Frontal Anterior Laryngectomy with Epiglottic Reconstruction (Tucker's Operation): Oncologic and Functional Results

Öz

Objective: To evaluate functional and oncological results of patients who were treated with frontal anterior laryngectomy with epiglottic reconstruction (Tucker's operation). Material and Methods: From September 1985 to November 2009, 58 patients whose early glottic carcinomas were operated on with Tucker's operation. The time of decannulation, nasogastric tube removal, hospitalization and oncological results were analyzed. Acoustic analysis and Voice Handicap Index (VHI) were used to evaluate vocal function. Results: The mean time for decannulation and nasogastric tube removal were 11.8±7.6 and 15.4±4.4 days, respectively. The mean duration of hospital stay was 19.3±6.1 days. It was found that early decannulation significantly reduced patient decannulation and hospitalization time. The 5-year overall and cause-specific actuarial survival rates were 81.5% and 96.9%, respectively. The 10-year overall and cause-specific survival rates were 67% and 92.3%, respectively. The 5-year local and nodal control rates were 95.4% and 95.2%, respectively. The mean values for jitter, shimmer and noise-to-harmonic ratio were 8.10±5.59%, 16.60±5.81% and 0.51±0.23, respectively, and these scores showed a significant increase. Total VHI score and subscale scores except VHI-emotional noted that patients had a mild level of vocal disability. Conclusion: Tucker's operation is one of the preferred techniques in the treatment of early glottic carcinoma with its high oncologic success rate and satisfactory functional results. Turkish Başlık: Epiglot Rekonstrüksiyonlu Frontal Anterior Larenjektomi (Tucker Operasyonu): Onkolojik ve Fonksiyonel Sonuçlar Anahtar Kelimeler: Larengeal neoplaziler; Karsinom, Skuamöz Hücre; Larenjektomi Amaç: Epiglot rekonstrüksiyonlu frontal anterior larenjektomi (Tucker operasyonu) ile tedavi edilen hastaların fonksiyonel ve onkolojik sonuçlarını değerlendirmek. Hastalar ve Yöntemler: Eylül 1985-Kasım 2009 yılları arasında, erken glottik tümörü olan 58 hastaya Tucker operasyonu uygulandı. Dekanülasyon zamanı, nazogastrik sondanın çıkarılması, hastanede yatış ve onkolojik sonuçlar analiz edildi. Akustik analiz ve Ses Handikap Endeksi (SHE) vokal fonksiyon değerlendirmesi için kullanıldı. Bulgular: Ortalama dekanülasyon ve nazogastrik sonda çıkarılma süreleri sırasıyla 11,8 ve 15,4 gündü. Ortalama hastanede yatış süresi 19,3 gündü. Erken dekanülasyon uygulamasının hastaların dekanülasyon ve hastanede yatış sürelerini belirgin şekilde azalttığı bulundu. Beş yıllık genel sağ kalım oranı %81,5, primer hastalığa spesifik sağ kalım oranı %96,9 bulundu. On yıllık genel ve primer hastalığa spesifik sağ kalım oranları sırasıyla %67 ve %95,2 bulundu. Beş yıllık lokal kontrol oranı %95,4, nodal kontrol oranı %95,2 bulundu. Hastaların jitter, shimmer ve gürültü-harmonik oranı sırasıyla %8,1, %16,6 ve 0.51 bulundu. Bu değerler belirgin bir artışı gösteriyordu. Total SHE skoru ve alt grup skorlarından SHE-emosyonel hariç diğerleri hastaların hafif düzeyde ses sorunu yaşadığını gösterdi. Sonuç: Tucker operasyonu yüksek onkolojik ve tatminkar fonksiyonel sonuçlarıyla erken glottik karsinomların tedavisinde tercih edilebilecek tekniklerden biridir.

Anahtar Kelimeler

• Laryngeal neoplasms, carcinoma, squamous cell, laryngectomy

Frontal Anterior Laryngectomy with Epiglottic Reconstruction (Tucker's Operation): Oncologic and Functional Results

Öz

Kaynakça

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