Laryngomicrosurgery for Early Glottic Cancer : The Indications, Techniques and Voice Outcomes

Abstract

Transoral laser microsurgery (TLM) has made great progress since first being developed in the 1970s, and now it has become an alternative treatment for early laryngeal cancer. Although TLM has some advantages in the duration of the treatment and avoidance of radiation exposure, radiation therapy is still chosen at many institutions instead of TLM. However, some previous studies have revealed that the voice outcome of TLM is not worse than that for radiotherapy and TLM has therefor recently been gaining popularity as a the treatment for early laryngeal cancer. On the other hand, laryngomicrosurgery with cold instrument dissection was also introduced for the treatment of laryngeal cancer treatment in the 1990s, and this modality reduces the degree of heat damage that is often caused to the normal vocal fold mucosa. In this article, we describe the indications and the methodology for performing laryngomicrosurgery for the treatment of early laryngeal cancer including, both TLM and cold-instrument dissection. The voice outcomes for TLM and dissection with cold-instruments are also described and statistically analyzed.