gms | German Medical Science

Introduction: We present a surgical technique for transoral resection of supraglottic malignant laryngeal carcinomas using microelectrodes, instead of a CO₂ laser; also the oncological and functional results.

Material and method: Prospective multicenter trial conducted between 2005–2009. 54 patients (23 T1, 14 T2, and 17 T3) with supraglottic cancer, follow-up of 2 years. Intervention: Transoral resection using microdissection electrodes. Outcome Measurement: tracheostomy, hospital stay, nasogastric feeding, recurrence, and length of surgery. Statistical analysis: Pearson chi square and logistic regression

Results: Four patients required permanent tracheostomies. Mean hospital stay was 8.1 days. Temporary nasogastric feeding was necessary in 13 patients. Postoperative complications included two hemorrhages requiring surgical intervention and one pneumonia. Local recurrences in 8 patients with T3 tumors, 4 patients developed a regional recurrence; of these, 2 were also in the group of local recurrences. In all cases salvage surgery was performed: 2 transoral surgeries, 6 total laryngectomies, 1 radical neck dissection and 3 bilateral functional neck dissections. Mean duration of operations was 56 minutes. In our series, 16 patients died: 3 of the patients due to larynx carcinoma, 13 for other diseases.

Conclusion: Clinical results are similar to those obtained with CO₂ laser. Advantages of microelectrodes over a CO₂ laser are: shorter operating time; the characteristics of the microelectrodes include the ability to cut at an angle, easier handling of instruments; very low cost of the equipment.

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