Abstract
We proposed transoral videolaryngoscopic surgery (TOVS) as a laryngeal preservation strategy for laryngo-pharyngeal cancer. By using a distending laryngoscope and rigid laryngeal endoscope, a large field of view and working space could be obtained which enabled us to resect tumors in en-bloc fashion. The indications for this surgery are oro-hypopharyngeal and supraglottic cancer in superficial, T1, T2 and selected T3 categories. TOVS can also be used for selected cases with recurrent tumor after radiation therapy. For resectable nodal metastasis, neck dissection can be performed simultaneously or 1-2 weeks later. In cases with more than a 1-year observation period (n = 42), 5-year crude survival, disease-specific survival, and laryngeal preservation rate were 74%, 85% and 89%, respectively.
A second advantage of TOVS is thorough evaluation of primary cancer lesion. Evaluation of tumor invasion depth is a promising way for optimizing the indication for neck dissection for clinically node negative cases.
