[Horizontal glottectomy according to Calearo-Teatini for the treatment of XXXX involving the anterior commissure of the larynx: oncological and functional results].

@entity1 @entity5 @entity5656 @entity189 @entity86
Among the different surgical options proposed for the treatment of glottic neoplasms involving the anterior commissure is the Horizontal Glottectomy (HG) proposed in 1978 by Calearo and Teatini. This type of laryngectomy is now included with good reason among the reconstructive horizontal laryngectomies in that it calls for the complete removal of the vocal folds and corresponding thyroid cartilage, with reconstruction of the airways by means of a thyrocricopexy. The object of our study was to describe the indications, surgical technique and oncological and functional results on the basis of the experience acquired by the Authors in 21 @entity1 affected by @entity189 (juxta-commissural T1a with diffuse @entity5656 of the contralateral cord and T1b infiltration to the anterior commissure) who underwent Horizontal Glottectomy (HG) according to the Calearo-Teatinin technique. For 3 of the 21 @entity1 , the follow-up was under 3 years; for 11 @entity1 it was over 5 years; and in 4 cases, it was over 10 years, with a survival rate at 5 years of 91.5%. There were 5 deaths (27.7%), 2 of which were due to non-neoplastic intervening causes, and 1 of which for a recurrence of N (5.5%) a year after surgery. In 3 @entity1 , @entity86 (radiotherapy) was carried out due to infiltration of the resection borders. With regard to the functional results, the naso-gastric tube was maintained for 8 days on average (min 4, max 12 days), and the tracheal cannula remained in situ an average of 11 days (min 7, max 19 days), while the average hospital stay was 9.3 days. The treatment options currently available for glottic @entity5 involving the anterior commissure may be divided among radiotherapy (RT), conventional surgery including vertical laryngectomies (Tucker's frontoanterior and Leroux-Robert's frontolateral laryngectomies) and horizontal laryngectomies (Calearo-Teatini's horizontal glottectomy, Majer-Piquet's crico-hyoido-epiglottopexy, and Labayle's crico-hyoidopexy), as well as endoscopic laser surgery. Each procedure is adopted on the basis of the experience and philosophy of the surgeon. For @entity5 involving the anterior commissure, our treatment protocol prescribes HG to be performed whenever possible, as its oncological and functional result have confirmed the validity of the procedure, as long as the indications are followed carefully. Furthermore, when compared to the frontolateral procedure, it provides similar oncological results, but being a much more economical operation on the vertical plane, it avoids stenotic complications, while, compared to the Majer-Piquet procedure, it allows easier and faster rehabilitation, even in elderly @entity1 .
