Transoral laser surgery for supraglottic cancer

Juan P. Rodrigo, Carlos Suárez, Carl E. Silver, Alessandra Rinaldo, Petra Ambrosch, Johannes J. Fagan, Eric M. Genden, Alfio Ferlito

Research output: Contribution to journalReview articlepeer-review

52 Scopus citations

Abstract

The goal of treatment for supraglottic cancer is to achieve cure and to preserve laryngeal function. Organ preservation strategies include both endoscopic and open surgical approaches as well as radiation and chemotherapy. The challenge is to select the correct modalities for each patient. Endoscopic procedures should be limited to tumors that can be completely visualized during diagnostic microlaryngoscopy. If complete resection can be achieved, the oncologic results of transoral laser surgery appear to be comparable to those of classic supraglottic laryngectomy. In addition, functional results of transoral laser resection are superior to those of the conventional open approach, in terms of the time required to restore swallowing, tracheotomy rate, incidence of pharyngocutaneous fistulae, and shorter hospital stay. The management of the neck remains of paramount importance, as survival of patients with supraglottic cancer depends more on cervical metastasis than on the primary tumor. Most authors advocate bilateral elective neck dissection. However, in selected cases (T1, T2 clinically negative [NO] lateral supraglottic cancers), ipsilateral selective neck dissection could be performed without compromising survival. The authors conclude that with careful selection of patients, laser supraglottic laryngectomy is a suitable, and often the preferred, treatment option for supraglottic cancer.

Original languageEnglish
Pages (from-to)658-666
Number of pages9
JournalHead and Neck
Volume30
Issue number5
DOIs
StatePublished - May 2008

Keywords

  • Complications
  • Outcome
  • Supraglottic cancer
  • Surgical technique
  • Transoral laser surgery
  • Treatment of the neck

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