BİR CERRAHİ ÇELİŞKİ: SUPRAKRİKOİD LARENJEKTOMİ SONRASI TEDAVİYE DİRENÇLİ ASPİRASYONUN TEDAVİSİNDE TEK TARAFLI ARİTENOİDEKTOMİ

Abstract

DOI: 10.26650/IUITFD.342778

Suprakrikoid larenjektomi larenks fonksiyonlarının korunduğu parsiyel larenjektomi metodlarından biridir. Bu operasyonları takiben en sık görülen fonksiyonel bozukluk yutma güçlüğüdür. Aritenoid kartilajların bilateral korunmasının postoperatif dönemde yutma fonksiyonlarının çabuk iyileşmesinde faydalı olduğu bildirilmektedir. Bu olgu sunumumuzda 2015 yılında her iki aritenoid kartilajın korunduğu suprakrikoid larenjektomi yapılmış bir erkek hastayı sunmaktayız. Hastanın postoperatif dönemde şiddetli aspirasyon ve yutma problemleri olmuştur. Hastayı total larenjektomiden kurtarmak için tek taraflı aritenoidektomi denenlmiş ve başarılı olmuştur. Hasta postoperatif 3. ay takibinde gastrostomi tübünden kurtulmuştur.

Keywords

• Suprakrikoid larenjektomi,yutma problemi,aritenoidektomi

UNILATERAL ARYTENOIDECTOMY FOR INTRACTABLE ASPIRATION FOLLOWING SUPRACRICOID LARYNGECTOMY: A CASE OF SURGICAL DILEMMA

Abstract

DOI: 10.26650/IUITFD.342778

Supracricoid partial laryngectomy (SCPL) is a procedure in which the functions of the larynx are preserved. Swallowing difficulties is the most common functional impairment following SCPL. It has been suggested that sparing the arytenoid cartilages is beneficial for the rapid recovery of the swallowing function after SCPL. In this case report we present a 67-year-old male who underwent SCPL in 2015, in which both arytenoid cartilages were preserved. Following the procedure, the patient had severe aspiration and swallowing problems. In order to save the patient from total laryngectomy a one sided arytenoidectomy was performed successfully. The patient no longer required his gastrostomy tube afer 3 months.

Keywords

• Supracricoid laryngectomy,swallowing problems,arytenoidectomy

References

1. 1. Flint PW, Haughey BH, Robbins KT, Thomas JR, Niparko JK, Lund VJ, et al. Cummings otolaryngology-head and neck surgery: E Health Sci; 2014.
2. 2. Makeieff M, Venegoni D, Mercante G, Crampette L, Guerrier B. Supracricoid partial laryngectomies after failure of radiation therapy. Laryngoscope 2005;115(2):353-7.
3. 3. Akbas Y, Demireller A. Oncologic and functional results of supracricoid partial laryngectomy with cricohyoidopexy. Otolaryngol Head Neck Surg 2005;132(5):783-7.
4. 4. Benito J, Holsinger FC, Pérez-Martín A, Garcia D, Weinstein GS, Laccourreye O. Aspiration after supracricoid partial laryngectomy: incidence, risk factors, management, and outcomes. Head Neck 2011;33(5):679-85.
5. 5. Chevalier D, Laccourreye O, Laccourreye H, Brasnu D, Piquet J-J. Cricohyoidoepiglottopexy for glottic carcinoma with fixation or impaired motion of the true vocal cord: 5-year oncologic results with 112 patients. Ann Oto Rhinol Laryn 1997;106(5):364-9.
6. 6. de Vincentiis M, Minni A, Gallo A, Di Nardo A. Supracricoid partial laryngectomies: oncologic and functional results. Head Neck 1998;20(6):504-9.
7. 7. Laccourreye O, Muscatello L, Laccourreye L, Naudo P, Brasnu D, Weinstein G. Supracricoid partial laryngectomy with cricohyoidoepiglottopexy for “early” glottic carcinoma classified as T1-T2N0 invading the anterior commissure. Am J Otolaryngol 1997;18(6):385-90.
8. 8. Page C, Mortuaire G, Mouawad F, Ganry O, Darras J, Pasquesoone X, et al. Supracricoid laryngectomy with cricohyoidoepiglottopexy (CHEP) in the management of laryngeal carcinoma: oncologic results. A 35-year experience. Eur Arch Otorhinolaryngol 2013;270(6):1927-32.

9. 9. Naudo P, Hans S, Laccourreye O, Laccourreye H, Weinstein G, Brasnu D. Functional outcome and prognosis factors after supracricoid partial laryngectomy with cricohyoidopexy. Ann Otol Rhinol Laryngol 1997;106(4):291-6.
10. 10. Bron L, Brossard E, Monnier P, Pasche P. Supracricoid partial laryngectomy with cricohyoidoepiglottopexy and cricohyoidopexy for glottic and supraglottic carcinomas. Laryngoscope 2000;110(4):627-34.