Transoral laser surgery for hypopharyngeal carcinomas

Organ preservation strategies are a major focus of interest in head and neck cancer. There are two ways to preserve the function in the treatment of squamous cell carcinomas of the hypopharynx: organ-sparing surgery or neoadjuvant or concomitant chemoradiotherapy. From the surgical point of view, the possibilities of organ sparing have been increased with the use of transoral carbon dioxide laser surgery. Our purpose is to review this technique as a preservation surgical strategy for hypopharyngeal carcinomas.

The role of primary surgery in the initial treatment of head and neck carcinomas is being reviewed. The transoral laser resection of hypopharyngeal carcinomas is the least established of the transoral laser surgical approaches. Recent data suggest that selected hypopharyngeal tumors may be treated with transoral laser surgery, achieving very good oncologic and functional outcomes.

Transoral carbon dioxide laser surgery is an alternative to treat hypopharyngeal carcinomas. Early tumors may be removed by a transoral approach with high local control rates and function preservation in most of the patients. For more advanced tumors experience is still limited, and the role of this technique has not yet been defined.