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Les cordectomies au laser CO2: indications, limites et résultats

Endoscopic treatment of early glottic cancer with CO2 laser: indications, limitations and results

  • Published:
Acta Endoscopica

Résumé

De 1983 à 1992, nous avons traité 34 cas de carcinome glottique (Tis et T1) par chirurgie endoscopique au laser CO2. 8 cas ont dû subir un traitement complémentaire en raison d’une résection incomplète et 3 cas ont présenté une récidive. Dans 2 cas, le traitement de rattrapage après cordectomie au laser CO2 a consisté en une laryngectomie totale. Aucun patient n’est décédé des suites de son cancer du larynx. La cordectomie au laser constitue une modalité thérapeutique efficace du point de vue oncologique à condition de respecter rigoureusement les indications (absence d’atteinte de la commissure antérieure du larynx, absence d’atteinte du processus vocal et du fond du ventricule de Morgagni). Le degré de dysphonie est directement dépendant de l’importance de l’exérèse.

Summary

Between 1983 and 1992, 34 patients with early glottic carcinoma (Tis, T1) were treated by endoscopic laser surgery. 8 cases needed further treatment because of incomplete resection. Among the 3 patients with a reccurrent cancer after CO2 laser cordectomy, 2 underwent a salvage total laryngectomy. No patient died because of local progression of the tumor. Endoscopic resection with CO2 laser is a good treatment for selected early glottic cancer not involving the anterior commissure and the vocal process of the larynx. An excellent endoscopic visualisation is mandatory. The phonation is good when the vocal cord muscle can be preserved.

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Références

  1. ANNYAS A.A., VAN OVERBEEK J.J.M., ESCAJADILLO J.R., HOEKSEMA P.E. — CO2-laser in malignant lesions of the larynx.Laryngoscope, 1984,94, 836–838.

    PubMed  CAS  Google Scholar 

  2. BLAKESLEE D., VAUGHAN CH., SHAPSAY S.M., SIMPSON G.T., STRONG M.S. — Excisional biopsy in the selective management of T1 glottic cancer: A three-year follow-up study.Laryngoscope, 1984,94, 488–494.

    Article  PubMed  CAS  Google Scholar 

  3. BROSSARD E., RAVUSSIN P., MONNIER PH. — Micro-chirurgie endoscopique du pharyngo-larynx: possibilités thérapeutiques actuelles.Acta Endoscopica, 1992,22, 141–152.

    Article  Google Scholar 

  4. BROSSARD E., RAVUSSIN P. — Le risque de feu endotrachéal lors de la chirurgie endoscopique par laser CO2: étude expérimentale.Aktuelle Probleme der Otolaryngologie, 1989,12, 138–145.

    Google Scholar 

  5. DAVIS R.K., JAKO G.J., HYAMS V.J. — The anatomic limitations of CO2 laser cordectomy.Laryngoscope, 1982,92, 980–984.

    PubMed  CAS  Google Scholar 

  6. ECKEL H.E., THUMFART W.F. — Vorläufige Ergebnisse der endolaryngealen Laserresektion von Kehlkopfkarzinomen.HNO, 1990,38, 179–183.

    PubMed  CAS  Google Scholar 

  7. ELNER A., FEX S. — Carbon dioxide laser as a primary treatment of glottic Tis and T1a tumours.Acta Otolaryngol. (Stockh), 1988,449, 135–139.

    Article  CAS  Google Scholar 

  8. FRIED M.P. — A survey of the complications of laser laryngoscopy.Arch. Otolaryng., 1984,110, 31–34.

    PubMed  CAS  Google Scholar 

  9. GLANZ H. — Late recurrence or radiation induced cancer of the larynx.Clin. Otolaryngol., 1976,1, 123–129.

    Article  PubMed  CAS  Google Scholar 

  10. GROSSENBACHER R. — Erste Erfahrungen mit der endolaryngealen CO2 Laser Chirurgie beim umschriebenen Kehlkopfkarzinomen.Fortschr. Med., 1983,101, 1030–1032.

    PubMed  CAS  Google Scholar 

  11. HARWOOD A., TIERIE A. — Radiotherapy of early glottic cancer.Int. J. Radiat. Oncol. Biol. Phys., 1979,5, 477–482.

    PubMed  CAS  Google Scholar 

  12. HIRANO M., HIRADE Y., KAWASAKI H. — Vocal function following carbon dioxide laser surgery for glottic carcinoma.Ann. Otol. Rhinol. Laryngol., 1985,94, 232–235.

    PubMed  CAS  Google Scholar 

  13. HOEFLER H., BIGENZAHN W. — Die Stimmqualität nach CO2 laserchordecktomie.Laryng. Rhinol. Otol., 1986,65, 655–658.

    Google Scholar 

  14. KIRCHNER J.A., CARTER D. — Intralaryngeal barriers to the spread of cancer.Acta Otolaryngol. (Stockh), 1987,103, 503–513.

    CAS  Google Scholar 

  15. KOUFMAN J.A. — The endoscopic management of early squamous carcinoma of the vocal cord with the carbon dioxide surgical laser: clinical experience and a proposed subclassification.Otolaryngol Head Neck Surg, 1986,95, 531–537.

    PubMed  CAS  Google Scholar 

  16. KRESPI Y.P., MELTZER C.J. — Laser surgery for vocal cord carcinoma involving the anterior commissure.Ann. Otol. Rhinol. Laryngol., 1989,98, 105–109.

    PubMed  CAS  Google Scholar 

  17. LEE F., PERLMUTTER S., OGURA J. — Laryngeal conservation after hemilaryngectomy.Laryngoscope, 1980,90, 1534–1539.

    PubMed  CAS  Google Scholar 

  18. LEHMAN J.J., BLESS D.M., BRANDENBURG J.H. — An objective assessment of voice production after radiation therapy for stage 1 squamous cell carcinoma of the glottis.Otolaryngol. Head Neck Surg., 1988,98, 121–129.

