Vertical partial hemilaryngectomy with reconstruction by false cord imbrication Kuauhyama Luna-Ortiz,* Eunice Campos-Ramos,* Verónica Villavicencio-Valencia,* Marlen Contreras-Buendía,† Philippe Pasche‡ and Angel Herrera Gómez* *Department of Head and Neck Surgery†Department of Phoniatric Rehabilitation, Instituto Nacional de Cancerología (México), Mexico City, Mexico‡Department of ORL and Cervicofacial Surgery, Centre Hospitalier Universitaire Vaudios, Lausanne, Switzerland Key words cancer, glottis, imbrication, reconstruction with false vocal cord, vertical partial hemilaryngectomy. Abbreviations VPHL, Vertical partial hemilaryngectomy; AJCC, American Joint Committee on Cancer; PSS-HNC, Performance status scale for head and neck cancer; CHEP, Cricohyoidoepiglottopexy. Correspondence Dr Kuauhyama Luna-Ortiz, Department of Head and Neck Surgery, Instituto Nacional de Cancerología (México), Av. San Fernando #22, Col. Sección XVI, Tlalpan, México, D. F. 14080, Mexico. Email: kuauhyama@yahoo.com.mx K. Luna-Ortiz MD; E. Campos-Ramos MD; V. Villavicencio-Valencia MD; M. Contreras-Buendía LTCH; P. Pasche MD, PhD; A. H. Gómez MD. Presented at the 7th International Conference on Head and Neck Cancer, 19–23 July 2008, San Francisco, CA. Accepted for publication 21 November 2008. doi: 10.1111/j.1445-2197.2010.05280.x Abstract Background: To evaluate global survival, disease-free period, complications, evolu- tion and function in vertical partial hemilaryngectomy (VPHL) plus reconstruction with false cord. Methods: Descriptive and retrospective study. In aertiary care medical center in Mexico City. Eight patients with early diagnosis of early glottic cancer (T1 and T2), treated with VPHL plus reconstruction with false cord imbrication. Results: Fifty percent of the patients were clinical stage I, 37.5% stage II and 12.5% stage III. Nasogastric tube was not placed and oral feeding was reinitiated within 3 days on average. Tracheostomy was removed after an average of 2.1 days. Average hospital stay was 3.3 days. Average of the PSS-HNC (Performance Status for Head and Neck Cancer) and Karnofsky Performance Status evaluation was 91 to 97 and 100 at 1 year of evaluation. Voice evaluation demonstrated normal voice in 87.5% of patients. Intensity was below normal with improvement on annual evaluation. Global survival was 100% and disease-free period was 71% at 3 years. Conclusions: VPHL with reconstruction by false cord imbrication is an excellent therapeutic option for early glottic cancers. Multiple functional advantages are dem- onstrated without sacrificing oncological control as well as providing an audible and intelligible voice. In cases of recurrence, various management options are available. Introduction Management of early laryngeal tumours has changed during the last two decades, displacing radiotherapy as the goal standard and recently returning to organ conservation surgery with open surgery or laser procedures. 1–5 The role of conservation surgery of the larynx varies among institutions 6 and is performed according to the hospital infrastructure and surgeon experience. Better results have been reported in relation to local control with partial laryngectomy com- pared with radiotherapy, which has shown better results with voice preservation. 7 However, vertical partial hemilaryngectomy (VPHL) for treatment of T1 glottic cancers has demonstrated excellent onco- logical results with local control ranging from 60% to 98%. 8–10 Suspension microlaryngoscopy does not show significant advan- tages in organ conservation. The advantage of performing VPHL is that it allows reconstruction with false cord imbrication shown to preserve voice quality when compared with CO 2 laser surgery and in VPHL without reconstruction. 11 We describe the experience and results obtained in our institution when performing glottic tumour resections with VPHL plus recon- struction with false vocal cord imbrication. The goal of our study is to evaluate overall survival, disease-free period, complications, evo- lution and function. Materials and methods Eight patients with early glottic carcinomas (TNM Stage as defined by American Joint Committee on Cancer) were included in this ORIGINAL ARTICLE ANZJSurg.com © 2010 The Authors Journal compilation © 2010 Royal Australasian College of Surgeons ANZ J Surg 80 (2010) 358–363