The Endoscopic Management of Early Squamous Carcinoma of the Vocal Cord with the Carbon Dioxide Surgical Laser: Clinical Experience and a Proposed Subclassification

1986 ◽  
Vol 95 (5) ◽  
pp. 531-537 ◽  
Author(s):  
James A. Koufman
Keyword(s):  
Vocal Cord ◽  
Anterior Commissure ◽  
Squamous Carcinoma ◽  
Invasive Disease ◽  
Endoscopic Management ◽  
Vocal Process ◽  
Small Series ◽  
Endoscopic Laser ◽  
Excellent Method ◽  
Laser Excision

Sixteen patients with T1 vocal cord squamous cell carcinoma were treated with endoscopic laser excision during a 4-year period. Laser excision was the initial treatment in 11 patients, and it was used to treat 5 patients who had recurrence after radiotherapy. Postoperatively, 13 (81%) of the 16 patients had normal voices. Two patients with persistent postoperative hoarseness had had anterior commissure lesions and previous radiotherapy; the other patient had a subtotal cordectomy. One patient developed a subsequent new lesion 27 months after the initial laser treatment; he was successfully managed with a second endoscopic laser excision. Involvement of the anterior commissure or involvement of the vocal process with minimally invasive disease proved not to be a contraindication to laser excision. The overall results in this small series suggest that laser excision of T1 vocal cord carcinoma is an excellent method of treatment.

scholarly journals A Case of Verrucous Carcinoma of Larynx

2020 ◽  
Vol 23 (2) ◽  
pp. 208-211
Author(s):  
Mahmudul Hassan ◽  
Md Zahedul Alam ◽  
Mohammad Hanif ◽  
Md Rafiqul Islam ◽  
Saif Rahman Khan ◽  
...  
Keyword(s):  
Vocal Cord ◽  
Male Patient ◽  
Anterior Commissure ◽  
Verrucous Carcinoma ◽  
Fiberoptic Laryngoscope ◽  
Laser Excision ◽  
The Right ◽  
Carcinoma Of Larynx

A 50 years old male patient was admitted with complaints of change in voice for 2 years, dry cough 2 month and difficulty in breathing for 1 month. On examination with fiberoptic laryngoscope, an exophytic lesion covered with whitish plaque involving right vocal cord extending from anterior commissure to right arytenoid region, extending upto the right vestibular area and hanging in the subglottic area was seen. Patient was treated with Microlaryngeal Laser excision and the Histopathology report was suggestive of Verrucous Carcinoma of Larynx. Bangladesh J Otorhinolaryngol; October 2017; 23(2): 208-211

Laser Surgery for Vocal Cord Carcinoma Involving the Anterior Commissure

1989 ◽  
Vol 98 (2) ◽  
pp. 105-109 ◽  
Author(s):  
Yosef P. Krespi ◽  
Charles J. Meltzer
Keyword(s):  
Radiation Therapy ◽  
Vocal Cord ◽  
Laser Surgery ◽  
Anterior Commissure ◽  
Thyroid Cartilage ◽  
Increased Risk ◽  
Endoscopic Laser ◽  
Benign Laryngeal Lesions ◽  
Endoscopic Laser Surgery ◽  
Glottic Tumors

Endoscopic laser surgery is an established means of treatment for benign laryngeal lesions. Laser surgery for early (stages I and II) squamous cell carcinoma is still being tested. Treatment of glottic tumors extending to the anterior commissure is in itself controversial. Approximately 20% of all glottic tumors involve the anterior commissure, with only 1% of these lesions being purely anterior commissure tumors. The anatomy of the anterior commissure is such that an apparent T1 lesion may actually be a T4 lesion if it involves the thyroid cartilage. The distance between the anterior commissure ligament and the thyroid cartilage is only 2 to 3 mm. A preoperative computed tomographic scan can aid us in evaluating this space. Therefore, tumors of the anterior commissure present as a therapeutic challenge. Radiation therapy has proven to be inadequate, with a high rate of recurrence and increased risk for radiochondronecrosis. The literature with regard to radiotherapy varies widely as to survival rates. Conservation surgery has consistently demonstrated an 80% survival in T1 lesions. Recently, it has been suggested that laser surgery in the region of the anterior commissure might offer satisfactory results. We have found the opposite. We will report on five patients who underwent endoscopic laser surgery on T1 vocal cord lesions involving the anterior commissure. All of these patients had tumor recurrence and subsequently have undergone salvage surgery and/or radiation therapy. The difficulties associated with endoscopic laser surgery of the anterior commissure will be discussed with a supporting animal study.

