Isoprognostic functional CT map for open partial horizontal laryngectomy

Eur Arch Otorhinolaryngol. 2024 Jun;281(6):3051-3060. doi: 10.1007/s00405-024-08596-y. Epub 2024 Mar 30.

Abstract

Purpose: To identify a radiological map of laryngeal subsites whose involvement by the tumor could predict patients' functional outcomes after open partial horizontal laryngectomy (OPHL).

Methods: The present retrospective analysis concerned 96 patients with glottic squamous cell carcinoma, who were radiologically staged with contrast-enhanced neck CT scans before undergoing supracricoid or supratracheal laryngectomy. A radiological map of patients' functional risk was developed by considering the distribution of functional outcomes in relation to the laryngeal subsites involved. The functional outcomes considered were: (i) decannulation at discharge; (ii) time to removal of the nasogastric feeding tube (NFT); (iii) postoperative complication rate; and (iv) length of hospital stay.

Results: Involvement of the anterior supraglottis was related to a longer need for NFT, and a longer hospital stay (p = 0.003, and p = 0.003, respectively). Involvement of the posterior glottis negatively affected the time to decannulation, and the likelihood of postoperative complications (p = 0.000, and p = 0.002, respectively).

Conclusions: Anterior glottic small tumors (without significant subglottic and/or supraglottic extension) are related to the best functional outcomes after OPHL, since the suprahyoid epiglottis and both the arytenoids are likely to be spared.

Keywords: Computerized tomography; Decannulation; Functional outcome; Map; Open partial horizontal laryngectomy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell* / diagnostic imaging
  • Carcinoma, Squamous Cell* / pathology
  • Carcinoma, Squamous Cell* / surgery
  • Female
  • Glottis / diagnostic imaging
  • Glottis / surgery
  • Humans
  • Laryngeal Neoplasms* / diagnostic imaging
  • Laryngeal Neoplasms* / pathology
  • Laryngeal Neoplasms* / surgery
  • Laryngectomy* / methods
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Tomography, X-Ray Computed* / methods
  • Treatment Outcome