Spriano Giuseppe, Mercante Giuseppe, Cristalli Giovanni, Pellini Raul, Ferreli Fabio
Department of Otolaryngology - Head & Neck Surgery, Regina Elena National Cancer Institute, Rome, Italy.
Department of Otolaryngology - Head & Neck Surgery, Regina Elena National Cancer Institute, Rome, Italy.
Am J Otolaryngol. 2017 Sep-Oct;38(5):598-602. doi: 10.1016/j.amjoto.2017.06.011. Epub 2017 Jun 27.
The supracricoid partial laryngectomy has been described for the treatment of T3 laryngeal glottic and supraglottic tumors as well as upfront and salvage surgery. Good oncological and functional outcomes are expected, while the post-operative rehabilitation can be quite difficult for the patient. Early and late complications can occur especially in salvage surgery. Neck dissection according to the T stage is often associated with the resection of the primary tumor.
To verify the feasibility of a minimally invasive procedure for supracricoid partial laryngectomy by adopting the lateral cervical approach.
METHODS/RESULTS: A 61-year old man affected by a cT3N0 glottic cancer already treated 10years prior with radiotherapy for oropharyngeal cancer underwent supracricoid laryngectomy using the lateral approach. The key point of the procedure was a subfascial dissection with the harvesting of anterior cervical flap including skin, fat, platysma, fascia superficialis, anterior jugular veins, homo- and sterno-hyoid muscles.
Supracricoid laryngectomy by a lateral approach is feasible and safe; it allows to perform a simultaneous neck dissection and the removal of the entire laryngeal specimen preserving ample healthy tissue compared to the classic anterior approach.
环状软骨上部分喉切除术已被用于治疗T3期喉声门和声门上肿瘤，以及初次手术和挽救性手术。预期可获得良好的肿瘤学和功能结果，而术后康复对患者来说可能相当困难。尤其是在挽救性手术中，可能会出现早期和晚期并发症。根据T分期进行的颈部清扫术通常与原发肿瘤的切除相关。
通过采用颈外侧入路，验证环状软骨上部分喉切除术微创方法的可行性。
方法/结果：一名61岁男性，患有cT3N0声门癌，10年前曾因口咽癌接受过放疗，此次采用外侧入路进行了环状软骨上喉切除术。该手术的关键在于在筋膜下进行解剖，获取包括皮肤、脂肪、颈阔肌、浅筋膜、颈前静脉、甲状舌骨肌和胸骨舌骨肌的颈前皮瓣。
外侧入路环状软骨上喉切除术是可行且安全的；与经典的前入路相比，它允许同时进行颈部清扫并切除整个喉部标本，同时保留足够的健康组织。
