Frontolateral laryngectomy: Siriraj experience

Objective: To report the functional results and oncologic outcome of patients undergoing frontolateral laryngectomy in Siriraj Hospital.

Material and Method: A retrospective review of T1 and T2 glottic squamous cell carcinoma patients undergoing frontolateral laryngectomy in the department of Otolaryngology, Faculty of Medicine Siriraj Hospital between 1986 and 2006 with a minimum of five years follow-up period.

Results: Out of 55 patients who underwent frontolateral laryngectomy, 50 cases that fitted the criteria were recruited for the present study. After surgery, all patients but one had tracheotomy decannulation and recovered good respiratory function. Forty-three successfully decannulated patients (87.8%) had tube decannulation within 14 days. The mean duration of feeding via nasogastric tube was 11.4 days (ranged from 5 to 22 days). Forty-eight patients (96%) resumed oral feeding before discharge from the hospital and all but two had grade 1 subjective functional speech during hospitalization. The one, three, and five years overall survival rate in our study were 98%, 92%, and 92%, respectively. The 5-year tumor control rate was 97.1% for T1 and 75% for T2 tumors. The larynx preservation rate was 90%.

Conclusion: Frontolateral laryngectomy is one of the excellent therapeutic options for treatment of T1 and T2 glottic cancer, especially those with anterior commissure involvement. It conserves reasonable laryngeal function with short hospitalization. Its local tumor control rate was above other treatment modalities and the survival rates were impressive.