A New Method for Functional Subtotal Laryngectomy

A new method for the reconstruction of the arytenoid region and the vocal fold after subtotal laryngectomy was developed. The lateral half of the thyroid ala on the affected side was conserved with the thyropharyngeal and sternothyroid muscles attached. The superior and inferior horns were resected, and the thyroid cartilage was directly and firmly fixed to the cricoid cartilage. A local skin flap from the anterior neck was used to cover the inside of the thyroid cartilage.This method was performed for a patient with T3 supraglottic carcinoma invading the pre-epiglottic space and the unilateral vocal fold. The superior half of the larynx including the hyoid bone, the arytenoid cartilage and the vocal fold on the affected side and the anterior third of the vocal fold on the unaffected side were resected. After surgery, the functions of phonation, respiration and swallowing were successfully conserved without a recurrence of the carcinoma.