GLOTTIC RECONSTRUCTION AFTER NEAR TOTAL LARYNGECTOMY

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Abstract

ABSTRACT

It is generally accepted that vertical partial laryngectomy can yield satisfactory cure rates in properly selected glottic carcinomas. Several authors have discussed different reconstructive techniques following extended vertical partial laryngectomy. These have included the use of stents, keels, various soft tissue “free” grafts, or muscle transplants. All of the above require prolonged tracheostomy and staged surgical procedures with the resultant upper airway sometimes being less than satisfactory.

Ten near total laryngectomies with epiglottic laryngoplasty have been performed by members of the Cleveland Clinic Department of Otolaryngology. Preserving only the body of one arytenoid and bilateral posterior thyroid alar struts, this technique permits the surgeon to successfully reconstruct the larynx, utilizing the epiglottis, as a one stage procedure. In general, this approach has resulted in prompt decannulation, an excellent upper airway, transient minor aspiration, and a good functional voice.

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