Results of Larynx Preservation Surgery for Advanced Laryngeal Cancer Through Tracheal Autotransplantation

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Abstract
THE TOP of the cricoid cartilage serves as the lower line of resection in conventional vertical hemilaryngectomy1 and in the various forms of supracricoid laryngectomy2 in which the cricoid cartilage and at least one arytenoid have to be preserved. Because of the caudal resection margin, laryngeal tumors with subglottic extension to the level of the cricoid and hypopharyngeal tumors extending to the apex of the pyriform sinus are contraindications for conservation laryngectomy. The currently used conservation procedures have their critical margin posteriorly because the cricoid plate lies only a few millimeters below the posterior glottic level. Unilateral T3 glottic tumors with subglottic extension and/or arytenoid cartilage fixation and pyriform sinus tumors extending to the apex of the pyriform sinus necessitate an ipsilateral resection of the cricoid.3 Cricoid resection is incompatible with decannulation, and a total or near-total laryngectomy with a permanent tracheostomy is the indicated surgical treatment for most of these tumors.