Oncologic and functional results of near-total laryngectomy.

Abstract

To report the oncologic and functional outcome of patients undergoing near-total laryngectomy. A retrospective analysis was carried out from 1991 through 1998. Eighty-seven patients underwent near-total laryngectomy. The Kaplan-Meier overall survival, cause-specific survival, and relapse-free survival estimates at 5 years were 48.2%, 75.8%, and 72.4%, respectively. Univariate analysis revealed prognosis significance for location, stage, and pathologic cervical lymph node status. Five percent of the patients developed local recurrence, 16% recurrence in cervical lymph nodes, and 10% distant metastasis. Pharyngocutaneous fistula was the most frequent complication (48%). Seventy-seven percent of cases achieved voice preservation. Symptomatic aspiration was noted in 12.3% of cases. Near-total laryngectomy can be a successful surgical procedure for selected patients; it does not replace total laryngectomy but reduces its indications. Voice preservation can be achieved in most cases. Near-total laryngectomy enhances the speech rehabilitation options for the laryngectomy patient by adding a physiologic, nonprosthetic tissue technique.