Publication:

Supraglottic laryngectomy for endoscopic resection: proposal of a new classification

Proposal of a new classification, which includes six types of resections, for supraglottic laser surgical treatment. Our classification defines precisely Type Ia excision as an en bloc procedure. Aside, the lateral supraglottic resections are described in detail, with type Ib, II and III modalities, which encompass excision of lateral supraglottic structures and partial paraglottic space excision, due to the potential for extension to this space present on laterally located tumors. Type IV resection refers to a complete supraglotic laryngectomy, which addresses the preepiglottic spread potential of midline supraglottic lesions. Type Va resection or arytenoidectomy is introduced, leaving types Vb and Vc as previously described cordectomies. A new concept of palliative procedures types VIa and VIb is presented, according to invasion to supraglottic structures and/or tongue base extension in T3-T4 lesions. A classification should be understandable, reproducible and easy to interpret, so that it facilitates comparison of results and potentially translates into better oncologic outcomes. Laser resection of the supraglottis must not be consider curative for all patients, objective are different according to the stage, so the present classification include: Partial,, Extended and Palliative Delbulking Resection.