[Surgical management of subglottic carcinoma].

OBJECTIVE

To explore the surgical management and evaluate the effect on patients with subglottic cancer.

METHODS

Fourteen cases with subglottic carcinoma were treated surgically from 1989 to 1998. There were T1-2N0 lesions in 5 cases, T3N0-2 lesions in 3 cases and T4N0-1 lesions in 6 cases. Eleven cases underwent partial laryngectomy and three cases underwent total laryngectomy. The defects of larynx were reconstructed by using uni-pedicled or bi-pedicled stemohyoid myofascial flap, platysma myocutaneous flap, sternocleidomastoid myoperiosteal flap, thyroid perichondral flap and epiglottis flap accordingly. Unilateral neck dissection was performed on 4 cases and bilateral on one.

RESULTS

The function of phonation had been restored in all cases except in 3 patients who underwent total laryngectomy. Seven out eleven(63.6%) were decannulated. The swallowing function was restored in all patients. In all cases the 3 and 5 year survival rates were 78.6%(11/14) and 63.6% (7/11), respectively.

CONCLUSIONS

The conservative surgery can be used for the majority of the subglottic carcinoma if the lesions were entirely resected. The proficiency in surgical methods is crucial for the preservation of laryngeal function.