Department of Sensorial Organs, Otorhinolaryngology Section, Sapienza University of Rome, Rome, Italy.
Laryngoscope. 2011 Nov;121(11):2375-80. doi: 10.1002/lary.22337.
OBJECTIVES/HYPOTHESIS: Our goal was to describe a total cricoidectomy, a laryngeal-preserving procedure for the treatment of low-grade chondrosarcomas of the larynx. These extremely rare cartilaginous tumors arise in the cricoid cartilage in most cases. Although these are slow-growing and rarely metastasizing tumors, large chondrosarcomas of cricoid cartilage are generally treated with total laryngectomy. An oncologically radical but function-preserving approach would therefore be preferable.
Case series.
Three consecutive patients with low-grade chondrosarcomas of the larynx underwent total cricoidectomy from 1996 to 2004. An end-to-end anastomosis between the remaining larynx and the trachea was performed to restore the continuity of airways. In all cases the laryngeal lumen was stented using a Montgomery T-tube. Oncologic and functional results were observed during at least 6 years of follow-up.
No evidence of tumor recurrence was detected during follow-up. One month after surgery, all patients were able to tolerate a soft diet and to speak satisfactorily. One patient was ultimately decannulated, and two patients still have a tracheostomy. However, even nondecannulated patients were able to keep the tracheostoma closed for most of the time, maintaining good phonatory and swallowing functions.
Total cricoidectomy with thyrotracheopexy may avoid the need for total laryngectomy in low-grade chondrosarcomas of the cricoid cartilage.
目的/假设：我们的目标是描述全环状切除术，这是一种保留喉功能的手术，用于治疗低级别喉软骨肉瘤。这些极为罕见的软骨肉瘤通常起源于环状软骨。尽管这些肿瘤生长缓慢，很少转移，但大的环状软骨软骨肉瘤通常需要全喉切除术治疗。因此，一种具有肿瘤学根治性但保留功能的方法会更可取。
病例系列研究。
1996 年至 2004 年间，连续 3 例低级别喉软骨肉瘤患者接受了全环状切除术。通过端对端吻合术将剩余的喉部和气管连接起来，以恢复气道的连续性。在所有病例中，使用 Montgomery T 型管对喉腔进行支架支撑。在至少 6 年的随访期间观察了肿瘤学和功能结果。
在随访期间未发现肿瘤复发的证据。手术后 1 个月，所有患者均能耐受软食并能满意地说话。1 例患者最终拔管，2 例患者仍有气管造口。然而，即使是未拔管的患者也能在大多数时间关闭气管造口，保持良好的发音和吞咽功能。
环状软骨全切除术加甲状腺气管固定术可避免在低级别环状软骨软骨肉瘤中需要进行全喉切除术。
