Management of bilateral glottic tumors

Objective: To compare the rates of cure and complication and the time to decannulation and deglutition in patients undergoing resection of bilateral glottic tumors. Designs: A 22-year, nonrandomized, prospective, retrospective analysis. Setting: Two academic tertiary care referral centers. Participants: Seventy-two patients with bilateral glottic carcinoma were treated using bilateral hemilaryngectomy. Depending on the size of the tumor and the extent of thyroid cartilage resection, patients underwent 1 of 3 methods of reconstruction: group 1, placement of an anterior commissure stent (34 patients); group 2, epiglottic laryngoplasty (15 patients); and group 3, staged posterior thyroid alar transposition laryngoplasty (23 patients). Intervention: Resection and reconstruction of 72 larynges with bilateral glottic tumors using the bilateral hemilaryngectomy procedures. Main Outcome Measures: Acceptable rates of cure and complication, intervals to decannulation and deglutition, and quality of speech. Results: High rates of tumor control and cure, low rates of recurrence and complication, acceptable time to decannulation and deglutition, and adequate quality and intelligibility of speech. Conclusions: Bilateral vocal cord carcinoma can be treated surgically with a high degree of tumor control and cure. The use of all 3 methods maintained laryngeal function with regard to tracheal decannulation, oral alimentation, and speech intelligibility.