Extended Transoral Resection of Anterior Commissure Tumors in a Canine Model: Impact on Laryngeal Framework, Glottis, and Vocal Function.

[BACKGROUND AND OBJECTIVES] Evaluate the feasibility and functional outcomes of extended transoral resection for anterior commissure (AC) tumors in canines, focusing on laryngeal framework, airway, and vocal function.

[METHODS] Twelve dogs underwent endoscopic partial thyroid cartilage resection, randomized into: Group A (AC + adjacent cartilage), Group B (AC + left vocal cord anterior 1/3), Group C (AC + bilateral vocal cord anterior 1/3). Outcomes assessed included laryngoscopic healing, CT-measured laminal angle (LA) and glottal area (GA), weight, and GRBAS vocal scores.

[RESULTS] The wound healed and epithelized in 4 weeks. Postoperative LA significantly decreased in all groups ( ≤ 0.010), with the largest reduction in Group C ( ≤ 0.030 vs. A/B). LA reduction ratio correlated with resected midline height (RMH) ( = 0.546,  = 0.041) rather than resection factors of width and area. GA remained stable. Group C showed severe vocal impairment (GRBAS 8.67 ± 0.58 vs. 5.63 ± 0.48 in A,  = 0.008). Weight transiently decreased at day 7 but recovered by day 35.

[CONCLUSION] Extended transoral resection effectively removes AC lesions while preserving airway dimensions. However, extensive resection causes significant vocal dysfunction, highlighting the balance between oncologic radicality and function preservation. The potential LA-RMH correlation reveals the stabilizing characteristics of cartilaginous structures, offering preclinical insights for optimizing AC cancer surgery.