Contraindication of supraglottic laryngectomy is/are-a) Poor pulmonary reserveb) Tumor involving pyriform sinusc) Tumor involving preepiglottic spaced) Vocal cord fixatione) Postcricoid area extension
High-Yield Explanation
Supraglottic laryngectomy: Removal of the supraglottis or upper part of larynx.
It should be done if following conditions are fulfilled.
For tumors with a T stage of T1 , T2 or T3 by pre epiglottic space involvement only (Thus involvement of pre-epiglottic space is not a contraindication for supraglottic larynygectomy).
Vocal cords are mobile
Cartilage is not involved (which includes cricoid cartilage so option e is correct)
Anterior commissure is not involved
Patient has good pulmonary reserve (i.e. Poor pulmonary reserve is a contraindication)
Base of the tongue is not involved past the circumvallate papillae
The apex of the pyriform sinus is not involved. (i.e. involvement of pyriform sinus is a contraindication)
The FEV1 is predicted to be > 50)
So if above criteria are not filled it is a contraindication of supraglottic laryngectomy. Answer is further supported by following lines of : Bellinger
“Supraglottic laryngectomy should not be attempted if there is vocal cord fixation, extensive involvement of pyriform sinus, thyroids or cricoid cartilage invasion or extensive involvement of base of tongue (to or beyond circumvallate papilla)” –Ballenger otolaryngology and Head and Neck Surgery 16th/ed pg-1285