Laryngeal Preservation Surgery.

Patients afflicted with selected laryngeal and hypopharyngeal cancers have garnered benefit from laryngeal preservation procedures for more than a century. Billroth performed the first hemilaryngectomy for malignancy in 1874 (1). Over the ensuing decades numerous procedures evolved to afford patients the maintenance of speech and swallowing without permanent tracheostomy. In 1947, Alonso (2,3) first described the open supraglottic laryngectomy to spare the true vocal cords and arytenoids by resecting the upper portion of the thyroid cartilage with the supraglottic structures. The procedure was popularized in Europe by Bocca and in the United States by Ogura, Som, and Kirchner (4). The boundaries of resection were pushed further by Majer and Reider (5) in 1959 with the introduction of the supracricoid partial laryngectomy, which provided an alternative to total laryngectomy for patients with selected glottic and supraglottic cancers. Critical review has provided refinements in these procedures. Specific indications have been established based on an improved understanding of surgical anatomy and patterns of tumor spread that have allowed for selected ablation of laryngeal components without the need for total laryngectomy and its associated morbidity. [ABSTRACT FROM AUTHOR]