Skip to main content
×
Home

Significance of pre-epiglottic space invasion in supracricoid partial laryngectomy with cricohyoidopexy

  • Y Suoglu (a1), M Guven (a2), E Kiyak (a1) and M Enoz (a1)
Abstract
Abstract

Cancerous involvement of the pre-epiglottic space has been known for many years to be an important prognostic factor. The aim of this study was to investigate the prognostic value of pre-epiglottic space invasion, according to the degree of invasion (i.e. absence, minimal or gross), and to assess the oncological suitability for supracricoid partial laryngectomy in patients with supraglottic laryngeal carcinomas. This study included 52 patients with squamous cell carcinomas of the supraglottic and glotto-supraglottic larynx, treated with supracricoid partial laryngectomy–cricohyoidopexy, between 1992 and 2001. Clinical and histopathological parameters were evaluated. Pre-epiglottic space invasion was seen in 35 patients (67.3 per cent); there was gross invasion in seven patients and minimal invasion in 28. Neoplastic invasion of the anterior commissure was seen in 18 patients (34.6 per cent) and thyroid cartilage involvement in eight (15.4 per cent). Neoplastic spread through the extralaryngeal tissues was not seen in any patient. The five-year overall survival was 71.5 per cent for patients with gross pre-epiglottic space invasion, 82.2 per cent for those with minimal pre-epiglottic space invasion, and 76.4 per cent for those without pre-epiglottic space invasion. It was observed that gross or minimal pre-epiglottic space invasion did not have a statistically significant effect on survival. Univariate analysis showed that nodal positivity was associated with a poor prognosis. None of the other parameters analysed showed a statistically significant relationship with survival. Four (7.6 per cent) patients had local laryngeal recurrence. Distant metastasis and a second primary tumour were detected in three (5.8 per cent) and four (7.6 per cent) patients, respectively. The five-year overall survival and cause-specific survival were 78.8 and 82 per cent, respectively. Supracricoid partial laryngectomy with cricohyoidopexy can safely be performed in supraglottic and glotto-supraglottic carcinomas with minimal or gross invasion of the pre-epiglottic space which have no extralaryngeal spread. Nodal status is an important predictor affecting survival.

Copyright
Corresponding author
Address for correspondence: Dr Mehmet Guven, Department of Otorhinolaryngology, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey. Fax:  +9 0356213 31 79 E-mail: Guvenmehmet28@yahoo.com
References
Hide All
1 De Santo LW. Early supraglottic cancer. Ann Otol Rhinol Laryngol 1990;99:593–7
2 Dursun G, Keser R, Aktürk T, Akiner MN, Demireller A, Sak SD. The significance of pre-epiglottic space invasion in supraglottic laryngeal carcinomas. Eur Arch Otorhinolaryngol 1997;254(suppl 1):110–12
3 Zeitels SM, Vaughan CW. Preepiglottic space invasion in “early” epiglottic cancer. Ann Otol Rhinol Laryngol 1991;100:789–92
4 Majer H, Rieder W. Cricohyoidopexy: a laryngectomy technique in which the airway is permanently protected [in French]. Ann Otolaryngol Chir Cervicofac 1959;76:677–83
5 Labayle J, Bismuth R. Total laryngectomy with reconstitution [in French]. Ann Otolaryngol Chir Cervicofac 1971;88:219–28
6 Laccourreye O, Brasnu D, Merite-Drancy A, Brasnu D, Chabardes E, Cauchois R et al. Cricohyoidopexy in selected infrahyoid epiglottic carcinomas presenting with pathological preepiglottic space invasion. Arch Otolaryngol Head Neck Surg 1993;119:881–6
7 Bron L, Brossard E, Monnier P, Pasche P. Supracricoid partial laryngectomy with cricohyoidoepiglottopexy and cricohyoidopexy for glottica and supraglottic carcinomas. Laryngoscope 2000;110:627–34
8 Targa L, Grandi E, Chiarello G, Farina A, Carinci F, Merlo R et al. Prognostic evaluation in supracricoid partial laryngectomy with cricohyoidopexy. Eur Arch Otorhinolaryngol 2005;262:465–9
9 Chevalier D, Piquet JJ. Subtotal laryngectomy with cricohyoidopexy for supraglottic carcinoma: review of 61 cases. Am J Surg 1994;168:472–3
10 Robbins KT, Michaels L. A study of whole organ cancerous larynges to determine resectability by conservation surgery. Head Neck 1984;7:27
11 Kirchner JA, Carter D. Intralaryngeal barriers to the spread of cancer. Acta Otolaryngol (Stockh) 1987;103:503–13
12 De Vincentis M, Minni A, Gallo A. Supracricoid laryngectomy with cricohyoidopexy (CHP) in the treatment of laryngeal cancer: a functional and oncological experience. Laryngoscope 1996;106:1108–14
13 Schwaab G, Kolb F, Julieron M, Janot F, Le Rinant AM, Mamelle G et al. Subtotal laryngectomy with cricohyoidopexy as first treatment procedure for supraglottic carcinoma: Institut Gustave-Roussy experience (146 cases, 1974–1997). Eur Arch Otorhinolaryngol 2001;258:246–9
14 De Santo LW, Magrina C, O'Fallon WM. The second side of the neck in supraglottic cancer. Otolaryngol Head Neck Surg 1990;102:351–61
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Full text views

Total number of HTML views: 1
Total number of PDF views: 6 *
Loading metrics...

Abstract views

Total abstract views: 106 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 23rd November 2017. This data will be updated every 24 hours.