Indications and results of extended total laryngectomy with en-bloc resection of overlying cervical skin
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Extended total laryngectomy with en-bloc resection of overlying cervical skin (ETL) is indicated in cases with infiltration of the pre-laryngeal soft tissues. The present study analyses the surgical indications and the results of ETL in our hospital.
Retrospective review of 38 patients treated with an ETL during the period 1988–2016.
The indications for ETL were the initial treatment of tumors with extralaryngeal extension (n = 16), salvage treatment after failure of partial surgery or radiotherapy (n = 17), and total laryngectomy in patients with infection or fibrosis of the skin over the larynx (n = 5). The surgical defect was reconstructed with local flaps in 3 cases, with pectoralis major flaps in 34 cases, and with an internal mammary artery perforator flap in one case. The rate of pharyngocutaneous fistula in the postoperative period was 16%. 5-year cancer-specific survival for patients treated with an ETL was 67.1%. The patients with positive margins and those operated as a salvage treatment after failure of previous treatments showed worse survival.
ETL offers acceptable oncological results for patients with tumors with extralaryngeal extension. Myocutaneous or myofascial pectoralis major flaps allow for adequate reconstruction of the surgical defect with a low rate of complications.
KeywordsExtended total laryngectomy Total laryngectomy Extralaryngeal extension Salvage surgery
Compliance with ethical standards
Conflict of interest
The authors declare no conflict of interest.
Research involving human participants
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional, regional and national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
For this type of study, formal consent is not required.
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