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80th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

20.05. - 24.05.2009, Rostock

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Endoscopic CO2 laser for supraglottic carcinoma with postoperative Irradiation

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  • corresponding author Stan Cotulbea - ENT Department Timisoara, Timisoara, Romania
  • Alin Horia Marin - ENT Department Timisoara, Timisoara, Romania
  • Nicolae Constantin Balica - ENT Department Timisoara, Timisoara, Romania
  • Caius Doros - ENT Department Timisoara, Timisoara, Romania

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 80. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Rostock, 20.-24.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09hnod414

doi: 10.3205/09hnod414, urn:nbn:de:0183-09hnod4141

Published: April 17, 2009

© 2009 Cotulbea et al.
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Introduction: We present the indications, general principles, contraindications, limits and results of this therapeutic method. Supraglottic cancer is aggressive, with nodal metastasis high tendency. Early detection and effective treatment is of outmost importance.

Methods: Between 1997–2007, 57 patients with supraglottic cancer T1-T2N0, were treated endoscopically with CO2 Laser. All patients were carefully selected using video-endoscopical procedures (flexible laryngoscopy, suspended microlaryngoscopy), CT-scan, MRI and neck ultrasonography. We performed simple epiglotectomy – 13 cases, extended epiglotectomy – 29 cases, HSL (horizontal supraglottic laryngectomy) – 15 cases with planned postoperative RT in all cases. 8 out of 32 cases initially staged T2 were restaged to T3 because of partially preepiglottic space invasion on final pathology review. Postoperative follow-up was between 12–48 months, average 36 months.

Results: Primary site control was maintained in 49 cases (85,96%). Regional control was attained in all cases. All patients with local reccurrence were in stage T2N0; the salvation treatment we applied consisted of total laryngectomy. Immediate functional results were very good and good in all cases. Naso-gastric feeding tube was necessary in only one case for a few postoperative days in a patient with HSL. The patients presented no tracheostomy dependency, no aspiration pneumonia and an average onset of independent swallowing at less than 2 weeks.

Conclusions: Endosocopic CO2 laser surgery appears to be an effective and safe alternative treatment for T1-T2N0 supraglottic cancer, with superior oncologic and functional results, short hospitalization, no tracheostomy and feeding tube, superior rehabilitative result and a good quality of life.