Skip to main content

Assessment of the paraglottic space in supracricoid laryngectomy

En

Abstract

Background

Supracricoid laryngectomy (SCL) is largely affected by invasion of the tumor into the paraglottic space.

Aim of the work

The aim of this study was to histopathologically examine whether SCL provides adequate safety margins in terms of the paraglottic space or not.

Patients and methods

A prospective study was carried out on 20 patients with advanced cancer larynx staged as T2b, T3 and cases with failed radiotherapy where SCL was performed, followed by whole-organ transverse sections of the specimens to evaluate the relation of the tumor to the paraglottic space.

Results

The local success rate in this study was 90%; one case showed infiltrated surgical margins and the other showed local recurrence 6 months after the operation.

Conclusion

SCL allows for a safe enbloc resection of a malignant tumor in the larynx with complete resection of the paraglottic space. A safety margin of at least 4 mm is needed to eradicate the tumor as revealed by the whole-organ section technique.

References

  1. Snyder M, William ML, Daniel DL Glottic cancer: follow-up. Available at: http://www.emedicine.com/ent/topic688.htm. 2006.

  2. Bron M, Brossard E, Monnier P, Pasche P. Supracricoid partial laryngectomy with cricohyoidoepiglottopexy and cricohyoidopexy for glottis and supraglottic carcinomas. Laryngoscope 2000;111:627–634.

    Article  Google Scholar 

  3. Laccourreye O, Weinstein G, Naudo P, Cauchois R, Laccourreye H, Brasnu D. Supracricoid partial laryngectomy after failed laryngeal radiation therapy. Laryngoscope 1996;106:495–498.

    Article  CAS  Google Scholar 

  4. Moretti A, Croci A. Total laryngectomy from hands of the general surgeon to the otolaryngologist. Acta Otorhinolaryngol Ital 2000;20:16–22.

    CAS  PubMed  Google Scholar 

  5. De Vincentiis M, Minni A, Gallo A, Di Nardo A. Supracricoid partial laryngectomies: oncologic and functional results. Head Neck 1998;20:504–509.

    Article  Google Scholar 

  6. Kim MS, Sun D, Park KH, Cho KJ, Park YH, Cho SH. Paraglottic space in supracricoid laryngectomy. Arch Otolaryngol Head Neck Surg 2002;128:304–307.

    Article  Google Scholar 

  7. Brzosca M, Pietrysiak A, Kurk-Zagajeweska A. The impact of paraglottic space for laryngeal cancer spread. Otolaryngol Pol 2005;59:527–532.

    Google Scholar 

  8. Coman WB, Grigg RG, Tomkinson A, Gallagher RM. Supracricoid laryngectomy: a significant advance in the management of laryngeal cancer. Aust N Z J Surg 1998;68:630–634.

    Article  CAS  Google Scholar 

  9. Chevalier D, Laccourreye O, Brasnu D, Laccourreye H, Piquet J. Cricohyoidoepiglottopexy for glottis carcinoma with fixation or impaired motion of the true vocal cord: 5-year oncologic results with 112 patients. Ann Otol Rhinol Laryngol 1997;106:364–369.

    Article  CAS  Google Scholar 

  10. El Shennawy M, Zohdi I, El Sharkawy L, Mosleh M. Supracricoid partial laryngectomies: oncologic and functional outcome. Egypt J Otolaryngol 2004;21:1–10.

    Google Scholar 

  11. Schindler A, Favero E, Capaccio P, Albera R, Cavalot AL, Ottaviani F. Supracricoid laryngectomy: age influence on long-term functional results. Laryngoscope 2009;119:1218–1225.

    Article  Google Scholar 

  12. Rifai M, Heiba MH, Salah H. Anterior commissure carcinoma II: the role of salvage supracricoid laryngectomy. Am J Otolaryngol 2002;23:1–3.

    Article  Google Scholar 

  13. Laccourreye H, Laccourreye O, Weinstein G, Menard M, Brasnu D. Supracricoid laryngectomy with cricohyoidopexy: a partial laryngeal procedure for selected supraglottic and transglottic carcinomas. Laryngoscope 1990;100:735–741.

    CAS  PubMed  Google Scholar 

  14. Crampette L, Garrel R, Gardiner Q, Maurice N, Mondain M, Makeieff M, Guerrier B. Modified subtotal laryngectomy with cricohyoidoepiglottopexy: long term results in 81 patients. Head Neck 1999;21:95–103.

