Author/Editor		Russolo, Mario; Tirelli, Giancarlo; Giacomarra, Vittorio
Title		Horizontal glottectomy: technique, oncological and functional results
Translated title		Horizontalna glotektomija: tehnika ter onkološki in funkcionalni rezultati
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 39, št. Suppl 3
Publication year		2000
Volume		str. 59-62
Language		eng
Abstract		Background: The aim of this study is to describe the indications, surgical technidue and oncological and functional results of horizontal glottectomy in laryngeal carcinoma. Materials and methods: Twenty-two patients suffering from differentiated glottal carcinoma (16 T1b and 6 T1a) treated between 1986 and 1996. Classic horizontal glottectomy, with some modifications, not extended to the ventricular fold or to the arytenoid cartilage, was performed in every patient. All patients followed a postoperative rehabilitation programme. The times of feeding tube removal, decannulation and voice production were considered. Results: No local recurrence was recorded in any of the patients, however follow-up on two cases lasted only three years. No postoperative radiotherapy was used. Two patients died from cardiovascular causes. Average post-operative times were: discharge from the hospital after 10.5 days; feeding tube removal after 7.5 days; decannulation after 9.5 days. No major pulmonary complications or laryngeal stenosis following surgery was recorded. In all patients, adequate voice production was achieved. Conclusions: Our results show that horizontal glottectomy is a safe procedure for the treatment of laryngeal cancer. Provided that case selection is very accurate, local control of the disease can reach 100%. Rapid and excellent laryngeal function may thus be obtained and the voice production is adequate in every patient.
Summary		Namen: Cilj naše raziskave je bil opisati indikacije, kirurško tehniko ter onkološke in funkcionalne rezultate horizontalne glotektomije pri zdravljenju karcinoma grla. Materiali in metode: 22 bolnikov z diferenciranim karcinomom glotisa (16 s stadijem T1b in 6 s stadijem T1a), ki so bili zdravljeni v letih 1986 do 1996. Pri vseh bolnikih smo opravili klasično horizontalno glotektomijo (z določenimi modifikacijami), ki pa ni segala do ventrikularne gube ali aritenoidnega hrustanca. Vsi bolniki so bili vključeni v program pooperacijske rehabilitacije. Obravnavali smo čas odstranitve cevke za hranjenje, čas odstranitve kanile in čas, po katerem so bili bolniki spet sposobni proizvodnje glasu. Rezultati: Pri nobenem od bolnikov nismo ugotovili lokalne ponovitve karcinoma, vendar pa je bil pri dveh bolnikih čas spremljanja le tri leta. Bolnikov po operaciji nismo obsevali. Dva bolnika sta umrla zaradi srčno-žilne bolezni. Povprečni pooperacijski časi so bili naslednji: odpust iz bolnišnice po 10,5 dneh, odstranitev cevke za hranjenje po 7,5 dneh, odstranitev kanile po 9,5 dneh. Večjih pljučnih zapletov ali stenoze grla po posegu nismo ugotovili. Pri vseh bolnikih smo po operaciji dosegli ustrezno proizvodnjo glasu. Sklep: Naši rezultati kažejo, da je horizontalna glotektomija varen poseg za zdravljenje raka grla. Če skrbno izberemo le bolnike, za katere je ta poseg primeren, lahko dosežemo celo 100% lokalni nadzor bolezni. Pri vseh bolnikih lahko dosežemo hitro in odlično povrnitev funkcije grla ter dobre rezultate glede proizvodnje glasu.
Descriptors		LARYNGEAL NEOPLASMS GLOTTIS TREATMENT OUTCOME RECURRENCE VOICE CARCINOMA, SQUAMOUS CELL RADIOTHERAPY LASER SURGERY