Some surgical treatments for laryngeal cancer

There are several surgical treatments for laryngeal cancer:

(1) Laryngeal cleft tumor resection: It is suitable for unilateral early glottic cancer, when the tumor has not invaded the anterior commissure and the vocal cord activity is normal. The entire vocal cord on the affected side is resected, and the mucosal edges are directly pulled together and sutured. It can also be repaired with strap muscles.

(2) Vertical lateral anterior laryngectomy: It is suitable for patients with unilateral vocal cord membranous cancer that invades the anterior commissure and has normal vocal cord activity. The resection range is the anterior 1/3 to 1/2 of the alar plate of the affected thyroid cartilage, the anterior 0.5 to 1 cm of the contralateral thyroid cartilage, the affected vocal cord, laryngeal ventricle, ventricular zone, anterior commissure and the anterior 1/3 of the contralateral vocal cord. The wound surface is usually repaired with a cervical myocutaneous flap and a cervical strap muscle perichondrium.

(3) Epiglottic resection: It is suitable for early-stage epiglottic apex cancer. The epiglottis and pre-epiglottic space can be resected, and the wound surface can be directly sutured after resection.

(4) Supraglottic laryngectomy: It is suitable for patients with supraglottic cancer limited to the epiglottis, ventricular floor and anterior commissure. The resection range includes the epiglottis, pre-epiglottic space and the upper 1/3 of the thyroid cartilage.

(5) Horizontal vertical partial laryngectomy (3/4 laryngectomy): It is suitable for patients with supraglottic laryngeal cancer that has invaded one vocal cord or vocal cord cancer that has invaded the supraglottic area, but the contralateral vocal cord has no lesions or only the anterior 1/3 is invaded. The resection range includes the entire epiglottis, the affected ventricular band, laryngeal ventricle, vocal cords, arytenoid cartilage, arytenoid cartilage folds, thyroid cartilage plate, the entire pre-epiglottic space and the laryngeal tissue above the contralateral vocal cord and the corresponding thyroid cartilage plate.

(6) Total laryngectomy: It is suitable for ① patients with laryngeal cancer or hypopharyngeal cancer who cannot undergo partial laryngectomy; ② patients with cancer recurrence after partial laryngectomy; ③ patients with T4 laryngeal cancer that involves and perforates the thyroid cartilage; ④ patients with glottic cancer that extends downward by more than 1.5 cm; and ⑤ elderly and frail patients with lung disease.

(7) Neck dissection is performed for patients with cervical lymphadenopathy.