gms | German Medical Science

Authors report their more than 20 years experience with CO2 laser surgery of early glottic cancer. Between 1987 and 2001 – during a period of 15 years, a minium of 5 years follow up – a total of 251 laser cordectomies were performed in 224 patients with Tis-T2 vocal cord tumours as a minimally invasive, curative, laryngomicroscopic CO2 laser resection.

Laser cordectomy was divided into 4 subgroups (due to ELS classifiction into 5 subgroups) in order to classify the extension of the compete resection of the tumour with adequate, clear margins.

A 5-years survival of 251 laser-cordectomies in 224 patients revealed in Tis tumours 100%, T1a 92%, T1b 77% and T2 83% respectively.

For 87% of their patients with vocal cord tumours CO2 laser-surgery proved a successful, single therapeutical intervention.

The quality of voice and closure of glottis highly depend on the extension of tumours and resection of the vocal cord. The video follow up showed that the phonation (good voice) is affected by the resection of anterior two-third of the vocal cord. The postoperative synechie-formation and granulation influence the closure and voice function too. Extended laser-cordectomy with vestibulectomy (resection of the false cord) results in a weak and hoarse voice.

Author’s experiences are the followings (a) Laser-treatment can be repeatedly performed; (b) The voice improves during the healing (reepithelization) after laser-cordectomy in subgroups 1, 2, (3); (c) Beside the ablative, oncologic result, from functional aspect in 2/3 of the total patients after laser-cordectomy the voice is almost normal or at least relative good; (d) There is no postoperatve swallowing disorder.