This patient suffered from severe subglottic stenosis(grade Ⅳb). During partial cricotracheal resection, we cut through the cricothyroid membrane and the cricoid arch along the line from the lower edge of the thyroid cartilage to 5 mm of the inferior thyroid cartilage corner anteromedially. This can protect the cricothyroid joint, effectively protect the recurrent laryngeal nerve, and also support the airway. Strictly adhere to airway separation, avoid excessive separation of scars, and combine with reasonable postoperative management to achieve a safe extubation.
Humans ; Constriction, Pathologic/surgery* ; Trachea/surgery* ; Airway Extubation ; Laryngostenosis/surgery* ; Larynx/surgery* ; Cricoid Cartilage/surgery* ; Treatment Outcome

Chondroblastoma ; pathology ; Chondroma ; pathology ; Chondrosarcoma ; metabolism ; pathology ; surgery ; Cricoid Cartilage ; Diagnosis, Differential ; Humans ; Laryngeal Neoplasms ; metabolism ; pathology ; surgery ; Laryngectomy ; Lymph Node Excision ; Male ; Middle Aged ; Osteoblastoma ; pathology ; Osteosarcoma ; pathology ; S100 Proteins ; metabolism ; Sarcoma, Clear Cell ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Adult ; Aged ; Airway Obstruction ; therapy ; Cricoid Cartilage ; surgery ; Female ; Humans ; Laryngeal Diseases ; therapy ; Male ; Middle Aged ; Punctures ; methods ; Thyroid Cartilage ; surgery

OBJECTIVE: To compare the results of supracricoid partial laryngectomy-cricohyoidopexy (SCPL-CHP) and horizontal-vertical hemilaryngectomy in the treatment of mid and late laryngeal carcinoma. METHOD: Retrospective analysis on the types of mid and late stage of laryngeal carcinoma clinical material, 22 patients supracricoid partial laryngectomy-cricohyoidopexy, 20 patients horizontal-vertical hemilaryngectomy, each with the added radiotherapy. The long term results of operation and glottic reconstruction were evaluated by postoperative visiting, semi-quantitative speech intelligibility analysis, electroglottograph (EGG) and so on. RESULT: Forty-two cases of laryngeal cancer patients were decannulated, the decannulation rate was 100%. Postoperative decannulation time: surgical CHP for (44.0 +/- 4.6) d, 3/4 throat operation for (39.0 +/- 2.7) d, two groups of postoperative decannulation time difference was statistically significant (t = 4.2395, P < 0.01). Eight weeks after evaluation, two groups's swallowing function and postoperative evaluation of patients after one year speech intelligibility difference was not statistically significant (P > 0.05). GRBAS in the evaluation of G rating, the difference between the two groups was statistically significant (P < 0.05), CHP group showed,for most patients, a severe hoarse degree, but 3/4 throat operation group mainly represented a moderate degree lever. EGG parameters were checked after 1 years. F0 comparative differences was not statistically significant (P > 0.05), and the jitter, shimmer and NNE compared CHP group to 3/4 laryngectomy group were significantly increased (P < 0.05). Kaplan-Meier method statistics show: CHP group and 3/4 laryngectomy group 3 years and 5 year accumulate survival rates were 95.5% and 89.7%, 85.1% and 83.7% respectively, two groups of three, five years of survival difference was not statistically significant (P > 0.05). CONCLUSION According to the laryngeal of middle-late carcinoma, the region and the involvement of the scope were considered to choose appropriate surgical treatments, and both can complete resection of the tumor, and can retain good laryngeal functions,and CHP has a wider range of operation indications and clinical application prospect, is worthy to be popularized.
Adult ; Aged ; Carcinoma, Squamous Cell ; surgery ; Cricoid Cartilage ; surgery ; Deglutition ; Humans ; Hyoid Bone ; surgery ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Male ; Middle Aged ; Pharynx ; surgery ; Retrospective Studies ; Treatment Outcome

Cricoid Cartilage ; surgery ; Humans ; Laryngectomy ; methods ; rehabilitation ; Larynx ; Recovery of Function

Chondroma ; surgery ; Cricoid Cartilage ; Humans ; Male ; Middle Aged

OBJECTIVETo Evaluate the incidence rates and extents of deglutition disorder in patients with laryngeal carcinoma after different types of supracricoid partial laryngectomy.

METHODSRetrospective analysis of postoperative deglutition disorder in patients with laryngeal carcinoma after different types of supracricoid partial laryngectomy treated in our department from 2005 to 2009. The extents of postoperative deglutition disorder were evaluated using a homemade quantitative score table at 5-20 days postoperation.

