Results of Partial Laryngectomy for Benign Neural Tumors of the Larynx in Children

Abstract

The objective of this study was to assess the long-term results of partial laryngectomy for benign neural tumors of the larynx. We reviewed 8 patients with laryngeal involvement -- 7 with neurofibromatosis and 1 without -- treated between 1980 and 1994. The mean age was 6.5 years. A partial laryngectomy was performed in 7 cases. All the tumors were located in the aryepiglottic folds. Clinical, radiologic, and endoscopic follow-ups were used for evaluating recurrence. A good laryngeal airway, swallowing without aspiration, and voice quality were sought in assessing the functional results. Five patients had good functional results with no recurrences. One patient died of malignant transformation and metastatic dissemination of his disease. To summarize, partial laryngectomy is a relatively safe and effective procedure, even in childhood, for treating this rare localization of neurofibromatosis. A malignant transformation of the tumor is possible and carries a poor prognosis.

Plexiform neurofibroma of the larynx in a child

“…This location implies that the tumour originates from the superior laryngeal nerve and/or from anastomoses between the superior laryngeal nerve and the recurrent laryngeal nerve (Galen anastomoses). 8 Because conservative treatment such as endoscopic partial resection allows further tumour growth, surgery was recommended. 9 Lateral pharyngotomy and excision or lateral pharyngotomy and supraglottic hemipharyngolaryngectomy have been recommended by several authors.…”

“…Garabedian et al reported successful results of seven cases that all underwent partial laryngectomy without tracheotomy. 8 Excision of laryngeal neuro broma using the CO 2 laser has been described by Willcox but it does not seem to be an effective treatment modality because of the growth pattern of plexiform neuro broma. 9 It may be used, however, to relieve laryngeal obstruction as a palliative measure in order to avoid total laryngectomy in large tumours.…”

The Biology and Management of Laryngeal Neurofibroma

“…An open approach (lateral thyrotomy, lateral pharyngotomy, or laryngofissure) for excision of laryngeal neurofibroma has also been advocated by some authors. 14 The open approach may provide a wider exposure and al-lows for more extensive removal of the tumors. However, regardless of surgical approach, there is significant likelihood of recurrence owing to the infiltrative nature of laryngeal neurofibroma.…”

“…However, regardless of surgical approach, there is significant likelihood of recurrence owing to the infiltrative nature of laryngeal neurofibroma. 14,15 We advocate a conservative laryngeal procedure to establish an adequate airway and preserve laryngeal function (Figure 8 and Figure 9). In cases of subtotal resection, endoscopic laser excision may be used to control the residual disease, maintain an adequate airway in a palliative measure, and preserve laryngeal functions.…”