The surgical procedure for subtotal laryngectomy

Laryngectomy is a type of laryngeal resection and is also a laryngeal function preservation surgery. With the rapid development of modern medical technology, laryngectomy has made great progress and the survival rate of laryngeal cancer patients has been significantly improved.

The main surgical methods for subtotal laryngectomy are:

1. Vertical partial laryngectomy: Glottic cancer involves one side of the vocal cord, the vocal cord activity is normal or slightly restricted, or the extension below the glottis does not exceed 0.5 cm. The surgical resection range includes part of the cricoid cartilage arch, and the defect is mainly repaired using the anterior cervical myocutaneous flap and sternohyoid muscle.

2. Horizontal supraglottic partial laryngectomy: Suitable for early epiglottic cancer or those with involvement of the ventricular band and aryepiglottic folds. This surgical method has been widely used at home and abroad since Alonso reported it in 1947. The resection range includes the epiglottis, epiglottic vallecula, pre-epiglottic space, epiglottic pharyngeal folds, part of the tongue root, bilateral aryepiglottic folds, ventricular band, and laryngeal ventricle. The surgical effect is good. A study report of 92 cases in 1997 showed that the 3-year and 5-year survival rates of patients who underwent this operation were 75% and 72% respectively, and the postoperative extubation rate reached 84%.

3. Subglottic resection: The subglottic area is defined as the area between 5 mm below the free edge of the vocal cord and the lower edge of the cricoid cartilage. Cancer originating from this area is rare, accounting for about 1% to 4% of laryngeal cancer. The scope of surgical resection is limited to T1 and T2 lesions in the subglottic area. After resection, the tracheal cut edge needs to be aligned and anastomosed with the cut edge of the glottis area.