RESULTSThe score of deglutition disorder was 2.71 ± 0.31 in the supracricoid partial laryngectomy-cricohyoidoepiglottopexy (SCPL-CHEP) operation group and 3.43 ± 0.64 in the supracricoid partial laryngectomy-cricohyoidopexy (SCPL-CHP) group, respectively. The deference was statistically significant between the two groups (P < 0.001). The coefficient between age and score of postoperative deglutition disorder was assessed by Pearson correlation analysis. The coefficient of correlation was 0.947 (P < 0.0001) in the SCPL-CHEP group and 0.907 (P < 0.0001) in the SCPL-CHP group. The incidence rate of deglutition disorder was 1/37 in the SCPL-CHEP group and 7/30 in the SCPL-CHP group, evaluated at 8 weeks postoperation (P = 0.012). The deference between the two groups was significant.

CONCLUSIONSThe type of operation procedure is an important factor affecting the occurrence of postoperative deglutition disorder in the patients after supracricoid partial laryngectomy, more serious in the SCPL-CHP group. The severity of postoperative deglutition disorder is more serious along with the increase of patient's age. For the elderly (> 70 years of age) patients with laryngeal carcinoma, the choice of surgical procedure should be more cautious, especially with the SCPL-CHP operation.

Adult ; Age Factors ; Aged ; Cricoid Cartilage ; surgery ; Deglutition Disorders ; etiology ; Female ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; adverse effects ; methods ; Male ; Middle Aged ; Postoperative Period ; Retrospective Studies

OBJECTIVE: To analyze the oncological outcomes, functional outcomes in patients undergoing supracricoid partial laryngectomy (SCPL). Provide clinical experience for application of SCPL. METHOD: A retrospective analysis of the 115 cases with laryngeal carcinoma accepted SCPL in our department from Jan 1996 to Dec 2004. Use the Kaplan-Meier method to analyze the patients'survival rate. Evaluate the value of reserve larynx function. RESULT: The 5-years survival rates and the decannulation rate was 80.8%, 99.1% respectively; and the average decannulation time was 22.25 days. The mean time of removal of gastric tube was 9.57 days. The function of CHEP was superior to CHP. The vocal function of 115 cases were all achieved in general communication. CONCLUSION SCPL get better oncological and functional outcomes and allows the preservation of the basic function of the larynx. It's a safe, effective technique and deserved to generalization.
Adult ; Aged ; Carcinoma, Squamous Cell ; mortality ; pathology ; surgery ; Cricoid Cartilage ; surgery ; Female ; Humans ; Laryngeal Neoplasms ; mortality ; pathology ; surgery ; Laryngectomy ; methods ; Male ; Middle Aged ; Retrospective Studies ; Survival Rate ; Treatment Outcome

OBJECTIVE: To evaluate the therapeutic effect of supracricoid partial laryngectomy(SCPL). METHOD: A retrospective analysis of the clinical data of 24 patients undergoing laryngeal carcinoma (including 5 senile patients). In those patients, 14 were glottic cancer, 9 were supraglottic cancer,and 1 were transglottic cancer. Fourteen cases underwent cricohyoidoepiglottopexy, and 10 cases treated with cricohyoidopexy. RESULT: In this study, 3 years and 5 years survival rates were 91.7% and 78.6%. The decannulation rate was 91.7%. All the patients resumed physiologic swallowing. CONCLUSION Supracricoid partial laryngectomy for selected laryngeal cancer is feasible, and also for senile patients. The patients can gain satisfied survival rate and physiologic function.
Aged ; Carcinoma, Squamous Cell ; surgery ; Cricoid Cartilage ; surgery ; Female ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: To investigate the surgical procedure and indication of the Extended supracricoid partial laryngectomy with tracheocricohyoidoepiglottopexy and tracheocricohyoidoglottopexy (ESCPL+-TCHEP/TCHP) as well as the rehabilitation of laryngeal functions. METHOD: ESCPL+TCHEP/TCHP were conducted in 10 cases with laryngeal carcinoma of T3 and T4 stages with subglottic invasion for 10-20 mm from 2000 to 2005. RESULT: All the 10 cases, 9 of them have survived until now and still be followed up. 1 of them succumbed to the recurrence of cervical lymph node metastasis 4 years after the surgery. Normal respiration, deglutition and the function of maintaining subglottic pressure were recovered in all the case. Postoperative phonation was also satisfactory among all of them. CONCLUSION If handle the surgical indication strictly, to some cases of laryngeal carcinoma with subglottic invasion for 10-20 mm, this surgical technique could replace the total laryngectomy.
Aged ; Carcinoma, Squamous Cell ; pathology ; surgery ; Cricoid Cartilage ; surgery ; Humans ; Laryngeal Neoplasms ; pathology ; surgery ; Laryngectomy ; methods ; Larynx ; surgery ; Male ; Middle Aged ; Treatment Outcome