Primary surgical treatment for carcinoma of the larynx: influence of the local invasion

In the period from 1976 to 1988, 417 patients with supraglottic carcinoma of the larynx were treated by primary surgery. Infiltration of the pre-epiglottic space was found in 11.99 per cent (50/417) of the patients. Carcinomas of the infrahyoid epiglottis spread to this space more frequently--14.24 per cent (44/309), than those of suprahyoid localization--5.55 per cent (6/108). Tumour invasion of the pre-epiglottic space is a relative contra-indication for reconstructive surgery. Partial conservation operations were performed on 32 per cent (16/50) of patients with invasion of the pre-epiglottic space. The remaining patients had a total laryngectomy. Infiltration of the paraglottic space intra-operatively was found in 2.4 per cent (10/417) of patients and all of these tumours were from the infrahyoid localization. Spread of tumours to this site is an indication for radical surgery and laryngectomy was performed on 80 per cent (8/10) of patients.