Cricohyoidopexy
Cricohyoidopexy is a surgical procedure performed after partial removal of the larynx due to laryngeal cancer. It is categorized under horizontal laryngeal surgeries, alongside cricohyoidoepiglottopexy, which particularly preserves the suprahyoid epiglottis, performed due to especially for tumors in the glottic region. The procedures aim to achieve oncological control while preserving essential laryngeal functions such as breathing, swallowing, and phonation.
History
Cricohyoidopexy was first described by E. Majer and W. Rieder in 1959 as a form of supracricoid partial laryngectomy. Cricohyoidoepiglottopexy was later described by Jean Jacques Piquet in 1974 as a modification of earlier techniques introduced by Majer and Rieder and by J. Labayle and R. Bismuth in 1971. The method was adopted in various surgical departments in the early 1980s as an alternative to total laryngectomy, particularly in patients with intermediate- to advanced-stage tumors.Surgical technique
Resection
In both CHP and CHEP, the patient is placed supine with neck extension. Orotracheal intubation and nasogastric tube placement are standard, and a tracheotomy is performed. A bilateral apron flap provides exposure and allows concurrent neck dissection.The thyroid cartilage and vocal cords are resected, preserving the cricoid cartilage, hyoid bone, and at least one mobile arytenoid. The suprahyoid epiglottis is preserved. Resection includes the aryepiglottic folds, vestibular folds, thyroarytenoid muscles, and the cricothyroid ligament. The pharyngeal muscles and paraglottic space are dissected. The superior laryngeal nerves are spared when possible. Frozen section analysis confirms clear surgical margins.