BackgroundTo assess functional results, complications, and success of larynx preservation in patients with recurrent squamous cell carcinoma after radiotherapy.MethodsFrom a database of 40 patients who underwent supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP) from June 2001 to April 2006, eight patients were treated previously with radiotherapy due to squamous cell carcinoma of the glottic region and were treated for recurrence at the site of the primary cancer.ResultsSCPL with CHEP was performed in six men and two women with a mean age of 67 years due to recurrence and/or persistence at a mean time of 30 months postradiotherapy (in case #8 after concomitant chemoradiotherapy). Bilateral neck dissection at levels II-V was performed in six patients. Only case #8 presented metastasis in one node. In case #5, Delphian node was positive. It was possible to preserve both arytenoids in five cases. Definitive surgical margins were negative. Complications were encountered in seven patients. Follow-up was on average 44 months (range: 20-67 months). Organ preservation in this series was 75%, and local control was 87%. Overall 5-year survival was 50%.ConclusionsIn selected patient with persistence and/or recurrence after radiotherapy due to cancer of the larynx, SCPL with CHEP seems to be feasible with acceptable local control and toxicity. Complications may occur as in previously non-irradiated patients. These complications must be treated conservatively to avoid altering laryngeal function.

This study assessed the functional results in patients treated primarily through supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP). Fifteen patients with a diagnosis of epidermoid carcinoma of the glottis region admitted to the Instituto Nacional de Cancerología (México) between June 2001 and September 2002 were studied. Three patients were at stage I, five at stage II, six at stage III, and one at stage IV. Both cricoarytenoid units were preserved in 12 patients, and only one in three. Each case was assessed through the clinical grading postoperative aspiration (CGPA) scale, the performance status scale for head and neck cancer (PSS-HNC), and the Karnofsky Performance Scale (KPS). Likewise, voice quality of the patients was assessed regarding tone and intensity using the SpeechViewer version 1 (IBM) and data were obtained with the Cool Edit 2000 software. Twelve patients received phoniatric rehabilitation and three were left without rehabilitation. The average time for decannulation was 12 days and 23 days for removal of the nasogastric catheter. The degree of aspiration was 0 in four patients and one in 11. According to PSS-HNC, the mean for normalcy in the diet was 95 and the mean for those eating in public was 91. Intelligibility reached an average of 90. Karnofsky's assessment was related to the disease and not to the treatment, as it remained at 100 per cent in most patients and was never below 80 per cent. The mean intensity of quality of voice was -18 dB below normal; however, the mean frequency was 243.7 Hz. SCPL and CHEP allows the preservation of the basic function of the larynx; however, a clear alteration in voice occurs after the procedure, although normal frequency is kept when both arytenoids are preserved. Likewise, preservation of both arytenoids shortens the time needed for cannula and feeding catheter removal. PSS-HNC, Karnofsky, and CGPA assessments demonstrated that patients can reach an almost normal bio-psycho-social integration. It is recommended that all patients be subjected to phoniatric rehabilitation.

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Objective:The objective of the study was to analyze the results of endoscopic laser microsurgery for early glottic carcinoma treatment (Stages I and II) at a Tertiary Center in Mexico City. Materials and methods: Descriptive, retrospective review of 40 patients with early glottic carcinoma who were treated with endoscopic laser microsurgery with curative intent at our institution from November 2003 to December 2013. Results: The study yielded 4 pTis, 19 pT1a, 8 pT1b, and 9 pT2 patients. Mean patient follow-up time was 7.4 years (range 3-12.9 years). Post-operative bleeding requiring surgical intervention occurred in 1 (2.5%) patient. Kaplan-Meier results at 3 and 5-year estimates were as follows: overall survival was 92.5 and 87%, respectively; laser only local control was 94.9 and 91.6%, respectively; and disease specific survival and ultimate local control rate were 97.5% for both time periods. We found a 97.5% (39/40) organ preservation rate. Conclusions: Laser microsurgery for glottic carcinoma treatment is an emerging technique in Mexico. Our results are promising as reported by other authors in Europe and United States of America, which support the replicability of the surgical technique refined by Dr. Wolfgang Steiner.