gms | German Medical Science

76th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

04.05. - 08.05.2005, Erfurt

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Difficult laryngectomy in a patient with transglottic carcinoma and severe ankylosing spondylitis

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  • corresponding author Robert Schatton - Department of Otolaryngology, Krupp Hospital, Essen, Germany
  • Britta Pfoertner - Department of Otolaryngology, Krupp Hospital, Essen, Germany
  • Juergen Lamprecht - Department of Otolaryngology, Krupp Hospital, Essen, Germany

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. Erfurt, 04.-08.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05hno318

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2005/05hno086.shtml

Published: September 22, 2005

© 2005 Schatton et al.
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Outline

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Objective: Diagnosis and treatment of laryngeal carcinoma are difficult in patients with flexion deformity of the cervical spine. A case of transglottic carcinoma combined with marked ankylosing spondylitis (AS) is presented.

Case: A 52-year old man with an eight-year history of AS complained about hoarseness since ten month. Laryngoscopy revealed a bilateral tumourous lesion of the vocal cords and ventricular folds with normal cord movement. Microlaryngoscopy was difficult due to severe flexion deformity of the cervical spine. Flexible endoscopy with biopsy confirmed the diagnosis of a transglottic squamous cell carcinoma. There was no distant metastasis. We planned a total laryngectomy with neckdissection on both sides. Preoperatively we discussed improvements of the tumour exposure. Extension osteotomy of the cervical spine was too riskful considering possible neurological damage. We suggested median mandibulotomy to improve the upper laryngeal exposure. The operation was difficult but resection of the larynx was achieved without median mandibulotomy.

Conclusion: In this case laryngectomy and neckdissection were successfully performed using the classical approach despite severe AS.