Long-term outcomes of supracricoid partial laryngectomy with cricohyoidoepiglottopexy and its modified version

OBJECTIVE: To investigate the long-term outcomes of supracricoid partial laryngectomy with cricohyoidoepiglottopexy (CHEP) and its modified version, in which we reserve the poster inferior borders of both thyroid cartilage laminas to protect swallowing function.

METHODS: This retrospective survival analysis was performed in 86 patients, wherein 46 undergoing CHEP and 40 undergoing modified CHEP. Their decannulation data were reviewed. We used swallowing quality-of-life questionnaire to measure the quality-of-life in 53 of the 65 survivals at the end of the follow-up period in 2011. Of the 53 patients, 24 underwent CHEP, while the remaining by modified CHEP.

RESULTS: The log rank test showed no significant difference in survival distributions of 2 the groups (p=0.92). The decannulation rate was 93.5% in CHEP and 100% in modified CHEP, showing no significant difference. The time span of decannulation in CHEP was 19.0+/-4.6 days, significantly longer than (14.0+/-2.3 days) the modified CHEP (p=0.000). As to quality-of life data, one-way multivariate analysis of variance, revealed a significant multivariate main effect for groups (p=0.001), and significant univariate main effects in 5 scales out of 11 (p<0.05), which showed a better swallowing life quality in modified CHEP.

CONCLUSION: There was no significant difference in survival rate between the 2 surgeries. The modified CHEP succeeded in earlier decannulation and better long-term swallowing life quality. Thus, modified CHEP is worth promoting, as long as indications were strictly conformed.