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Cricohyoepiglottopexy: long-term results in 55 patients

Published online by Cambridge University Press:  29 June 2007

J. G. Lallemant ,
P. Bonnin ,
I. El-Sioufi  and
J. Bousquet
J. G. Lallemant*
Affiliation:
Department of Otorhinolaryngology and Medical Information, Gaston Doumergue Hospital, Nimes, France.
P. Bonnin
Affiliation:
Department of Otorhinolaryngology and Medical Information, Gaston Doumergue Hospital, Nimes, France.
I. El-Sioufi
Affiliation:
Department of Otorhinolaryngology and Medical Information, Gaston Doumergue Hospital, Nimes, France.
J. Bousquet
Affiliation:
Department of Otorhinolaryngology and Medical Information, Gaston Doumergue Hospital, Nimes, France.
*
Address for correspondence: J. G. Lallemant, M.D., Chef du service ORL et CMF, C.H.U. Gaston Doumergue, 5, Rue Hoche, BP 26 30029 Nimes CedexFrance. Fax: 0 11 33 66 68 31 00
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Abstract

Near total laryngectomy with cricohyoepiglottopexy (CHEP) allows cure of glottic carcinomas with voice preservation. The subject of this study was to evaluate CHEP in terms of tumour control and functional result in T1 and T2 glottic carcinomas.

This study reviewed retrospectively 55 consecutive cases of CHEP performed between January 1, 1981 and September 1, 1992 with the exclusion of post-radiotherapy salvage surgery. CHEP was indicated for a T1a limit to the anterior commissure and/or with dysplasia of the other vocal fold (10 cases), T1b (11 cases) and T2 (34 cases) glottic carcinomas. All our patients have a follow-up of more than five years.

The post-operative course after this surgery was generally uneventful. The median time to decannulation was 18 days, to removal of the nasogastric tube was 15 days and to discharge from hospital was 23 days. No significant difference was observed according to the preservation of one or both arytenoid cartilages. The long-term functional result can be considered to be good in three-quarters of cases, with normal oral swallowing and an easily understood voice. The remaining one quarter had a whispery voice and sometimes episodes of aspiration when swallowing liquids. In terms of oncological results, the five-year recurrence-free survival rate was 94 per cent for T1 and 84 per cent for T2. The ultimate tumour control (taking into account four cases of total laryngectomy) was 94 per cent for T1 and 93 per cent for T2.

Primary surgery by CHEP therefore appears to be a good option for early glottic carcinomas. The main problem remains that voice recovery is mediocre in one quarter of patients.

Keywords

GlottisSquamous cell carcinomaSurgerySurvival rateVoice qualityDeglutition disorders
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 113 , Issue 6 , June 1999 , pp. 532 - 537
Copyright
Copyright © JLO (1984) Limited 1999

