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 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 (< 1 mm, 1-5 mm, > 5 mm), cartilage extension and vascular embolism. Mean time to observation was 18 months (range, 12-36 months).

RESULTS:

Resection margins were < 1 mm in 7 cases (28%), 1-5 mm in 9 and > 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.

• Authors: J-M Prades, M Gavid, J-M Dumollard, A-T Timoshenko, A Karkas, M Peoc'h
• Journal: European annals of otorhinolaryngology, head and neck diseases (Eur Ann Otorhinolaryngol Head Neck Dis) Vol. 133 Issue 1 Pg. 27-30 (Feb 2016) ISSN: 1879-730X [Electronic] France
• PMID: 26778447 (Publication Type: Journal Article)
• Copyright: Copyright © 2015. Published by Elsevier Masson SAS.

Topics

• Adult
• Aged
• Carcinoma, Squamous Cell (pathology, surgery)
• Cricoid Cartilage (pathology, surgery)
• Female
• Humans
• Laryngeal Neoplasms (pathology, surgery)
• Laryngectomy (methods)
• Male
• Middle Aged
• Neoplasm Invasiveness
• Retrospective Studies