[Multidisciplinary treatment of carcinoma of the larynx]

The prognosis of the laryngeal carcinoma is better than that of other head and neck carcinomas. The five-year survival rate ranges between 70 and 80%. The proportion of cases of early glottic carcinoma has increased at our clinic. In 1986, about 70% of all laryngeal carcinomas were glottic carcinoma, and about half of these were early-stage cases. The principle of management is, primarily, life-saving and then functional preservation. For this purpose, it is mandatory to make an exact diagnosis and to treat the condition appropriately. Generally, the modality of treatment is mainly radiation and surgery; radiation or partial laryngectomy for early-stage cancer, total laryngectomy for advanced-stage cancer. However, selection of therapy should not only be based on stage, but also on various other factors, e.g., type of growth, medical facilities available and the patient's situation (age, etc.). Recently, laser therapy has been tried for early carcinoma. Patients with advanced carcinoma still have a poor prognosis, and so planned combined therapy including chemotherapy and immunotherapy should be considered. Vocal rehabilitation following total laryngectomy is also very important. There are three main methods of rehabilitation, i.e., esophageal speech, artificial larynx (pneumatic larynx or electro-larynx) and surgery (reconstructive laryngectomy, tracheoesophageal shunt).