4 types of subtotal laryngectomy

Subtotal laryngectomy is a laryngeal function preservation surgery that can not only retain the right to speak of laryngeal cancer patients, but also relieve the patient's pain. With the rapid development of medical technology, subtotal laryngectomy has made great progress. Postoperative efficacy has proved that the five-year survival rate is not lower than that of total laryngectomy. There are mainly four types of surgery.

Vocal cord resection

1. Minimally invasive vocal cord surgery: This surgery is suitable for patients with carcinoma in situ of the vocal cord or carcinoma of the membranous part of the vocal cord, which extends to the anterior commissure and involves the vocal process posteriorly but with normal vocal cord activity. The surgery is performed through the mouth under the observation of a supporting laryngoscope and a microscope, and laser or fiber instruments are used to remove the cancerous part.

2. Laryngeal slit vocal cord resection: Suitable for patients whose cancer has invaded the superficial layer of vocal cord muscle and whose vocal cord activity is normal or slightly limited. Vocal cord resection includes the entire membrane to the vocal process and the thyroid cartilage. The front part of the ventricular band is loosened to form a strip flap with the pedicle at the back, which is transferred and sutured to the vocal cord defect. After the operation, the glottis is closed during pronunciation, which can achieve better results.

Vertical lateral anterior partial laryngectomy

Suitable for patients with early-stage vocal cord membranous cancer on one side, close to the anterior commissure and with normal vocal cord activity. The anterior 2/3 of the thyroid cartilage on the affected side is removed, the vocal cord area reaches the anterior commissure anteriorly and the vocal process posteriorly, and the defect is closed with anterior cervical myocutaneous flap or sternohyoid myofascia.

Epiglottectomy

It is suitable for early-stage cancer of the epiglottic tip, which occupies 1/3 of the laryngeal surface of the epiglottis. The epiglottis or pre-epiglottic space can be resected.