Surgery for locally advanced laryngeal cancer

Surgical options for locally advanced laryngeal cancer range from organ-preservation surgeries, such as transoral laser microsurgery and partial laryngectomy, to total or near-total laryngectomy with partial or total pharyngectomy. Herein, we describe preoperative workup, surgical technique for total laryngectomy, including stomal incision and design, laryngeal framework isolation and thyroid management, entry into the larynx and pharynx, tracheoesophageal puncture, and closure options. Early and late postoperative complications are considered. Lastly, conservation laryngeal surgical options, including vertical versus horizontal partial laryngectomy and transoral laser microsurgery are discussed.