseasefree at the last follow-up ranging from 12 months to 104 months (median, 35 mo). A total of 7.3% had local/ locoregional recurrences and 11.7% had purely regional recurrences. The local control rate for postradiation salvage with NTL was 93.3%. A total of 88.6% developed communicable speech, and the speech success rate was 100% in 12 cases of ENTLP. Complications included major wound dehiscence with total shunt breakdown in 2 cases (1.5%), pharyngeal leak requiring surgical intervention in 7 cases (3.6%), significant aspiration through the shunt necessitating completion laryngectomy in 1 case (0.7%), and complete shunt stenosis in 9 cases (6.6%). Conclusion: The study shows that NTL is an oncologically safe voice conservation procedure in advanced, lateralized laryngeal and pyriform cancers treated not only per primum, but also in carefully selected post-radiation failures. It has a high success rate of speech development even in those cases requiring extensive pharyngeal resections. Major complications were acceptably low. Key Words: Near-total laryngectomy, pyriform, larynx, cancer.
URI:	http://hdl.handle.net/123456789/1781
Appears in Collections:	Otorhinolaryngology (ENT)

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