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European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 11, pp 3179–3184 | Cite as

Indications and results of extended total laryngectomy with en-bloc resection of overlying cervical skin

  • Xavier LeónEmail author
  • Montserrat López
  • Jacinto García
  • Maria Casasayas
  • Carlota Rovira
  • Miquel Quer
Head and Neck
  • 41 Downloads

Abstract

Purpose

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.

Methods

Retrospective review of 38 patients treated with an ETL during the period 1988–2016.

Results

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.

Conclusions

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.

Keywords

Extended total laryngectomy Total laryngectomy Extralaryngeal extension Salvage surgery 

Notes

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.

Informed consent

For this type of study, formal consent is not required.

Supplementary material

405_2019_5573_MOESM1_ESM.docx (14 kb)
Supplementary file1 (DOCX 13 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Otorhinolaryngology Department, Hospital de La Santa Creu I Sant PauUniversitat Autònoma de BarcelonaBarcelonaSpain
  2. 2.Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN)MadridSpain

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