A Novel Functional Reconstruction Method for Recurrent Laryngeal Cancer after Vertical Partial Laryngectomy

Background: To evaluate our novel approach to composite reconstruction through combining the myocutaneous flap and free cartilage grafts following resection of recurrent laryngeal cancer.

Methods: A vertical incision was made from the thyroid notch to the cricoid cartilage. The myocutaneous flaps below the strap muscle were elevated. The thyroid cartilage was removed sufficiently to secure the required surgical margin. After tumor resection, the composite reconstruction was carried out by combining the myocutaneous flap and free cartilage grafts. At first, small pieces of cartilage were grafted into the paraglottic space and covered with omohyoid muscle. Following this, cartilage approximately 15 mm in length and 3mm in width was inserted along the level of the vocal cord. This cartilage altered the vocal cord plastic protrusion and demonstrated good postoperative vocal function. The flap was fixed to the edge of the laryngeal mucosa.

Results: There was neither local infection nor partial wound dehiscence associated with this new procedure. Patients could receive nutrition orally the day after the procedure was performed. In this series, no aspiration was observed. The mean postoperative maximum phonation time (MPT) was 19.5 seconds with good phonation.

Conclusion: This novel approach to reconstruction was effective in terms of healing and functional outcomes.