Article
Transhyoid Glossectomy and Partial Laryngectomy for the Treatment of Squmous Cell Carcinoma of Tongue Base Involving Larynx
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Published: | April 4, 2012 |
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Surgical treatment for 16 cases with tougue base carcinoma involving larynx were reviewed retrospectively. All cases were male,aged from 39 to 66 years old, age 48. Among 16 cases, 15 cases suffered from SCC,and 4 of them with highly to moderately differentiated SCC,7 with moderately differentiated and 4 with moderate to poorly differentiated SCC, and the last 1 patient had adenoid-cystic carinoma.The patients was classified as T2 5 cases, T3 3 cases and T4 8 cases respectively, and 11 cases were N1 to N2 neck. Hemiglossectomy,partial epiglotorectomy and lateral pharyngectomy were applied to 2 cases and reconstruction was accomplished with strip muscle flap and radial forearm free flap. Tongue base resection and epiglotorectomy were applied to one patient, and futher lateral pharyngectomy were applied to 2 cases. All 7 cases were reconstructed with the PMM while the patients with partial glossectomy preserved reasonable speech quality. Pharyngocutaneous fistula was observed for 3 cases (19%), PMM necrosis was encounted for 2 cases, multiple primary was found for 3 cases postoperatively, 2 cases were found to have esophageal carcinoma and 1 patient with soft palate carcinoma .
Recurrence and metastasis: neck metastasis was found in one case ,and parapharyngeal space metastasis was found in 2 cases .one case has pulmonary metastasis.
Prognosis: 3-year tumor-free survival was achieved for 10 cases (63%), 2 cases have been currently followed up more than half a year. 4 cases were deceased during follow up. 2 died of parapharyngeal metastasis, 1 died of neck metastasis and 1 died of multiple primary of esophageal carcinoma.
Conclusion: In the surgical treatment of tongue base carcinoma involving larynx, reconstruction with free or pedicled flap was usually mandotory .