Artikel
Endoscopic CO2 laser resection for T1, T2 supraglottic tumours and neck dissection
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Veröffentlicht: | 22. September 2005 |
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Gliederung
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Authors present the option of utility of endolaryngeal CO2 laser resection in T1, T2 supraglottic tumours in selected cases and in 6 patients beside the endoscopic resection neck dissection was performed at the same session for the management of the neck. .
At the Department of Otorhinolaryngology, Head and Neck Surgery, University of Szeged, Hungary 48 (15% of the supraglottic tumours) patients with supraglottic cancer underwent laryngomicroscopy and CO2 laser resection of the tumour (1987-2003).
A total of 30 epiglottis, 9 other supraglottic, 6 vallecula és 3 supraglottic-marginal (hypopharyngeal extension) tumours were resected with laser. In 6 cases (2 epigottis, 2 vallecula und 2 marginal tumours) neck dissection (mRND) was performed too, to remove the manifest metastatic lymphnodes.
36 (75%) patients show no recurrence after a single laser-excision. In 12 patients locally recurred tumour was found, so 6 patients underwent repeated laser-resection, 3 got radiation therapy, 2 horizontal supraglottic resection und 1 laryngectomy (salvage-therapy). Furthermore, development of late metastasis required 2 RNDs. No postoperativ oedema und minimale aspiration was observed.
Endoscopic CO2 laser resection of supraglottic cancer could be a method of choice in selected patients and neck dissection can also be performed in one stage to manage metastatic nodes. Nevethless, majority of the patients with supraglottic tumour (277 patient, 85%) were treated with external horizontal supraglottic resection.