[TREATMENT AND PREVENTION OF METASTASIS TO THE PRE- AND PARATRACHEAL LYMPH NODES IN CANCER OF THE LARYNX WITH SPREAD TO THE SUBGLOTTIC SECTION].

Based on the specificity of the subglottic cancer, the basic method of treatment is surgical, because many years of experience have shown the ineffectiveness of chemotherapy and the low effectiveness of radiation therapy. We have developed and introduced in practice the method of extended-combined laryngectomy is effective not only in terms of treating the underlying disease, but also for preventive purposes, reducing the risk of metastases in pre- and paratracheal lymphatic zones. The method of extended-combined laryngectomy includes mobilization of the larynx and its removal at level V or VI of the tracheal rings, lymph node dissection at level VI, both on the affected side and prophylactically from the opposite side, as well as removal of either the thyroid gland on the side of the lesion subglottic cancer, or at its circulatory location total removal of the gland. Despite the ongoing controversy over such a scale of operations, the effectiveness of extended-combined laryngectomy remains irrelevant, as indicated by a decrease in the frequency of metastasis recurrence from 65.5% to 15.3% with cancer of the subglottic localization and from 63.2% to 25.8% in the case of the spread of the tumor to the subglottic section.