Vascular Pedicle Flap of the Thyroid Gland in Horizontal Supraglottic Laryngectomy

Supraglottic laryngectomies formed 68% of 322 partial laryngectomies performed between 1971–1981 or 52% of all our operated cases of laryngeal carcinoma. No X-ray therapy was applied. They include 26% of extended partial resections limited to the larynx itself and 10% with extension into the tongue. Surgical problems with the operation were mentioned in our report on the three quarters laryngectomy. In the remaining cases of partial extended laryngectomies limited to the larynx, functional consequences of excision of the arytenoid cartilage were pointed out. The technique of reconstruction of the arytenoid cartilage eminence by use of a vascular pedicle thyroid flap was presented above. In our supraglottic carcinoma cases with tongue base involvement the results were poor, due mainly to local recurrences. There were 8% deaths due to tumor. One of the reasons seemed to be a too narrow safety margin around the tumor, due to our fear of the well known functional consequences. Hie possibility of tongue base reconstruction with use of vascular pedicled thyroid or submandibular gland flap was presented. Functional result was uniformly good in all three cases where this technique was applied.