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Contralateral laryngoplasty. An update on reconstruction of the larynx following supraglottic laryngectomy with vertical extension.

Twenty patients with supraglottic carcinoma extending onto an arytenoid or true vocal cord underwent supraglottic laryngectomy with vertical extension that included the resection of an arytenoid. In these patients, the contralateral superior thyroid cornu was used to reconstruct the resulting defect. In this technique, the thyroid cornu is mobilized and greenstick fractured across the posterior commissure, thus maintaining its blood supply by leaving the inferior and middle pharyngeal constrictor muscles attached. This muscle-cartilage pedicle provides bulk for the posterior glottis and can be anchored anteriorly to form a new hemilarynx. This reconstruction has provided excellent anteroposterior diameter and bulk in the laryngeal remnant, resulting in preservation of airway and voice and prevention of aspiration comparable with that achieved following supraglottic laryngectomy without vertical extension or resection of an arytenoid. It is a reliable technique for reconstructing extended laryngeal defects and is herein presented with long-term follow-up.