Horizontal Vertical Laryngectomy in Transglottic Laryngeal Cancer

Organ preservation surgery in the larynx cancer started with cordectomy technique in 1850s. Leading laryngologists have described alternative techniques to total laryngectomy (TL). But the extent of their indications, resection limits and reconstruction problems led to oncological and functional failure. Therefore, these techniques were forgotten until 1950s. Studies on the embryology, surgical anatomy of the larynx and biologic behavior of squamous cell cancer provided surgical return. In the organ preservation surgery vertical partial laryngectomy (VPL), horizontal supraglottic partial laryngectomy (SGPL) and their extended modifications were developed by the pioneer laryngologists. Adoption and application of any new technique usually take some time. However, the important problem is that when a technique becomes popular it is being used instead of other techniques. In this article, I would like to introduce our horizontal vertical laryngectomy (HVL) technique that we have been using successfully in unilateral selected T2-T3 transglottic cancer since 1977. In this 3/4 laryngectomy, SGPL and VPL are applied together. Reconstruction with restoration of glottis is performed with two stage Cevanşir’s laryngostoma technique. Early decanulation (from 4-5 days) and aspiration free swallowing (from 7-10 days) are the important advantages along with its oncological safety.