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ORIGINAL ARTICLE  PIGNAT’S ANTERIOR VERTICAL LARYNGECTOMY 

Otorhinolaryngology 2021 June;71(2):47-50

DOI: 10.23736/S2724-6302.21.02343-2

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Pignat’s anterior vertical partial laryngectomy: oncologic and functional outcomes

Giuseppe RIVA 1 , Nora VALSECCHI 1, Mariavittoria POMARA 1, Isabella POLLICINA 1, Drita NDREV 1, Flavio PEROTTINO 2, Giancarlo PECORARI 1

1 Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Turin, Italy; 2 Division of Otorhinolaryngology, Escartons Hospital, Briançon, France



BACKGROUND: Pignat’s vertical partial laryngectomy (VPL) with cricoiodoepiglottoplasty (CHEPL) has been proposed for cT1-cT3 laryngeal cancer. This technique maintains a vertical posterior portion of each wing of the thyroid cartilage and reconstruction is achieved through a wires net. Consequently, the pharyngeal height is preserved, and the superior laryngeal nerves are not traumatized, facilitating laryngeal functional recovery after surgery. The aim of this retrospective study was to evaluate oncologic and functional outcomes after Pignat’s VPL with CHEPL.
METHODS: Twenty-four patients underwent Pignat’s VPL with CHEPL between 2016 and 2020. Oncologic and functional outcomes were analyzed. Furthermore, 9 patients underwent a long-term assessment of swallowing and voice (after a mean follow-up of 23 months). Laryngeal functions were evaluated by means of Fiberoptic Endoscopic Evaluation of Swallowing (FEES), M.D. Anderson Dysphagia Inventory (MDADI) questionnaire, and Self Evaluation of Communication Experiences after Laryngeal cancer (SECEL) questionnaire.
RESULTS: Two-year overall and disease-free survival were 93.33% and 94.11%, respectively. The nasogastric feeding tube was removed on average after 8.87±7.66 days and the tracheostomy tube after 7.94±6.23 days. Laryngeal penetration was observed in 22.2% of patients at the examination with liquids and 11.1% with semi-solid bolus. No tracheal aspiration was observed. Head flexion solved swallowing alterations. good subjective results obtained by means of MDADI and SECEL questionnaires.
CONCLUSIONS: Pignat’s vertical partial laryngectomy with CHEPL has good oncologic and functional outcomes. It allows a fast and effective recovery of swallowing function.


KEY WORDS: Laryngectomy; Laryngeal neoplasms; Survival; Declutition

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