Transoral CO2 laser management for selected supraglottic tumors and neck dissection
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This study aimed to evaluate transoral laser resection as a method of choice for conservation surgery for supraglottic laryngeal carcinoma in carefully selected patients. Between 1987 and 2006, 55 patients with early supraglottic carcinoma were selected for transoral laser surgery. The outcome of the endoscopic CO2 laser resection and larynx-sparing functional results without tracheotomy was evaluated. Fifty-five patients with T1, T2 supraglottic carcinomas underwent transoral CO2 laser resection and seven patients with manifest neck metastasis required a neck dissection at one session with additional postoperative radiation therapy. There was no need for tracheotomy; deglutition was moderately disturbed. Forty of the 55 (73%) patients had no signs of recurrence to date. Fifteen patients with local recurrences underwent salvage therapies: six repeated laser excisions, three radiotherapies, four supraglottic laryngectomies and two total laryngectomies. Laser-specific survival is 84% and larynx preservation is 96%. The overall 5-year-survival after salvage treatment is 98%. Development of late metastasis required five radical neck dissections (RND) and radiation therapy. The results indicated that transoral laser resection can control early supraglottic cancer in selected patients and can be combined with simultaneous neck dissection with less morbidity than “open surgery”.
KeywordsEarly supraglottic tumor Transoral approach CO2 laser resection Sparing laryngeal functions Avoiding tracheotomy
Conflict of interest
The authors declare that they have no conflict of interest.
- 3.Banhidy F, Kasler M (1989) The use of lasers in otorhinolaryngology and head and neck surgery. Fortschritte der Onkologie 16. Akademie Verlag, BerlinGoogle Scholar
- 7.Thumfahrt WF, Eckel HE (1990) Endolaryngeal laser surgery in the treatment of laryngeal cancers. The current Cologne concept. HNO 38(5):174–178Google Scholar
- 17.Elo J, Koppany J, Takacsi-Nagy L (1996) CO2 laser surgery of the marginal laryngeal tumours. Hung J Otorhinolaryngol 42(2):101–106Google Scholar
- 21.Lichtenberger G, Meszaros B, Huszka J et al (2002) Endoscopic laser management of enlarged supraglottic cancer without tracheotomy. Otorhinolaryngologia Hungarica 4:213–218Google Scholar
- 24.Remacle M, Hantzakos A, Eckel H, Evrard AS, Bradley PJ, Chevalier D, Djukic V, de Vincentiis M, Friedrich G, Olofsson J, Peretti G, Quer M, Werner J (2009) Endoscopic supraglottic laryngectomy: a proposal for a classification by the working committee on nomenclature, European Laryngological Society. Eur Arch Otorhinolaryngol 266(7):993–998PubMedCrossRefGoogle Scholar