    Article  CAS  Google Scholar 

  15. Yücetürk AV, Günhan K. Supracricoid laryngectomy: oncological and functional outcome. Kulak Burun Bogaz Ihtis Derg 2004;13:57–61.

    PubMed  Google Scholar 

  16. Farrag TY, Koch WM, Cummings CW, Goldenberg D, Abou-Jaoude PM, Califano JA, et al.. Supracricoid laryngectomy outcomes: the Johns Hopkins experience. Laryngoscope 2007;117:129–132.

    Article  Google Scholar 

  17. Karasalihoglu AR, Yagiz R, Tas A, Uzun C, Adali MK, Koten M. Supracricoid partial laryngectomy with cricohyoidopexy and cricohyoidoepiglottopexy: functional and oncological results. J Laryngol Otol 2004;118:671–675.

    Article  Google Scholar 

  18. Nakayama M, Okamoto M, Miyamoto S, Takeda M, Yokobori S, Masaki T, Seino Y. Supracricoid laryngectomy with cricohyoidoepiglottopexy or cricohyoido-pexy: experience on 32 patients. Auris Nasus Larynx 2007;35:77–82.

    Article  Google Scholar 

  19. Rifai M. Extended supracricoid laryngectomy with excision of both arytenoids: the modified reconstructive laryngectomy. Acta Otolaryngol 2007;127:642–650.

    Article  Google Scholar 

  20. Yüce I, Cağli S, Bayram A, Karasu F, Sati I, Güney E. The effect of arytenoid resection on functional results of cricohyoidopexy. Otolaryngol Head Neck Surg 2009;141:272–275.

    Article  Google Scholar 

  21. Maguire A, Dayal VS. Supraglottic anatomy the pre- or the peri-epiglottic space? Can J Otolaryngol 1974;3:432–445.

    CAS  PubMed  Google Scholar 

  22. Pinar E, Imre A, Calli C, Oncel S, Katilmis H. Supracricoid laryngectomy: analyses of oncologic and functional outcomes. Otolaryngol Head Neck Surg 2012;147:1093–1098.

    Article  Google Scholar 

  23. Dufour X, Hans S, Laccourreye O. Quality of voice after supracricoid laryngectomy. Arch Otolaryngol Head Neck Surg 2004;130:1092–1099.

    Article  Google Scholar 

  24. Weinstein GS, El-Sawy MM, Ruiz C, Dooley P, Chalian A, El-Sayed MM, Goldberg A. Laryngeal preservation with supracricoid partial laryngectomy results in improved quality of life when compared with total laryngectomy. Laryngoscope 2001;111:191–199.

    Article  CAS  Google Scholar 

  25. Pellini R, Pichi B, Ruscito P, Ceroni AR, Caliceti U, Rizzotto G, et al. Supracricoid partial laryngectomies after radiation failure: a multi-institutional series. Head Neck 2008;30:372–379.

    Article  Google Scholar 

  26. Nakayama M, Okamoto M, Hayakawa K, Ishiyama H, Kotani S, Miyamoto S, et al. Clinical outcome of supracricoid laryngectomy with cricohyoidoepiglottopexy: radiation failure versus previously untreated patients. Auris Nasus Larynx 2013;40:207–210.

    Article  Google Scholar 

  27. Spriano G, Pellini R, Romano G, Muscatello L, Roselli R. Supracricoid partial laryngectomy as salvage surgery after radiation failure. Head Neck 2002;24:759–765.

    Article  Google Scholar 

  28. Sprinzl GM, Eckel HE, Sittel C, Thumfart WF, Koebke J. Whole organ plastination in otorhinolaryngology. HNO 1995;43:282–286.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hazem M. AbdelTawab MD.

Additional information

Conflicts of interest

There are no conflicts of interest.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

AbdelRaouf, M., Mansy, M.M., Raafat, S.A. et al. Assessment of the paraglottic space in supracricoid laryngectomy. Egypt J Otolaryngol 29, 242–248 (2013). https://doi.org/10.7123/01.EJO.0000433254.01960.bf

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.7123/01.EJO.0000433254.01960.bf

Keywords

  • paraglottic space
  • supracricoid laryngectomy
  • whole-organ section