Outcome of Total Laryngectomy (One Centre Experience)Download PDF
Objectives: To assess the patients with advance carcinoma of larynx and its sequelae post total laryngectomy.
Patients and method: The study was conducted as a prospective study including patients had undergone total laryngectomy for histologically proven laryngeal cancer at Medical City Complex, Surgical Specialties Hospital at the department of otolaryngology and head and neck surgery from January 1st 2011 to 31st December 2013. Total of (39) patients were included in the study. Patients exluded from the study were those who had undergone neck dissection, total pharyngolaryngectomy, and partial laryngectomy. Local and general complications were noted along with the possible affecting factors. Outcomes were noted in this study and statistical analysis was done by simple percentage and frequency.
Results: Total of (39) patients had undergone total laryngectomy over a period of three years and followed for three years. Male: female ratio 3.875:1. Mean age was 56 years, ranged from 40 up to 75. Smokers constituted (87.5%) of patients. Salvage laryngectomy was done for (17.9%) of cases. Histological findings were: 25 (64 %) well differentiated, 1 ( ) verrocus carcinoma, 11 (28.2 %) moderately differentiated and 3 (7.69%) poorly differentiated. Early Complications: pharyngocutaneouse fistula 11 (36.5%), wound infection 5 (12.5%), none of the patients had developed superficial wound necrosis and wound haematoma. Two patients had passed peroperatively due to cardiac problem proved by ECG. One case was admitted to the CCU after developing myocardial infarction at 7th day postoperatively. Subclinical hypocalcaemia was noted in 5 ( ) of the patients detected by regular postoperative electrolyte follow up.
Conclusion and recommendations: Total laryngectomy plays major role in the management of laryngeal carcinoma. Pharyngocutaneous fistula was the most common early postoperative complication. The recognition of the risk factors for complications is essential to prevent them.
Keywords: Laryngectomy, laryngeal carcinoma, phayngocutaneous fistula, wound infection