[Epiglottic reconstruction after near total laryngectomy].

Near total laryngectomy results in large defect of the larynx requiring reconstruction. Pedicled composite epiglottic flap containing cartilage and epithelium is an ideal reconstructive tissue. This paper describes our experiences with 15 cases who underwent epiglottic laryngoplasty after near total laryngectomy since 1983. In order to avoid too wide a glottis leading to aspiration and poor voice, the Tucker technique has been modified in two ways: (1) The posterior edge of the epiglottis was sutured separately to the posterior edge of the cricoid opposing the true and false cords rather than the thyroid alar struts; An arytenoid was reformed. (2) Bilateral edge of the epiglottis was lowered. Anew pseudocord was formed. (3) The anterior epiglottic flap was manipulated to simulate the shape of anterior commissure. These modified reconstructive techniques resulted in decreasing in the transverse diameter and increasing slightly in the anterior-posterior length of the glottis, the functions of deglutition, phonation and respiration were improved significantly None had developed local recurrence and distant metastasis in more than 2-4 years.