Abstract
Purpose
To identify a radiological map of laryngeal subsites whose involvement by the tumor could predict patients’ functional outcomes after open partial horizontal laryngectomy (OPHL).
Methods
The present retrospective analysis concerned 96 patients with glottic squamous cell carcinoma, who were radiologically staged with contrast-enhanced neck CT scans before undergoing supracricoid or supratracheal laryngectomy. A radiological map of patients’ functional risk was developed by considering the distribution of functional outcomes in relation to the laryngeal subsites involved. The functional outcomes considered were: (i) decannulation at discharge; (ii) time to removal of the nasogastric feeding tube (NFT); (iii) postoperative complication rate; and (iv) length of hospital stay.
Results
Involvement of the anterior supraglottis was related to a longer need for NFT, and a longer hospital stay (p = 0.003, and p = 0.003, respectively). Involvement of the posterior glottis negatively affected the time to decannulation, and the likelihood of postoperative complications (p = 0.000, and p = 0.002, respectively).
Conclusions
Anterior glottic small tumors (without significant subglottic and/or supraglottic extension) are related to the best functional outcomes after OPHL, since the suprahyoid epiglottis and both the arytenoids are likely to be spared.
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Data availability
Not available.
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Acknowledgements
The authors thank Frances Coburn for correcting the English version of this paper. They also thank all the medical and paramedical staff at the Otolaryngology Unit—Vittorio Veneto Hospital, for collecting the follow-up data, and the Association “Amici della voce” (Friends of the Voice) for its support in preparing the manuscript.
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This study was supported by a personal grant.
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Bertolin, A., Varago, C., Salemi, M. et al. Isoprognostic functional CT map for open partial horizontal laryngectomy. Eur Arch Otorhinolaryngol 281, 3051–3060 (2024). https://doi.org/10.1007/s00405-024-08596-y
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DOI: https://doi.org/10.1007/s00405-024-08596-y