Previous to 1888 the death rate for laryngectomy was very high. According to Sendziak,1 who has collected the largest number of cases, the mortality is 35 per cent. for all cases up to 1897. If we now look at the cases operated on from 1888 to 1898, we find that the death rate has fallen to 14.5 per cent., with a corresponding fall in the number of recurrences—11.2 per cent. as compared with 30.3 per cent. This marked improvement ha [ill] due to the new methods which aim to avoid sepsis and to do away with aspiration pneumonia. These two conditions have been responsible for the majority of the fatal cases, while reflex inhibition of the heart through the superior laryngeal nerve and death from vagus degeneration deserves mention. Recurrence is less frequent because of early and more radical operating with regard for the lymphatics.
The first step in advance
GERMAIN HH. LARYNGECTOMY FOR CANCER.. JAMA. 1904;XLII(15):954–955. doi:10.1001/jama.1904.92490600020001g