[Current role of functional and economic surgery in the treatment of cancer of the larynx]

Abstract

Unfortunately, cancer of the larynx is a frequent occurrence. In most cases, surgical treatment gives the best chances of survival. However, this type of surgery has always been dreaded and the loss of the voice has been the consequence most justly feared by patients and doctors alike. Our knowledge of anatomy and pathology has given us a better understanding of tumerous evolution in cancer of the larynx as well as the knowledge that the larynx is not a single block, but an organ composed of compartments with anatomically designated limits separating the segments. Therefore, in certain precise but numerous cases, segmentary surgery is possible. This segmentary surgery, which has proven effective from the oncological point of view, is at the same time functional, preserving the voice and normal respiration. A definition has been developed for partial laryngectomy, either vertical (laryngofissure and cordectomy, frontal-lateral laryngectomy, hemiglottectomy) or horizontal (supraglottic laryngectomy with neck dissection) and their indications have been specified. Over the last twenty years, functional subtotal laryngectomy or reconstructive laryngectomy have appeared (J. J. Piquet, Labayle). These have proven their reliability on the functional level as well as on the level of the lesions. These techniques have transformed surgery for cancer of the larynx. Early diagnosis of cancer of the larynx is essential as is the medical procedure for determining the best adapted type of surgery for each patient to save his life and his voice.