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References

Benninger, M. S., Gillen, J., Thieme, P., Jacobson, B., Dragovich, J. (1994) Factors associated with recurrence and voice quality following radiation therapy for T1 and T2 glottic carcinomas. Laryngoscope 104: 294–298.CrossRefGoogle ScholarPubMed
Calearo, C. V., Teatini, G. (1978) Horizontal glottectomy. Laryngoscope 88: 1529–1535.CrossRefGoogle ScholarPubMed
Fernberg, J. O., Ringborg, U., Silfversward, C., Ewert, G., Haglund, S., Schiratzki, H., Strander, H. (1989) Radiation therapy in early glottic cancer. Analysis of 177 consecutive cases. Acta Otolaryngologica (Stockh) 108: 478–481.CrossRefGoogle ScholarPubMed
Guiney, M, Smith, J., Narayan, H. (1992) Radiation therapy of glottic carcinoma: Peter MacCallum cancer institute experience. Australian and New Zealand Journal of Surgery 62: 622–627.CrossRefGoogle ScholarPubMed
Hirano, M. (1989) Objective evaluation of the human voice: clinical aspects. Folia Phoniatrica 41: 89–144.CrossRefGoogle ScholarPubMed
Hirota, S., Soejima, T., Obayashi, K., Hishikawa, Y., Honda, K., Okamoto, Y., Maeda, H., Takada, Y., Inoue, K., Kinishi, M. Amatsu, M., Kimura, S. (1996) Radiotherapy of Tl and T2 glottic cancer: analysis of anterior commissure involvement. Radiation Medicine 14: 297–302.Google Scholar
Howel-Burke, D., Peters, L. J., Goepfert, H., Oswald, M. J. (1990) T2 glottic cancer. Recurrence, salvage and survival after definitive radiotherapy. Archives of Otolaryngology – Head and Neck Surgery 116: 830–835.CrossRefGoogle Scholar
Inoue, T., Inoue, T., Ikeda, H., Teshima, T., Murayama, S. (1992) Prognostic factor of telecobalt therapy for early glottic carcinoma. Cancer 70: 2797–2801.3.0.CO;2-5>CrossRefGoogle ScholarPubMed
Kanonier, G. Fritsch, E., Rainer, T., Thumfart, W. F. (1996) Radiotherapy in early glottic carcinoma. Annals of Otology, Rhinology and Otolaryngology 105: 759–763.CrossRefGoogle ScholarPubMed
Labayle, J., Bismuth, R. (1971) Laryngectomie totale avec reconstruction. Annales d'Oto-laryngologie et de Chirurgie Cervico-faciale 88: 219–228.Google Scholar
Laccourreye, H., Menard, M., Fabre, A., Brasnu, D., Janot, F. (1987) Les laryngectomies partielles sus-cricoidiennes. Techniques, indications, résultats. Annales d'Oto-laryngologie et de Chirurgie Cervico-faciale 104: 163–173.Google Scholar
Leroux-Robert, J. (1975) A statistical study of 60 laryngeal carcinomas of the glottic region personally operated upon more than five years ago. Laryngoscope 85: 1522–1535.CrossRefGoogle Scholar
MacLaughlin, M. P., Parson, J. T., Fein, D. A., Stringer, S. P., Cassisi, N. J., Mendenhall, W. M., Million, R. R. (1996) Salvage surgery after radiotherapy failure in T1-T2 squamous cell carcinoma of the glottic larynx. Head and Neck Surgery 18: 229–235.Google Scholar
Majer, E., Rieder, W. (1959) Technique de laryngectomie permettant de conserver la perméabilité respiratoire (la crico-hyoïdo-pexie). Annales d'Oto-laryngologie et de Chirurgie Cervico-faciale 76: 677–681.Google Scholar
Mendenhall, W. H., Parsons, J. T., Stringer, S. P., Cassisi, N. J., Million, R. R. (1988) T1-T2 vocal cord carcinoma: a basis for comparing the results of radiotherapy and surgery. Head and Neck Surgery 10: 373–377.CrossRefGoogle ScholarPubMed
Nishimura, Y., Nagata, Y., Okajima, K., Mitsumori, M., Hiroaka, M., Masunaga, S., Ono, K., Shoji, K., Kojima, H. (1996) Radiation therapy for T1-T2 glottic carcinoma: impact of overall treatment time on local control. Radiotherapy and Oncology 40: 225–232.CrossRefGoogle Scholar
Pech, A., Cannoni, M., Giovanni, A., Thomassin, J. M., Zanaret, M., Goubert, J. L. (1986) La nécessaire sélection des techniques chirurgicales dans le traitement du cancer du larynx. Annales d'Oto-laryngologie et de Chirurgie Cervicofaciale 103: 565–575.Google ScholarPubMed
Pelliteri, P. K., Kennedy, T. L., Vrabec, D. P., Beiler, D., Hellstrom, M. (1991) Radiotherapy. The mainstay in the treatment of early glottic carcinoma. Archives of Otolaryngology – Head and Neck Surgery 117: 297–301.CrossRefGoogle Scholar
Perrin, C., Brunet, A., Apap, E. (1987) La laryngectomie frontale antérieure avec épiglottoplastie de glissement. Intervention de Tucker. Indications. Techniques et résultats. Annales d'Oto-laryngologie et de Chirurgie Cervicofaciale 104: 277–279.Google Scholar
Pessey, J. J., David, J. M., Dubarry, B., Moreau, G. A., Serrano, E., Lacomme, Y. (1985) Résultats fonctionnels aprés laryngectomies reconstructives, In Comptes-rendus des séances du 82ème Congrès Français d'ORL et de Chirurgie Cervico-faciale. (Masson, ed. Paris) pp 349–353.Google Scholar
Piquet, J. J. (1988) La crico-hyoïdo-épiglottopexie Majer Piquet dans le traitement des cancers glottiques. Journal Français d'Oto-Rhino-Laryngologie 37: 63–66.Google Scholar
Piquet, J. J., Chevalier, D., Darras, J. A., Ruox, X. (1990) Laryngectomie avec épiglottoplastie de Tucker. Annales d'Oto-laryngologie et de Chirurgie Cervico-faciale 107: 555–558.Google ScholarPubMed
Piquet, J. J., Desaulty, A., Decroix, G. (1974) La crico-hyoïdo-épiglotto-pexie. Technique opératoire et résultats fonctionnels. Annales d'Oto-laryngologie et de Chirurgie Cervicofaciale 91: 681–686.Google Scholar
Sagar, S. M., MacKenna, G., Nolan, M. C. (1994) A clinical audit of glottic cancer in Nova Scotia: a paradigm for effectiveness research. Clinical Oncology 6: 14–23.CrossRefGoogle ScholarPubMed
Traissac, L., Verhulst, J. (1991) Indications, techniques et résultats des laryngectomies reconstructives. Revue de Laryngologie Otologie et Rhinologie 112: 55–58.Google Scholar
Tucker, H. M., Benninger, M. S., Robert, J. K., Woods, B. G., Levine, H. L. (1989) Near total laryngectomy with epiglottic reconstruction. Archives of Otolaryngology – Head and Neck Surgery 115: 1341–1344.CrossRefGoogle ScholarPubMed
Tucker, H. M., Wood, B. J., Levine, H., Katz, R. (1979) Glottic reconstruction after near total laryngectomy. Larynoscope 89: 609–618.CrossRefGoogle ScholarPubMed
Turesson, I., Sandberg, N., Mercke, C., Johansson, K. A., Sandin, I., Wallgren, A. (1991) Primary radiotherapy for glottic laryngeal carcinoma stage I and II. A retrospective study with special regard to failure patterns. Acta Oncologica 30: 357–362.CrossRefGoogle Scholar
Zanaret, M., Giovanni, A., Gras, R., Cannoni, M. (1993) Near total laryngectomy with epiglottic reconstruction: long-term results in 57 patients. American Journal of Otolaryngology 14: 419–425.CrossRefGoogle ScholarPubMed