Serafini I, Pazzaia T, Lucioni M, Bittesini L
Divisione Otorinolaringoiatrica, Ospedale di Vittorio Veneto.
Acta Otorhinolaryngol Ital. 1990 Jul-Aug;10(4):391-7.
Three-quarter laryngectomy is regarded as a supraglottic laryngectomy which has been extended on one side to the glottic plane. Indications are those for supraglottic laryngectomy at the vestibular level and of cordectomy extended to the arytenoid at the glottic level (undamaged lower paraglottic space, preserved motility). Surgical technique includes total removal of the laryngeal vestibule together with the hyoid bone, pre-epiglottic space and one supracricoid hemilarynx (vocal cord, arytenoid, medial wall of the entrance of the pyriform fossa) through an internal, subperichondrial approach. Reconstruction of a new cord on the hemilaryngectomy side is through a triangular strip of the exterior thyroid perichondrium. From 1975 to 1989 44 patients underwent a three-quarter laryngectomy in the authors' department. Functional results were positive in all cases. The oncological results were as follows: 6 recurrences (3 local, 2 locoregional lymph node recurrences and 1 distant metastasis) and 4 primary secondary tumors. 9 patients expired (6 of T, 2 of secondary tumor, 1 of other causes). The actuarial 5-year survival rate for the tumor was 79%.
四分之三喉切除术被视为一种声门上喉切除术，其一侧已扩展至声门平面。适应证为前庭水平的声门上喉切除术以及声门水平扩展至杓状软骨的声带切除术（下咽旁间隙未受损，活动度保留）。手术技术包括通过内部软骨膜下入路，完全切除喉前庭、舌骨、会厌前间隙和一个环状软骨上半喉（声带、杓状软骨、梨状窝入口内侧壁）。在半喉切除侧通过甲状腺软骨外膜的三角形条带重建新的声带。1975年至1989年，作者所在科室有44例患者接受了四分之三喉切除术。所有病例的功能结果均为阳性。肿瘤学结果如下：6例复发（3例局部复发，2例区域淋巴结复发，1例远处转移）和4例原发性继发肿瘤。9例患者死亡（6例死于肿瘤，2例死于继发肿瘤，1例死于其他原因）。肿瘤的精算5年生存率为79%。
