Carbon dioxide laser resection of superficial oral carcinoma: indications, technique, and results

A retrospective medical record review was done of 51 consecutive patients with 56 biopsy-proven squamous cell carcinomas of the oral cavity and oropharynx treated for cure by one of the authors (H.H.D.) using the carbon dioxide laser via microdirect pharyngoscopy. All 51 patients were followed for at least 3 years unless they died, and 27 were followed for 5 years. The tumors treated were superficial, accessible lesions without bone involvement or clinically apparent metastases. Eighteen patients had had irradiation or surgery at the same site, so were having salvage CO2 laser surgery. Indications and technique are discussed. Local recurrence and disease control rates were comparable to those of conventional local surgical excision at 3 and 5 years. Complication rate was low. Carbon dioxide laser resection with microscopic control is, we propose, an excellent modality for transoral excision of carefully selected lesions, and it offers increased precision, better visualization, minimal bleeding, and decreased postoperative morbidity compared to other surgical techniques.