Tips for Partial Laryngectomy

Abstract

Conservation laryngeal surgery for T 1 -2 lesions (and selected T3) includes endoscopic resection, transoral resection, and open conservation laryngeal surgery (partial or subtotal laryngectomy). The Japanese guidelines also include total laryngectomy for T 2 ; however, the NCCN (National Comprehensive Cancer Network) guidelines do not include the option of total laryngectomy. T3-4 lesions are rarely candidates for conservation laryngeal surgery, as postoperative irradiation impairs the functional prognosis, and the efficacy of induction chemotherapy before conservation laryngeal surgery has not yet been verified in clinical trials. In clinical practice, partial laryngectomy is often considered for recurrence after definitive radiotherapy. There are few cases in which open conservation laryngeal preservation surgery can be applied as a salvage operation; therefore, the decision should be made carefully. In a surgical technique seminar, I showed surgical videos of vertical partial laryngectomy, horizontal partial laryngectomy, and subtotal laryngectomy (supracricoid partial laryngectomy) and explained tips and the pitfalls associated with each surgical technique. It is important to make appropriate judgments regarding the indications to ensure a good postoperative function. Lung health is an important consideration to be made before surgery. To perform surgery with fewer complications, it is necessary to minimize the extent of undermining, and care must be taken to prevent wound healing failure after salvage surgery.