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1 KISEP Head and Neck Korean J Otolaryngol 2004;47: 성문암종에서수직부분후두절제술 한양대학교의과대학이비인후과학교실 이형석 김기태 민현정 박철원 태경 Vertical Partial Laryngectomy in Glottic Cancer Hyung Seok Lee, MD, Ki Tae Kim, MD, Hyun Jung Min, MD, Chul Won Park, MD and Kyung Tae, MD Department of Otolaryngology, College of Medicine, Hanyang University, Seoul, Korea ABSTRACT Background and Objectives:The surgical goals of glottic cancer should not only be to preserve life but also to preserve laryngeal functions such as airway, aspiration prevention, and voice production. Vertical partial laryngectomy preserve laryngeal functions if we carefully select surgical indications. The aim of our study was to evaluate the surgical outcome of vertical partial laryngectomy oncologically and physiologically for the treatment of glottic cancer. Subjects and Method:Forty-one glottic cancer patients were treated with vertical partial laryngectomy at the Department of Otolaryngology-Head and Neck Surgery, Hanyang university hospital from 1993 to We reviewed the patient charts retrospectively with respect to age, sex, tumor stage, reconstruction, tracheostomy tube decannulation, oral feeding time, postoperative complication, and recurrences. Results:There were six recurrences (14.6%) in the primary site, and recurrence rate was higher in T2 & T3 stage. No patient had recurrence of the cervical lymph nodes. The average decannulation time of tracheostomy tube was 13 postoperative days. The average oral feeding time was 12 postoperative days. There were significant differences in MPT, jitter, shimmer and HNR between the normal control and the cases group (p<0.05). Conclusion:Functional outcome after vertical partial laryngectomy was relatively satisfactory. Vertical partial laryngectomy is a oncologically safe procedure for the treatment of T1 and selected T2 glottic cancer. (Korean J Otolaryngol 2004;47: ) KEY WORDS:Glottic cancer Glottis Partial laryngectomy. 1146

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3 수직부분후두절제술 Table 1. Local recurrence according to T stage 1148 T stage T1a T1b T2 T3 0/20 00% 0/03 00% 5/ % 1/02 50% 6/ % Tabel 2. Local recurrence according to vocal cord mobility in T2, T3 lesionn18 Vocal cord mobility Normal mobility Impaired mobility 4/ % 2/ % 6/ % Table 3. Local recurrence according to surgical margin Surgical margin Negative Dysplasia Positive 3/ % 2/ % 1/ % 6/ % Table 4. Voice analysis after vertical partial laryngetomy VPL Voice paramater Normal n20 VPL n22 p value Fundamental frequency Hz Jitter % Shimmer db Harmonics to noise ratio db Maximal phonation time sec Korean J Otolaryngol 2004;47:

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5 수직부분후두절제술 REFERENCES 1) Kim KM, Kim YM, Shim YS, Kim KH, Chang HS, Choi JO, et al. Epidemiologic survey of head and neck cancers in Korea. J Korean Med Sci 2003;18: ) Rothman KJ, Cann CI, Flanders D, Fried MP. Epidermiology of laryngeal cancer. Epidemiol Rev 1980;2: ) Tufano RP. Organ preservation surgery for laryngeal cancer. Otolaryngol Clin N Am 2002;35: ) Biller HF. The Joseph H. Ogura memorial lecture: Conservation surgery past, present, and future. Laryngoscope 1987;97: ) Tucker HM, Wood BJ, Levine HL, Karz R. Glottic reconstruction after near total laryngectomy. Laryngoscope 1979;89: ) Biller HF, Ogura JH. Hemilaryngectomy for T2 glottic cancers. Arch Otolaryngol 1971;93: ) Kessler DJ, Trapp TK, Calcaterra TC. The treatment of T3 glottic carcinoma with vertical partial laryngectomy. Arch Otolaryngol Head Neck Surg 1987;113: ) Lesinski SG, Bauer WC, Ogura JH. Hemilaryngectomy for T3 (fixed cord) epidermoid carcinoma of the larynx. Laryngoscope 1976;86: ) Daniilidis J, Nikilaou A, Fountzilas G. Vertical partial laryngectomy: Our results after treating 81 cases of T2 and T3 laryngeal carcinomas. J Laryngol Otol 1992;106: ) Biller HF, Som ML. Vertical partial laryngectomy for glottic carcinoma with posterior subglottic extension. Ann Otol Rhinol Laryngol 1977;85: ) Giovanni A, Guelfucci B, Yu P, Gras R, Zanaret M. Partial frontolateral laryngectomy with epiglottic reconstruction for management of early-stage glottic carcinoma. Laryngoscope 2001;111: ) Elo J, Horvath E, Kesmarszky R. A new method for reconstruction of the larynx after vertical partial resections. Eur Arch Otorhinolaryngol 2000;257: ) Laccourreye O, Weinstein G, Brasnu D, Trotoux J, Laccourreye H. Vertical partial laryngectomy: A critical analysis of local recurrence. Ann Otol Rhinol Laryngol 1991;30: ) Soo KC, Shah JP, Gopinath KS, Jaques DP, Gerold FP, Strong EW. Analysis of prognostic variables and results after vertical partial laryngectomy. Am J Surg 1988;156: ) Ogura JH, Jumera AA, Watson RK. Partial laryngectomy and neck dissection for carcinoma of pyriform sinus cancer. Laryngoscope 1960;70: ) Laccourreye O, Laccourreye L, Garcia L, Gutierrez-Fonseca R, Brasnu D, Weinsteine G. Vertical partial laryngectomy versus supracricoid partial laryngectomy for selected carcinomas of the true vocal cord classified as T2N0. Ann Otol Rhinol Laryngol 2000;109: ) Kim CH, Jung SH, Shin JW, Kim YH, Choi HS, Choi EC, at al. Voice analysis after the vertical partial laryngectomy. Korean J Otolaryngol 2003;46: ) Burgess LP. Laryngeal reconstruction following vertical partial laryngectomy. Laryngoscope 1993;103: ) David LM, Peak W, Daniel LM. Videolaryngostroboscopy following vertical partial laryngectomy. Ann Otol Rhinol Laryngol 1999;108: ) Hirano M, Kurita S, Matsuoka H. Vocal function following hemilaryngectomy. Ann Otol Rhinol Laryngol 1987;96: Korean J Otolaryngol 2004;47:

Table 1. Distribution by site and stage of laryngeal cancer Supraglottic Glottic Transglottic Total Stage Total 20

Table 1. Distribution by site and stage of laryngeal cancer Supraglottic Glottic Transglottic Total Stage Total 20 KISEP Head and Neck Korean J Otolaryngol 1999;42:1284-9 후두암수술환자에대한치료성적 송달원 김희준 정현수 김영한 안재현 이복수 박선호 Treatment Result in Laryngeal Cancer Patients Submitted to Surgical Treatment Dal Won Song, MD, Hee Jun