Extended Frontolateral Partial Laryngectomy

Abstract

In stage T₂ tumors of the vocal cord, microscopic examination of the larynx often shows an extension to the vocal process of the arytenoid cartilage. In fronto-lateral partial laryngectomy by Leroux-Robert’s technique (1957) resection of the anterior commissure offers no problem, but this method appears not to be radical enough to encompass posterior invasion. In tumors having reached the vocal process (and being verified as a carcinoma) we prefer an extended frontolateral partial laryngectomy. Resection of the vocal cord is extended into the ventricle and a half or one centimeter below the vocal cord — depending on the tumor extension. Posteriorly the resection may be extended about half a centimeter by removing the arytenoid cartilage. The first figure shows the borders of resection in extended fronto-lateral resection. The specimen shows that the arytenoid cartilage of the affected side of the larynx is resected together with a triangle from the thyroid cartilage. In the center we can see that the tumor (stage T₂N₀M₀) has already reached the vocal process (Fig. 2 b). This surgical technique should be reserved for cases with retained mobility of the involved vocal cord.