Open Partial Horizontal Laryngectomies: Functional and Oncologic Outcomes

OBJECTIVE: Since the development of the chemoradiation protocols and the transoral technology-based procedures, the use of Open Partial Horizontal Laryngectomies (OPHL) has been discontinued in many centers. We aim to analyze OPHL in terms of oncologic and functional results. STUDY DESIGN: Retrospective case series. SETTING: University-affiliated tertiary care center. METHODS: All patients with laryngeal squamous cell carcinoma who underwent open horizontal supraglottic laryngectomy (OHSL) and supracricoid partial laryngectomy (SCPL) between 2000 and 2020 at our institution were included. RESULTS: One hundred twelve patients were identified. 89% were male, with a mean age of 58 years old. Seventy had supraglottic tumors, while 42 had glottic tumors. OHSL was performed in 61 patients, while SCPL was in 51, of whom an arytenoid was resected in 9 patients and the epiglottis in 7. The series includes 30.4% T3-T4 classified tumors. Postoperative pneumonia appeared in 13.4% of patients. Decannulation was achieved in 93% of patients at a median of 14 days. The feeding tube was discontinued in 95% of patients at a median of 20 days. The mean follow-up was 91 months. The 5-year-LC rate was 90.2% in T1-T2 classified tumors and 80.9% in T3-T4 classified tumors. The 5-years-LEDFS was 72.1%. Total laryngectomy was performed in 14 patients: 11 following locoregional recurrence and the remaining 3 for functional reasons. Eleven patients maintained a tracheostomy or feeding tube for over 2 years. CONCLUSION: OPHL in selected patients with early and locally-advanced laryngeal tumors allows oncological results comparable to total laryngectomy while obtaining excellent stable functional results.