2015 年 27 巻 2 号 p. 91-96
Transoral Laser Microsurgery(TLM)with a CO2 laser is an alternative treatment to radiotherapy(chemoradiotherapy)for early glottic cancer. Generally, the indication for TLM is based on the patient’s age, general condition, or the preference of the patient or physician as well as the tumor site and its extent, or penetration. At Kurume University Hospital, TLM alone was performed as the primary treatment for 77 patients with early glottic cancer from 1986 to 2011. The T classifications of the patients were as follows: Tis(n=11),T1a(n=56), T1b(n=5), and T2(n=5). The types of cordectomy were classified, according to the European Laryngological Society Classification, as follows; type I (n=24), type II (n=8), type III (n=32), type IV (n=3), type Va (n=5), type Vb(n=3)and type VI(n=2). In the present study, after explaining our surgical procedures, we describe the treatment outcomes and postoperative voice quality of the patients. The main findings of this study were as follows: 1) the 5-year local control rate was 93.0% in TLM alone; 2) the aerodynamic functions stabilized about 6 months after TLM alone; and 3) the patients’ phonatory functions were significantly poor after Type III cordectomy that included the anterior macula flava.