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      Transoral Laser Microsurgery in Early Glottic Lesions

      review-article
      Author(s):
      Publication date (Electronic):
      Journal: Current Otorhinolaryngology Reports
      Publisher: Springer US
      Keywords: Early glottic carcinoma, Early glottic cancer, Tis–T1–T2, TLM, Laser, Voice outcome

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Purpose of Review

          To give an overview of the evolvement of transoral laser microsurgery (TLM) in the treatment of early glottic carcinoma and highlight the contribution of recent literature.

          Recent Findings

          The indications and limits of TLM have been well specified. Effects on swallowing have been well documented. Introduction of narrow-band imaging (NBI) and diffusion-weighted magnetic resonance has been shown of additional value for outcome. The first reports on transoral robotic surgery show that it may be of added value in the future.

          Summary

          TLM for early glottic carcinoma (Tis–T2) has very good oncological outcomes with indications of higher larynx preservation in TLM than that in radiotherapy. The anterior commissure is a risk factor if involved in the cranio-caudal plane, and reduced vocal fold mobility is a risk factor when this is due to arytenoid involvement. The best voice results are achieved when the anterior commissure can be left intact along with part of the vocal fold muscle although even in larger resections, patient self-reported voice handicap is still limited.

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          Most cited references91

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          Management of T1-T2 glottic carcinomas.

          William M Mendenhall, John W Werning, Russell W Hinerman … (2004)
          T1-T2 glottic carcinomas may be treated with conservative surgery or radiotherapy. The goals of treatment are cure and laryngeal voice preservation. The aim of the current study was to review the pertinent literature and discuss the optimal management of early-stage laryngeal carcinoma. Literature review indicated that the local control, laryngeal preservation, and survival rates of patients were similar after transoral laser resection, open partial laryngectomy, and radiotherapy. Voice quality depended on the extent of resection for patients undergoing surgery; results for patients undergoing laser resection for limited lesions were comparable to the corresponding results for patients receiving radiotherapy, whereas open partial laryngectomy yielded poorer results. Costs were similar for laser resection and radiotherapy, but open partial laryngectomy was more expensive. Patients with well defined lesions suitable for transoral laser excision with a good functional outcome were treated with either laser or radiotherapy. The remaining patients were optimally treated with radiotherapy. Open partial laryngectomy was reserved for patients with locally recurrent tumors. Copyright 2004 American Cancer Society.
          Article 0 comments Cited 69 times – based on 0 reviews     Review now
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            Laser surgery in the larynx. Early clinical experience with continuous CO 2 laser.

            John M Strong, G. Jako (1972)
            Article 0 comments Cited 61 times – based on 0 reviews     Review now
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              Endoscopic cordectomy. A proposal for a classification by the Working Committee, European Laryngological Society.

              D Brasnu, H Rudert, H Eckel … (1999)
              The European Laryngological Society is proposing a classification of different laryngeal endoscopic cordectomies in order to ensure better definitions of post-operative results. We chose to keep the word "cordectomy" even for partial resections because it is the term most often used in the surgical literature. The classification comprises eight types of cordectomies: a subepithelial cordectomy (type I), which is resection of the epithelium; a subligamental cordectomy (type II), which is a resection of the epithelium, Reinke's space and vocal ligament; transmuscular cordectomy (type III), which proceeds through the vocalis muscle; total cordectomy (type IV); extended cordectomy, which encompasses the contralateral vocal fold and the anterior commissure (type Va); extended cordectomy, which includes the arytenoid (type Vb); extended cordectomy, which encompasses the subglottis (type Vc); and extended cordectomy, which includes the ventricle (type Vd). Indications for performing those cordectomies may vary from surgeon to surgeon. The operations are classified according to the surgical approach used and the degree of resection in order to facilitate use of the classification in daily practice. Each surgical procedure ensures that a specimen is available for histopathological examination.
              Article 0 comments Cited 46 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                EV Sjögren: evsjogren@lumc.nl
                Journal
                Journal ID (nlm-ta): Curr Otorhinolaryngol Rep
                Journal ID (iso-abbrev): Curr Otorhinolaryngol Rep
                Title: Current Otorhinolaryngology Reports
                Publisher: Springer US (New York )
                ISSN (Electronic): 2167-583X
                Publication date (Electronic): 11 March 2017
                Publication date PMC-release: 11 March 2017
                Publication date (Print): 2017
                Volume: 5
                Issue: 1
                Pages: 56-68
                Affiliations
                ISNI 0000000089452978, GRID grid.10419.3d, Department of ENT and Head and Neck Surgery, , Leiden University Medical Center, ; Albinusdreef 2, 2300 RC Leiden, The Netherlands
                Article
                Publisher ID: 148
                DOI: 10.1007/s40136-017-0148-2
                PMC ID: 5357474
                PubMed ID: 28367361
                SO-VID: f626aecd-0e63-492c-9d9d-09eba77a47f0
                Copyright © © The Author(s) 2017
                License:

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Funding
                Funded by: Leiden University Medical Center (LUMC)
                Categories
                Subject: Head and Neck: Laryngeal Cancer (C Piazza, Section Editor)
                Custom metadata
                issue-copyright-statement © Springer Science+Business Media New York 2017

                Keywords: early glottic carcinoma,early glottic cancer,tis–t1–t2,tlm,laser,voice outcome
                Data availability:
                Keywords: early glottic carcinoma, early glottic cancer, tis–t1–t2, tlm, laser, voice outcome

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