Transoral Laser Surgery for Laryngeal Cancer

Kang Dae Lee; Sung Won Kim

doi:10.7599/hmr.2009.29.3.210

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Lee and Kim: Transoral Laser Surgery for Laryngeal Cancer

Review Article

Hanyang Medical Reviews 2009; 29(3): 210-219.

Published online: 31 August 2009

DOI: https://doi.org/10.7599/hmr.2009.29.3.210

Transoral Laser Surgery for Laryngeal Cancer

Kang Dae Lee, M.D., Sung Won Kim, M.D.

Department of Otolaryngology-Head & Neck Surgery, Kosin University College of Medicine, Busan, Korea.

Corresponding author (kdlee@ns.kosinmed.or.kr)

Received 29 May 2009 Accepted 10 August 2009

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The quality of life after surgery for laryngeal cancer may be as important as complete resection of the tumor. Transoral CO₂ laser partial laryngectomy for the management of early laryngeal cancer has advangtages with regard to oncological results, preservation of laryngeal functions, complications and cost in comparison to those of open surgery or radiation therapy (RT). Moreover, transoral laser surgery could be a good choice as a salvage surgery in RT-failured early laryngeal cancer. Accumulation of more clinical experiences may lead to consensus for laser surgery as an alternative surgical method to open conserative laryngeal surgery, as it has been with the shift from total laryngectomy to conservative laryngectomy.

Keywords: Laser surgery, Laryngeal cancer

Figures and Tables

Fig. 1

Laryngoscope. (A) laryngoscope. (B) Distensible laryngoscope.

Fig. 2

Microinstruments for laser surgery. (A) Grasping forcep. (B) Suction bovie. (C) Coagulation forcep. (D) Vascular clip.

Fig. 3

Protection of true vocal cord with Protecting shield (Rudert protector).

Fig. 4

En bloc resection of small glottic T1a cancer with 1~2 mm of safety margin.

Fig. 5

Multiple piece resection of glottic T1b cancer. Middle portion of left glottic cancer is incised with laser to estimate the depth of invasion.

Fig. 6

Use of distensible laryngoscope.

Fig. 7

En bloc resection for small suprahyoid epiglottic cancer (A and B).

Fig. 8

Technique of multiple piece resection. (A) Sagittal splitting of epiglottis in the midline and vallecular incision are shown. (B) Unilateral suprahyoid segments of the epiglottis is now removed. Contralateral side of suprahyoid epiglottis will be removed by same technique. The resection proceeds caudally in a stepwise fashion. (C) Specimen removed with multiple piece resection.

Table 1

Classification of endoscopic cordectomy by working committee, Europian Laryngological Society (2000)

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