Contraindication of supraglottic laryngectomy is/are-a) Poor pulmonary reserveb) Tumor involving pyriform sinusc) Tumor involving preepiglottic spaced) Vocal cord fixatione) Postcricoid area extension
**Core Concept**
Supraglottic laryngectomy is a surgical procedure used to treat cancers of the supraglottic larynx. This procedure involves the removal of the cancerous tissue along with a portion of the larynx, while preserving the vocal cords and the ability to speak and breathe. However, this surgery is not suitable for all patients, and certain conditions make it contraindicated.
**Why the Correct Answer is Right**
The correct answer is related to the anatomical and physiological limitations of the procedure. Supraglottic laryngectomy is contraindicated in cases where the tumor involves the preepiglottic space. This is because the preepiglottic space is a critical area that is often involved in the surgical field, and tumor extension into this space can compromise the oncological safety of the procedure. Additionally, involvement of the preepiglottic space can make it difficult to achieve a clear margin around the tumor, which is essential for preventing recurrence.
**Why Each Wrong Option is Incorrect**
**Option A:** Poor pulmonary reserve is not a contraindication for supraglottic laryngectomy, as this procedure is often performed in patients with advanced cancer who have already compromised pulmonary function.
**Option B:** Tumor involving the pyriform sinus is not an absolute contraindication for supraglottic laryngectomy, as this procedure can be modified to include the pyriform sinus if necessary.
**Option C:** Tumor involving the preepiglottic space is the correct answer, as explained above.
**Option D:** Vocal cord fixation is not a contraindication for supraglottic laryngectomy, as the vocal cords are often preserved during this procedure.
**Option E:** Postcricoid area extension is not a contraindication for supraglottic laryngectomy, as this procedure can be extended to include the postcricoid area if necessary.
**Clinical Pearl / High-Yield Fact**
It's essential for surgeons to carefully evaluate the extent of tumor involvement in the preepiglottic space before deciding on supraglottic laryngectomy, as this can significantly impact the success and safety of the procedure.
**Correct Answer:** C. Tumor involving preepiglottic space.