A chronic smoker with history of hoarseness of voice found to have fixation of vocal cords on examination. The most likely treatment he will require is
Fixation of vocal cords on examination is T3 lesion.Total laryngectomy. The entire larynx including the hyoid bone, pre-epiglottic space, strap muscles and one or more rings of trachea are removed. Pharyngeal wallis repaired and lower tracheal stump sutured to the skin for breathing. Laryngectomy may be combined with block dissection for nodal metastasis.Total laryngectomy is indicated in the following conditions:(i) T3 lesions (i.e. with cord fixed)(ii) All T4 lesions(iii) Invasion of thyroid or cricoid cailage(iv) Bilateral arytenoid cailage involvement(v) Lesions of posterior commissure(vi) Failure after radiotherapy or conservation surgery(vii) Transglottic cancers, i.e. tumours involving supraglottis and glottis acrossDhingra 6e pg: 310
LASER
Subtotal laryngectomy
Stripping of the vocal cord
Radiotherapy
Pharynx