Background: Transoral laser surgery has grown in popularity for the management of
laryngeal dysplasia and early stage laryngeal cancers, due to its lower morbidity and
improved organ preservation compared to open surgery or radiation therapy.
Methods: An eight year retrospective review of a single surgeon database in a
tertiary hospital was carried out. All patients who underwent endoscopic CO2 laser
excision for previously untreated early glottic cancer and dysplastic lesions were
considered for inclusion. Data was analysed using Statistical Package for Social
Sciences (SPSS).
Results: One hundred and forty three patients were included in final analysis with a
strong male preponderance. The majority were either current or ex-smokers. Thirty-
five had invasive carcinoma, while 48 had carcinoma in situ, and the remainder had
confirmed dysplasia. Three patients with invasive carcinoma, developed recurrence,
necessitating laryngectomy. Those with anterior commissure disease were more
likely to be offered post excision radiotherapy. Six out of the 60 dysplastic lesions
progressed to invasive carcinoma.
Conclusion: Laser resection is a suitable single-modality treatment for selected early
stage glottic cancers and dysplastic lesion with acceptable cure rates.
Danielle James1, Orla Young1
1 Department of Otolaryngology, Head & Neck Surgery, University Hospital Galway, Galway