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January 1989

The Cutting Edge

Author Affiliations

Ann Arbour, Mich

Arch Otolaryngol Head Neck Surg. 1989;115(1):22. doi:10.1001/archotol.1989.01860250024017

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A well-established concern when performing an emergency tracheostomy for obstructive laryngeal and hypopharyngeal cancer is the risk of developing stomal recurrence following total laryngectomy. In an attempt to combat this problem, Drs J. Breneman, A. Bradshaw, and B. Aron, Department of Radiology, University of Cincinnati College of Medicine, administered a short course of prelaryngectomy irradiation to patients requiring emergency tracheostomy for such tumors. Twenty-one patients were treated after emergency tracheostomy with a course of irradiation that usually consisted of 20 Gy delivered in five fractions, followed by laryngectomy in one or two days. Sixteen patients also received postoperative radiotherapy of some type. Follow-up of 18 assessable patients revealed only two (11%) stomal recurrences. However, local recurrences were seen in 11 patients (61%), which is higher than reported in most series of similar tumors. The most likely explanation for this seems to be that the short-course preoperative irradiation prevented the administration

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