KBB-Forum 2002 , Cilt 1, Sayı 2


Dr. Sinan KOCATÜRK, Dr. Ünsal ERKAM
SSK Ankara Eğitim Hastanesi, II. KBB Kliniği, Ankara, Türkiye Most of local recurrens after the supraglottic horizontal laryngectomies (SHL) become evident at anterior commissur and paraglottic region at lower surgical margins and the pharynx and tongue base at superior margins and usually total laryngectomy is performed for salvage surgery. This paper defines the surgical technique, its advantages in reaching the safe inferior margins and functional results obtained in eight patients who were operated using the subperichondrial dissection technique utilized as a step for SHL. The mean decanulation time was found to be 18 days, while the mean feeding tube removal time was 17 days. No local recurrence was observed in any of the patients in the mean follow-up period of 11 months. It was concluded that, the subperichondrial dissection approach provided advantages in reaching to the anterior comissure and paraglottic space under direct visual control, in having the potential to decrease the incidence of local recurrences by frozen sectioning of these hidden areas, and in achieving 3 to 4 mm safety margins while making precise incisions through the thyroid cartilage and soft laryngeal tissues. Keywords : supraglottic horizontal laryngectomy, subperichondrial approach, functional results