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Anterior laryngeal commissure: Histopathologic data from supracricoid partial laryngectomy

Abstract Objectives To analyze histopathologic invasion of the anterior laryngeal commissure on surgical specimens from patients operated on for stage-2 squamous-cell carcinoma managed by supracricoid partial laryngectomy (SCL). Patients and methods Twenty-five patients with previously untreated sta...

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Bibliographic Details
Published in:European annals of otorhinolaryngology, head and neck diseases head and neck diseases, 2016-02, Vol.133 (1), p.27-30
Main Authors: Prades, J.-M, Gavid, M, Dumollard, J.-M, Timoshenko, A.-T, Karkas, A, Peoc’h, M
Format: Article
Language:English
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Summary:Abstract Objectives To analyze histopathologic invasion of the anterior laryngeal commissure on surgical specimens from patients operated on for stage-2 squamous-cell carcinoma managed by supracricoid partial laryngectomy (SCL). Patients and methods Twenty-five patients with previously untreated stage-2 squamous-cell carcinoma were selected. Preoperative endoscopy confirmed anterior commissure involvement; CT found no cartilage lysis. SCL was performed in all cases: 15 anterior frontal SCLs with epiglottoplasty, 8 with cricohyoidepiglottopexy, and 2 with cricohyoidopexy. Histopathology analyzed resection margins ( 5 mm), cartilage extension and vascular embolism. Mean time to observation was 18 months (range, 12–36 months). Results Resection margins were  5 mm in 9 patients. Vascular emboli were found in 15 patients (60%). Twenty patients were free of medial thyroid cartilage involvement; 5 showed cartilage extension (20%), restricted to the internal cortical layer in 4 cases (stage T3) and transfixing in 1 (stage T4a). Mucosal extension appeared non-predictive of cartilage invasion. The T4a patient showed local laryngeal recurrence at 12 months. Conclusions In laryngeal commissure squamous-cell carcinoma, SCL enables pathologic analysis of the entire anterior commissure as organogenetically defined: medial thyroid wing, in which the three laryngeal regions are inserted. Microscopic cartilage invasion is poorly predicted by mucosal extension, and may affect 20% of initially T2 patients.
ISSN:1879-7296
1879-730X
DOI:10.1016/j.anorl.2015.08.017