Hemi-laryngectomy

The purpose of hemi-laryngectomy is to remove the laryngeal cancer while retaining the vocal function. However, its proper scope is narrow and it should be strictly controlled. It must not leave cancer in order to preserve the physiological function of the larynx, causing irreparable recurrence. From the study of embryo, anatomy and clinicopathology, some suitable cases can be selected for hemi-laryngectomy. The supraglottic region originated from the primitive pharynx, the ventricular zone, epiglottis, and epiglottis were wrinkled from the fourth gill arch, and the vocal cords and subglottic zone were from the upper trachea. And the acoustic examination can be used for hemi-laryngectomy, which does not violate the principle of radical cure of cancer and obtain the expected results. The anterior epiglottic space is located between the hyoid bone and the anterior commissure of the vocal cords. It is shaped like a cone with its bottom facing upwards. Cancers in the upper and superior glottic areas often develop into this area. Sometimes the clinical examination is limited to cancers in the epiglottic root, and microscopic examination has spread the cancer to the ventricle, and epiglottic cancer is prone to cervical lymph node metastasis. Therefore, hemi-laryngectomy should include all anterior epiglottic spaces and, if necessary, radical cervical lymphadenectomy. If a pharynx is made from under the hyoid bone, only the epiglottis is removed, and the cancer is very likely to recur. There are many methods of hemi-laryngectomy, such as transverse upper laryngectomy, anterior and lateral hemi-laryngectomy, and oblique angle hemi-laryngectomy. Among them, transverse upper laryngectomy is more practical. Focused on the operation.