15 Locally Advanced Supraglottic Cancer: Larynx Preservation by Transoral Laser Microsurgery

Carbon Dioxide transoral laser microsurgery represents a reliable option for the treatment of early glottic carcinoma (Tis–T2), with good functional and oncological outcomes, nowadays representing one of the main options in larynx preservation protocols. The development and improvement of laser devices means surgeons are able to use more precise instruments compared with classic cold dissection in laser-assisted phonosurgery. Secondary effects on voice, swallowing, or quality of life as well as complications have been well documented. Also, with the introduction of a new proposal for staging systems following the principle of the three-dimensional map of isoprognostic zones, the use of narrow-band imaging in clinical evaluation and intraoperative, and the implementation of diffusion-weighted magnetic resonance during preoperative evaluation, the development of new tools to improve surgical quality and preliminary reports regarding the use of carbon dioxide laser in transoral robotic surgery suggests an exciting future for this technique.

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Transoral robotic surgery vs transoral laser microsurgery for resection of supraglottic cancer: a pilot surgery

International Journal of Medical Robotics and Computer Assisted Surgery ◽

10.1002/rcs.1546 ◽

2013 ◽

Vol 10 (1) ◽

pp. 107-112 ◽

Cited By ~ 34

Author(s):

Mohssen Ansarin ◽

Stefano Zorzi ◽

Maria Angela Massaro ◽

Marta Tagliabue ◽

Michele Proh ◽

...

Keyword(s):

Robotic Surgery ◽

Transoral Robotic Surgery ◽

Transoral Laser Microsurgery ◽

Laser Microsurgery ◽

Supraglottic Cancer

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Platysma myofascial flap for reconstruction of oropharyngeal defects after transoral laser microsurgery of locally advanced carcinomas

The Journal of Laryngology & Otology ◽

10.1017/s0022215106003628 ◽

2006 ◽

Vol 120 (12) ◽

pp. 1055-1058 ◽

Cited By ~ 4

Author(s):

M C Jäckel

Keyword(s):

Primary Tumour ◽

Locally Advanced ◽

Fistula Formation ◽

Bleeding Complications ◽

Transoral Laser Microsurgery ◽

Laser Microsurgery ◽

Laser Resection ◽

Substantial Risk ◽

Neck Vessels

Introduction: Transoral laser microsurgery of locally advanced carcinomas of the lateral oropharynx often results in exposure of major vessels of the neck and may be accompanied by a substantial risk of intra- and post-operative bleeding.Procedure: Six patients with tonsillar cancers radiologically infiltrating the parapharyngeal space underwent ipsilateral neck dissection with temporary protection of neck vessels. While the neck remained open, transoral laser resection of the primary tumour was performed. Pharyngeal defects were subsequently closed by a superiorly based platysma myofascial flap.Results: All tumours were completely resected. Intra- and post-operative bleeding complications requiring blood transfusion or surgical revision did not occur. None of the patients developed a cervical fistula. During a mean follow-up time of 24.8 months, no local and/or regional recurrence was observed.Conclusion: The described approach is oncologically safe and seems to ensure reliable protection of neck vessels during and after transoral laser resection of locally advanced oropharyngeal carcinomas, as well as to prevent fistula formation.

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