FRONTO-LATERAL LARYNGECTOMY AND EPİGLOTTİC LARYNGOPLASTY İN EARLY STAGED GLOTTİC CANCER

Abstract

This study was conducted on 81 larynx carcinoma patients who were treated surgically from January 1992 until January 2003 with frontolateral laryngectomy and epiglottic laryngoplasty. 12 patients had T2N0M0 and 69 patients had T1bN0M0 glottic carcinomas. In 16 of them, one arytenoid was sacrified and in the remaining 65 patients, both arytenoids were preserved. So, 2 groups, frontolateral laryngectomized n=65 and extended frontolateral laryngectomized n=16 were described. Surgical defects in all patients were reconstructed using epiglottic pull-down method as described by Tucker. Decanulation and oral feeding times were rewieved and compared. There is a statistically significant difference in oral feeding and decannulation times between this 2 groups. None of the cases had aspiration and dyspnea problems. Frontolateral laryngectomy and extended frontolateral laryngectomy with epiglottic pull-down method, with it`s advantages, such as reconstruction of the laryngeal structures in one stage, early oral feedinf time, early decanulation, a satisfactory voice quality and minimal morbidity is a acceptable laryngeal reconstruction method

Keywords

• Frontolateral laryngectomy,epiglottic laryngoplasty,Tucker,larynx cancer

ERKEN EVRE GLOTTİK KANSERLERDE FRONTO-LATERAL LARENJEKTOMİ VE EPİGLOTTİK LARİNGOPLASTİ

Öz

Bu çalışma, Ocak 1992- Ocak 2003 yılları arasında larinks kanseri nedeniyle fronto-lateral larenjektomi ve epiglottik laringoplasti ile rekonstrüksiyon yapılan 81 olgu üzerinde gerçekleştirilmiştir. Olguların 12 tanesinde T2N0M0, 69 tanesinde ise T1bN0M0 glottik kanser mevcuttu. Olguların 16’sında ameliyat esnasında bir aritenoid feda edilmiş, 65’inde ise aritenoidler korunmuştur. Bu şekilde frontolateral larenjektomili n=65 ve genişletilmiş frontolateral larenjektomili n=16 hastalar olmak üzere 2 grup oluşturulmuştur. Tüm olgularda Tucker yöntemiyle epiglottik pulldown yapılarak operasyon defekti rekonstrükte edildi. Olguların dekanülman süresi ve oral beslenmeye geçiş süreleri karşılaştırıldı. Bu 2 hasta grubunun oral beslenmeye geçiş ve dekanülman süreleri arasında istatistiksel anlamlı fark bulunmuştur. Hiçbir olguda aspirasyona ilişkin problem olmamış ve dispne gelişmemiştir. Frontolateral larenjektomi ve genişletilmiş frontolateral larenjektomi yapılan olgularda epiglottik larengoplasti yöntemi, larinks yapılarının tek seansta rekonstrüksiyonunu sağlaması, kısa sürede oral beslenmeye geçiş, kısa sürede dekanüle edilebilmesi, iyi bir ses kalitesi sağlaması ve minimal morbiditeye neden olması gibi avantajları ile seçkin bir larengeal rekonstrüksiyon yöntemidir

Anahtar Kelimeler

• Frontolateral larenjektomi,epiglottik laringoplasti,Tucker,larinks kanseri

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