    PubMed  CAS  Google Scholar 

  19. LEONARD R.J., GALLIA L.J., CHARPIED G. — Effects of stripping and laser excision on vocal fold mucosa in cats.Ann. Otol. Rhinol. Laryngol., 1988,97, 159–163.

    PubMed  CAS  Google Scholar 

  20. LILLIE J.C., DE SANTO L.W. — Transoral surgery of early cordal carcinoma.Trans. Am. Acad. Ophthal. Otolaryngol., 1973,77, 92–96.

    Google Scholar 

  21. LUSINCHI A., DUBE P., WIBAULT P. — Radiation therapy in the treatment of early glottic carcinoma: the experience of Villejuif.Radiotherapy and Oncology, 1989,15, 313–319.

    Article  PubMed  CAS  Google Scholar 

  22. LYNCH R.C. — Intrinsic carcinoma of the larynx with a second report of cases operated by suspension and dissection.Trans. Am. Laryngol. Assoc., 1920,42, 119–126.

    Google Scholar 

  23. MITTAL B., RAO D., MARKS J., PEREZ C. — Role of radiation in the management of early vocal cord carcinoma.Int. J. Radiat. Oncol. Biol. Phys., 1983,9, 997–1002.

    PubMed  CAS  Google Scholar 

  24. MONNIER PH., RAVUSSIN P., SAVARY M., FREEMAN J. — Percutaneous transtracheal ventilation for laser endoscopic treatment of laryngeal and subglottic lesions.Clin. Otolaryngol., 1988,13, 209–217.

    Article  PubMed  CAS  Google Scholar 

  25. OSSOFF R.H., SISSON G.A., SHAPSAY S.M. — Endoscopic management of selected early vocal cord carcinoma.Ann. Otol. Rhinol. Laryngol., 1985,94, 560–564.

    PubMed  CAS  Google Scholar 

  26. OSSOF R.H. — Laser safety in otolaryngology and head and neck surgery: anesthetic and educational considerations for laryngeal surgery.Laryngoscope, 1989,99, S48, 1–26.

    Google Scholar 

  27. PAMPURIK J., GUYOT J.P., LEHMANN W. — Bilan de 738 microlaryngoscopies en suspension.ORL, Aktuelle Probleme der Otorhinolaryngologie M Huber Verlag, 1988,12, 124–130.

    Google Scholar 

  28. RAVUSSIN P., FREEMAN J. — A new transtracheal catheter for ventilation and resuscitation.Canad. Anaesth. Soc. J, 1985,31, 60–64.

    Google Scholar 

  29. RUDERT H. — Larynx un hypopharynxkarzinome Endoskopische Chirurgie mit dem laser: Möglichkeiten und Grenzen.Arch. Otorhinolaryngol. Suppl., 1991,1, 3–18.

    PubMed  CAS  Google Scholar 

  30. SPILLMANN T., GROSSENBACHER R., SCHWARZ C. — Eine Methode zur Beurteilung der Stimmfunktion nach Behandlung des Larynkarzinoms.ORL J. Otolaryngo. Relat. Spec., 1985,7, 245–252.

    Google Scholar 

  31. STEINER W., JAUMANN M.P., PESCH H.J. — Endoscopic therapy of early cancer of the larynx.Arch Otolaryngol. Head. Neck. Surg., 1981,231, 637–643.

    Google Scholar 

  32. STRONG M.S. — Laser excision of carcinoma of the larynx.Laryngoscope, 1975,85, 1286–1289.

    Article  PubMed  CAS  Google Scholar 

  33. STRONG M.S., JAKO G.J. — Laser surgery in the larynx: early clinical experience with continuous CO2 laser.Ann. Otol. Rhinol. Laryngol., 1972,81, 791–798.

    PubMed  CAS  Google Scholar 

  34. VAUGHAN C.W., STRONG S., JAKO G.J. — Laryngeal carcinoma: transoral treatment utilizing the CO2 laser.Am. J. Surg., 1978,136, 490–493.

    Article  PubMed  CAS  Google Scholar 

  35. VECERINA S., KRAJINA Z. — Phonatory function following unilateral laser cordectomy.J. Laryngol. Otol., 1983,97, 1139–1144.

    Article  PubMed  CAS  Google Scholar 

  36. WETMORE S.J., KEY J.M., SUEN J.Y. — Laser therapy for T1 glottic carcinoma of the larynx.Arch. Otolaryngol. Head Neck Surg., 1986,112, 853–855.

    PubMed  CAS  Google Scholar 

  37. WOLFENSBERGER M., DORT J.C. — Endoscopic laser surgery for early glottic carcinoma: a clinical and experimental study.Laryngoscope, 1990,100, 1100–1105.

    Article  PubMed  CAS  Google Scholar 

  38. YEAGER V.L., ARCHER C.R. — Anatomical routes for cancer invasion of laryngeal cartilages.Laryngoscope, 1982,92, 449–452.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Clinique ORL, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne, Suisse

    E. Brossard, P. Ravussin, D. Leuba & Ph. Monnier

  2. Service d’Anesthésiologie, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne, Suisse

    P. Ravussin

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  1. E. Brossard
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  2. P. Ravussin
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  3. D. Leuba
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  4. Ph. Monnier
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Brossard, E., Ravussin, P., Leuba, D. et al. Les cordectomies au laser CO2: indications, limites et résultats. Acta Endosc 23, 343–350 (1993). https://doi.org/10.1007/BF02969557

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  • DOI: https://doi.org/10.1007/BF02969557

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