Indications and results of extended total laryngectomy with en-bloc resection of overlying cervical skin

Xavier León, Montserrat López, Jacinto García, Maria Casasayas, Carlota Rovira, Miquel Quer

Research output: Contribution to journalArticleResearch

Abstract

© 2019, Springer-Verlag GmbH Germany, part of Springer Nature. Purpose: Extended total laryngectomy with en-bloc resection of overlying cervical skin (ETL) is indicated in cases with infiltration of the pre-laryngeal soft tissues. The present study analyses the surgical indications and the results of ETL in our hospital. Methods: Retrospective review of 38 patients treated with an ETL during the period 1988–2016. Results: The indications for ETL were the initial treatment of tumors with extralaryngeal extension (n = 16), salvage treatment after failure of partial surgery or radiotherapy (n = 17), and total laryngectomy in patients with infection or fibrosis of the skin over the larynx (n = 5). The surgical defect was reconstructed with local flaps in 3 cases, with pectoralis major flaps in 34 cases, and with an internal mammary artery perforator flap in one case. The rate of pharyngocutaneous fistula in the postoperative period was 16%. 5-year cancer-specific survival for patients treated with an ETL was 67.1%. The patients with positive margins and those operated as a salvage treatment after failure of previous treatments showed worse survival. Conclusions: ETL offers acceptable oncological results for patients with tumors with extralaryngeal extension. Myocutaneous or myofascial pectoralis major flaps allow for adequate reconstruction of the surgical defect with a low rate of complications.
Original languageEnglish
Pages (from-to)3179-3184
JournalEuropean Archives of Oto-Rhino-Laryngology
Volume276
DOIs
Publication statusPublished - 1 Nov 2019

Keywords

  • Extended total laryngectomy
  • Extralaryngeal extension
  • Salvage surgery
  • Total laryngectomy

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