Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2025, Vol. 39 ›› Issue (1): 77-84.doi: 10.6040/j.issn.1673-3770.0.2023.319

• Original Article • Previous Articles    

Application of epiglottic tongue flap in supraglottic defect repair of laryngeal cancer

QU Xiangyu1, ZHU Han1,2, LIU Zhonglu1, MU Yakui1, GUO Wentao1, ZHANG Hua1   

  1. 1. Department of Otorhinolaryngology & Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University/ Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases/ Yantai Key Laboratory of Otorhinolaryngologic Diseases, Yantai 264000, Shandong, China2. Department of the 2nd Medical College of Binzhou Medical University, Yantai 264000, Shandong, China
  • Published:2025-01-17

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2

Abstract: Objective To summarize our experience of laryngeal function reconstruction using an epiglottic tongue flap combined with an anterior cervical muscle flap to repair supraglottic defects during laryngeal cancer surgery. Methods A retrospective analysis of 119 operations in patients hospitalized in the Yantai Yuhuangding Hospital who underwent laryngectomy for laryngeal cancer, mainly T2 and T3 lesions with postoperative defects on the glottis, according to the 2017 AJCC on Cancer staging criteria, including the glottis type in 61 cases(T2N0M0 23, T2N1-2M0 12, T3N0M0 22, T3N1-2M0 4)and 58 cases of supraglottic carcinoma(T2N0M0 25, T2N1-3M0 20, T3N0M0 3, T3N1-3M0 10). The study included 116 males and 3 females aged 45-81 years. Horizontal partial laryngectomy, vertical partial laryngectomy, and extended horizontal/vertical partial laryngectomy were performed to ensure safe margin and complete tumor resection. The epiglottis, tongue base tissue, and combined anterior cervical strap muscle flaps were used to repair the laryngeal supraglottic defects. To evaluate the advantages of the epiglottic tongue flap in the reconstruction of supraglottic defects after laryngeal cancer surgery, the postoperative recovery of voice and swallowing function, postoperative complications, extubation rate, survival rate, metastasis, and recurrence were recorded. Results Among the 119 patients, the phonation function was successfully recovered after extubation, and the total extubation rate was 94.96%. Nasogastric feeding tubes were removed within 5-19 days after the surgery. There were five cases of infection around the incision and cannula, and two cases of laryngeal fistula. All patients were followed up for 36 to 70 months. The 3-year and 5-year survival rates were 82.35% and 74.00%, respectively. Recurrence occurred in 14 patients(11.80%), and distant metastasis in 11 patients(9.20%). Conclusions Adequate preoperative evaluation and individualized surgical plans should be created for patients with large supraglottic defects during laryngeal cancer surgery. The epiglottis, tongue flap, or epiglottis tongue flap combined with the anterior cervical strap myofascial flap can be used to repair large defects in the upper laryngeal cavity. These flaps are simple to repair, reduce surgical trauma, and increase the extubation rate and swallowing function recovery after surgery. This finding has important clinical significance for the reconstruction of laryngeal function after laryngeal cancer surgery.

Key words: Laryngeal cancer, Epiglottic flap, Tongue flap, Anterior cervical strap muscle flap, Reconstruction of laryngeal function

CLC Number: 

  • R767.91
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