Horizontal Partial Supracricoid Laryngectomy with Crico-Hyoidopexy or Crico-Hyoido-Epiglottopexy

Surgery can be offered to patients as a valuable method to preserve part of the larynx and its functions (phonation and swallowing), avoiding the negative physical and psychosocial impact of a permanent tracheostomy. Supracricoid partial horizontal laryngectomies with crico-hyoido-epiglottopexy (SCPL–CHEP) and supracricoid partial horizontal laryngectomies with crico-hyoidopexy (SCPL–CHP) have been used extensively with excellent results as upfront treatment in early laryngeal cancer (stage I–II), as well as in more advanced stages (stage III). In selected cases, this type of surgery also can be adopted in advanced laryngeal cancer with very limited extralaryngeal extension, especially when the patient categorically refuses the option of total laryngectomy. After appropriate selection-based essentially on pre- and post-treatment tumour extent, SCPL–CHEP and SCPL–CHP also can be used as salvage procedures in radio-recurrent and laser-recurrent laryngeal cancer, achieving comparable survival rates, an acceptable (although higher) morbidity, effective swallowing and a sufficiently intelligible voice. In this chapter, a step-by-step technique for both the procedures is described.