Artikel
Transoral CO2 laser resection of early supraglottic laryngeal cancer – 20 years experience
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Autoren
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Miklós Csanády
- Department of Otorhinolaryngolgy, University of Szeged, Szeged, Hungary
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Jenő Czigner
- Department of Otorhinolaryngolgy, University of Szeged, Szeged, Hungary
| Veröffentlicht: | 3. August 2011 |
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Gliederung
Text
Authors report their more than 20 years experience (1989–2010) with transoral CO2 laser surgery of early supraglottic cancer.
A total of 63 patients with T1, T2 supraglottic tumour underwent transoral supraglottic laser resection as a minimally invasive, curative, laryngomicroscopic procedure.
Supraglottic laser resection of 40 epiglottis (36 T1, 4 T1N1), 4 vestibular fold (T1), 13 vallecula (10 T2, 3 T2N1), 6 aryepiglottic fold (3 T2, 3 T2N1) tumours was performed with 10 neck dissections (ND) in one session due to established neck metastasis. 20 patients of this supraglotttic group recieved postoperative radiation therapy.
47 patients are free of tumour after primary laser excision so far. In 16 patients local recurrence was detected, so they underwent salvage treatments: 7 repeated laser resections, 3 radiation therapies, 4 supraglottic laryngectomies and 2 laryngectomies. Late neck metastasis developed in 5 patients, that required radical neck dissections (RND). Local tumor free survival was 85%. Tumor free survival: 75%. Survival after salvage therapy resuted in 98%.
After transoral supraglottic resection no postoperative oedema, but minimal to severe aspiration was observed, that rarely required an insertion of a naso-gastric tube or PEG. Tracheostomy was not indicated. Video-endoscopic long-term follow up revealed an acceptable – good swallowing and relative good voice.
Transoral CO2 laser surgery of the early supraglottic cancer proved to be a primary treatment option with success, good oncological and acceptable functional results.