Negative pathology following endoscopic resection of T1a squamous carcinoma of the glottis

2005 ◽  
Vol 119 (8) ◽  
pp. 592-594 ◽  
Author(s):  
R Nassif ◽  
S Loughran ◽  
C Moyes ◽  
K MacKenzie
Keyword(s):  
Endoscopic Resection ◽  
External Beam Radiotherapy ◽  
Squamous Carcinoma ◽  
Invasive Disease ◽  
Glottic Cancer ◽  
Resected Specimen ◽  
Squamous Cancer ◽  
Initial Biopsy ◽  
Laser Excision ◽  
Disease Free

Endoscopic CO2 laser excision for T1a glottic cancer is a recognized treatment modality producing equivalent disease-free and voice results to external beam radiotherapy. On reviewing a series of 15 patients who had undergone endoscopic resection of a T1a glottic squamous cancer, it was noted that five patients had negative excisional pathology following the initial biopsy of an invasive squamous carcinoma. The histopathology of each patient’s resected specimen was reviewed by a second pathologist who confirmed the accuracy of the results in all cases. We conclude that a significant number of early squamous carcinomas of the glottis present with very small localized, minimally invasive disease and that a proportion may be treated by biopsy alone.

Laser Excision of Early Vocal Cord Carcinoma: Indications, Limitations, and Precautions

1990 ◽  
Vol 99 (1) ◽  
pp. 46-50 ◽  
Author(s):  
Stanley M. Shapshay ◽  
Roger L. Hybels ◽  
R. Kirk Bohigian
Keyword(s):  
Vocal Cord ◽  
Laser Excision

Total Cervical Tracheal Stenosis: Treatment by Laser, Dilation, and Stenting

1989 ◽  
Vol 98 (11) ◽  
pp. 890-895 ◽  
Author(s):  
Stanley M. Shapshay ◽  
John F. Beamis ◽  
Jean-Francois Dumon
Keyword(s):  
Tracheal Stenosis ◽  
Carbon Dioxide Laser ◽  
Average Duration ◽  
Surgical Techniques ◽  
Initial Therapy ◽  
Tube Placement ◽  
T Tube ◽  
Endoscopic Laser ◽  
Laser Excision

Twelve patients with total cervical tracheal stenosis were treated by endoscopic laser excision (neodymium:yttrium aluminum garnet or carbon dioxide laser), bronchoscopic dilation, and prolonged stenting with a silicone T-tube. All patients had previous traumatic or prolonged endotracheal intubation requiring a tracheotomy and presented with aphonia as the major complaint. Multiple laser and dilation treatments were necessary in ten patients. Average duration of T-tube placement was 6 months. Excellent results (decannulation and good voice) were achieved in eight patients with a follow-up of 9 months to 6 years. Persistent granulation tissue and some degree of fibrosis were the most common complications (eight of 12 patients). Two patients died of medical complications. A high success rate with this endoscopic technique justifies this approach as our initial therapy, with open surgical techniques reserved for failure.

scholarly journals Endoscopic CO2-Laser Surgery for Vocal Cord Cancer

1994 ◽  
Vol 1 (2) ◽  
pp. 69-74 ◽  
Author(s):  
J. Czigner ◽  
L. Sávay
Keyword(s):  
Vocal Cord ◽  
Laser Surgery ◽  
Preoperative Assessment ◽  
Therapeutic Endoscopy ◽  
Salvage Treatment ◽  
Treatment Modalities ◽  
Endoscopic Laser ◽  
Voice Preservation ◽  
Endoscopic Laser Surgery

A retrospective study is reported on endoscopic CO2-laser microsurgery in 69 patients with histologically verified early vocal cord cancer. A flexible nasopharyngolaryngoscope (STORZ Co) was used for preoperative assessment and occasionally for postoperative follow-up.Six years of experience with this technique have led to endoscopic cordectomy, previously not accepted as a therapeutic method alone, but which has become the favored method with use of the CO2 laser endoscopically. Laser surgery as a therapeutic endoscopic procedure provided successful treatment of early vocal cord cancer in 59 (86%) of the 69 patients. The initial success rate together with “salvage” treatment modalities reached 96% (66/69 patients).Endoscopic laser surgery resulted in a decrease in voice intensity and phonatory duration from near normal to mildly abnormal. Voice preservation succeeded in 97% of all patients. Thus, the data demonstrate that endoscopic laser surgery is a useful modem method of therapeutic endoscopy for early vocal cord carcinoma.

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