Transoral Surgery for Laryngeal Cancer

Abstract

We described transoral surgery for laryngeal cancer in terms of surgical indication, treatment outcome and postoperative functional analysis. The indication of laser cordectomy for glottic carcinoma is Tis to T2 lesion. As the type of cordectomy by ELS classification advanced, the postoperative voice quality deteriorated. Voice quality after either type I or type II cordectomies is almost equivalent to that after radiation therapy for T1 glottic carcinoma (T1RT). When a partial or total thyroarytenoid muscle resection is required (type III-VI), surgeons should inform patients about the possibility of postoperative dysphonia. Since transoral surgery has its own merits such as shorter treatment duration, no risk for radiation induced cancer and keeping the choice of radiation therapy for the future, treatment modality should be determined after thorough discussion with patients.
With regard to supraglottic cancer, T1 and T2 cases indicate transoral videolaryngoscopic surgery (TOVS). By using a distending laryngoscope and a rigid video endoscope a wide working space and a wide view of the operative area could be obtained. The oncological outcome by this system is excellent and patients‘ larynges could be preserved (5 year laryngeal preservation rate 90%) with good swallowing function.