Personal experience with total and subtotal reconstructive laryngectomy

: Customary total laryngectomy is a severe mutilating intervention with understandable efforts to offer better solutions. The author has conducted 95 subtotal reconstructive laryngectomies in the period of 1976 to 1984, with the following effects: decannulation, with the mean time of 6 weeks in 82%; deglutition without difficulties, after the third postoperative month in 90% of operated patients; the restoration of phonetics with sonorous-understandable speech in 11%. An average of a five-year survival of all subtotal reconstructive laryngectomies amounts to 63%. The author is of the opinion that this intervention presents important progress in the treatment of laryngeal carcinoma in certain patients, because it avoids mutilations which occur after total radical laryngectomy. Better results can be expected with the further advancement of the operative technique.