Transoral Laser Microsurgery for Early Glottic Carcinoma in Japanese Patients Over 75 Years Old

This study examined the feasibility of carbon dioxide (CO 2 ) transoral laser microsurgery (TLM) for early glottic carcinoma in Japanese patients over 75 years old. A retrospective chart review was performed for 43 patients with (r)Tis-T2 glottic cancer who underwent TLM in our institution between 2010 and 2018. The on-cological results, postoperative voice/swallowing function, and complications were evaluated. Results show that TLM is a viable option for Tis and T1a cases when general anesthesia is possible. TLM appears to be appro-priate for T1b lesions that are clear and localized. However, if type Ⅵ cordectomy is required, prolonged hospi-talization owing to aspiration may occur. T 2 carcinomas with unclear lesion extension may require salvage treatment. In salvage cases, TLM should be carefully considered according to the extent of lesion progression at the time of the initial treatment and postoperative complications. The postoperative voice function was found to be equivalent to that observed after radiation therapy, and approximately 80% of patients were able to start oral intake the day after surgery. TLM is minimally invasive and requires a short hospital stay, making it an attractive treatment option for elderly patients. Furthermore, actively performing transoral surgery in elderly patients should be encouraged.