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Functional outcomes in supracricoid laryngectomy

Vittorio D’Aguanno, Massimo Ralli, Marco Fiore, Mauro Ceccanti, Cinzia Severini, Flavia Flaccadoro, Lucia Longo, Antonio Greco, Marco de Vicentiis

Abstract

Supracricoid laryngectomies (SCLs) are conservative surgical techniques for the treatment of selected laryngeal carcinomas and are considered an organ-sparing alternative to total laryngectomy and chemo-radiotherapy. The main characteristics of SCLs are the preservation of the main laryngeal functions as respiration, phonation and swallowing, without a permanent tracheostomy. Supracricoid laryngectomies have been questioned for many years as regarding functional and oncological outcomes and are currently accepted, although patient selection criteria and functional results are still debated. The mainstream of this surgery is the maintenance of one functioning cricoarytenoid unit to allow restoring of swallowing and phonation. Thus, post-operative rehabilitation protocol is required to archive functional outcomes and avoid functional failure of this surgery; an early rehabilitation protocol improves functional results, in particular regarding swallowing. Swallowing and voice functional outcomes differ among several centres and are often related to the post-operative management, although SCLs provide commonly good swallowing and respiratory outcomes. To date, SCLs are proven surgical procedures for the treatment of laryngeal cancer and should be a valuable option to total laryngectomy and chemo-radiotherapy for selected advanced laryngeal squamous cell carcinoma. In this clinical review, we discuss the clinical outcomes in patients treated with SCLs with particular attention to rehabilitation protocol and functional outcomes for swallowing and voice rehabilitation.

Keywords

laryngeal squamous cell cancer, supracricoid laryngectomy, functional results, swallowing

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DOI: http://dx.doi.org/10.14748/bmr.v29.5851

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About The Authors

Vittorio D’Aguanno
Sapienza University of Rome, Italy
Italy

Department of Sense Organs

Massimo Ralli
Sapienza University of Rome, Italy
Italy

Department of Sense Organs

Marco Fiore
Institute of Cell Biology and Neurobiology, IBCN-CNR, Rome, Italy
Italy

Mauro Ceccanti
Centro Alcologico della Regione Lazio, Rome, Italy
Italy

Cinzia Severini
Institute of Cell Biology and Neurobiology, IBCN-CNR, Rome, Italy
Italy

Flavia Flaccadoro
Sapienza University of Rome, Italy
Italy

Department of Sense Organs

Lucia Longo
Sapienza University of Rome, Italy
Italy

Department of Sense Organs

Antonio Greco
Sapienza University of Rome, Italy
Italy

Department of Sense Organs

Marco de Vicentiis
Sapienza University of Rome, Italy
Italy

Department of Oral and Maxillofacial Sciences

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