Supracricoid laryngectomy : age influence on long-term functional results

Objectives/Hypothesis: Supracricoid laryngectomies
(SCL) are conservative surgical techniques for
the treatment of selected laryngeal carcinomas, currently
adopted also in old patients. Long-term functional
results have not been reported in elderly
patients. The aim of this study is to compare voice
and swallowing in elderly and younger patients following
SCL.
Study Design: Cross-sectional study.
Methods: Twenty male patients who underwent
SCL were recruited in the study; 10 were younger
than 65 years at the time of surgery and 10 were
older. Video-endoscopic ratings were taken of neoglottic
vibration patterns and bolus transit. Voices were
perceptually rated using the GIRBAS scale. The maximum
phonation time (MPT) and the syllables diadochokinesis
were measured. Spectrograms were
recorded. All of the patients completed a self-assessment
questionnaire for both voice and swallowing.
The data obtained from the two groups were compared
through the Mann-Whitney test.
Results: Video-endoscopic ratings of neoglottal
vibration and bolus transit showed no difference
between the two groups. The perceptual assessment
showed a harsh voice in both groups. No significant
difference was found for mean syllable diadochokinesis
and the mean MPT was 6.3 seconds and 8.8 seconds,
respectively in the younger and older group.
The mean value of the Yanagihara scale of voice spectrogram
was 3.8 and 3.7. Voice and swallowing quality-
of-life questionnaires revealed satisfied patients in
both age groups.
Conclusions: Age by itself does not have a significant
impact on long-term functional results following
SCL. Meticulous selection of the candidate to SCL
allows the application of this surgical technique with
adequate long-term functional results.