Outcomes of Laryngeal Cancer Surgery after Open Partial Horizontal Laryngectomies with Lateral Cervical Approach

Andrea Colizza; Massimo Ralli; Arianna Di Stadio; Francesca Cambria; Federica Zoccali; Fabrizio Cialente; Diletta Angeletti; Antonio Greco; Marco de Vincentiis

doi:10.3390/jcm11164741

Outcomes of Laryngeal Cancer Surgery after Open Partial Horizontal Laryngectomies with Lateral Cervical Approach

J Clin Med. 2022 Aug 14;11(16):4741. doi: 10.3390/jcm11164741.

Authors

Andrea Colizza¹, Massimo Ralli¹, Arianna Di Stadio², Francesca Cambria¹, Federica Zoccali¹, Fabrizio Cialente¹, Diletta Angeletti¹, Antonio Greco¹, Marco de Vincentiis¹

Affiliations

¹ Department of Sense Organs, Sapienza University of Rome, 00161 Roma, Italy.
² Department GF Ingrassia, University of Catania, 95125 Catania, Italy.

Abstract

Background: Open partial horizontal laryngectomies (OPHL) are one of the surgical techniques used for the conservative management of laryngeal cancers. The aims of this study are to analyze the oncological and functional results of a group of patients affected by laryngeal squamous cell carcinoma (LSCC) treated with OPHL, performed using a minimally invasive technique. Methods: This is a prospective case−control study. We enrolled 17 consecutive patients with LSCC treated with OPHL through a lateral cervical approach (LCA). Patients were evaluated using their Penetration Aspiration Scale score (liquid, semiliquid and solid) and Voice Handicap Index (VHI) at three different endpoints: 15 days (T1), 3 months (T2), and 6 months (T2) after surgery. Results: The functional outcomes of the LCA are stackable with that of the classical anterior cervical approach in terms of respiration, swallowing, and speech. One-way ANOVA was performed to evaluate the variances of PAS and VHI scores at the three different observation points. No statistically significant differences were observed between OPHL- PAS scores for liquid (p = 0.1) at the three different observation points. A statistically significant improvement was observed in the OPHL- PAS score for semisolids and solids (p < 0.00001) between T1 and T3 (p = 0.0001) and for solids between T2 and T3 (p < 0.00001). The improvement of VHI-10 was statistically significative (p < 0.00001) at the three different observation points (T1−T2 and T2−T3). Conclusion: The LCA is a potential approach for laryngeal surgery in selected cases. The preoperative staging and planning are of the utmost importance to ensure oncological radicality. The main advantage of this approach is the preservation of the healthy tissues surrounding the larynx and the functional and oncological outcomes are stackable with the classic anterior cervical approach.

Keywords: anterior myocutaneous flap; laryngeal squamous cell carcinoma; lateral cervical approach; open partial horizontal laryngectomies; penetration aspiration scale.

Grants and funding

This research received no external funding.