6 major indications for total laryngectomy

Total laryngectomy is a safe and reliable method for the treatment of laryngeal cancer. It started in 1873, when the first total laryngectomy for laryngeal cancer was successful. Since then, total laryngectomy has been considered a radical surgery for laryngeal cancer.

Indications for total laryngectomy:

1. Glottic cancer invades the interarytenoid area, the thyroid fascia or cricoid cartilage, or extends to the subglottis.

2. Supraglottic cancer has invaded the vocal cords or thyroid fascia and involved the bilateral arytenoid cartilages.

3. Hypopharyngeal cancer invades the pyriform sinus and postcricoid area, or the invaded vocal cords are fixed.

4. Thyroid cancer invades the larynx.

5. Subglottic cancer extends to the supraglottis or invades the cricoid cartilage.

6. Patients with various types of laryngeal cancer and hypopharyngeal cancer that recur after radiotherapy.

The advantage of laryngectomy is that the cancerous tissue is removed relatively thoroughly, and the chance of local recurrence is relatively small. Its disadvantages and shortcomings are that the surgery causes the patient to lose the function of the larynx for life, lose normal language, and cannot guarantee the normal physiological respiratory pathway, which is indeed regrettable for some patients with limited early lesions. In addition, the incidence of pharyngeal fistula after total laryngectomy can reach 14.8% to 17.8%, and about 50% of patients need to wear a tube for a long time. For the problem of postoperative aspiration, some patients need to go through a long period of training and adaptation to solve it, and sometimes they need to pay great patience and perseverance. These reductions in quality of life may directly affect the patient's quality of life and survival time.