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[CO2 laser treatment; an effective and minimally disruptive endoscopic therapy for small glottic laryngeal
H F Mahieu1, D P Kooper, C R Leemans
1Academisch Ziekenhuis Vrije Universiteit, afd. Keel-, Neus- en Oorheelkunde, Amsterdam.
Objective:
To evaluate endoscopic CO2 laser vaporization as a treatment of small glottic laryngeal carcinomas selected by means of video laryngo-stroboscopy.
Design:
Prospective.
Setting:
ENT department, University hospital, Free University Amsterdam.
Methods:
Patients with a small glottic laryngeal carcinoma (stage Tis or T1a), were selected by means of video-laryngo-stroboscopy for a single stage endoscopic CO2 laser vaporization treatment as an alternative for radiotherapy. They were followed up for at least 24 months.
Results:
Three of the 46 patients (6%) developed a local recurrence within 2 years; one of these could be treated once more with the CO2 laser, the other two were irradiated. None of these patients developed metastases in cervical lymph nodes or distant metastases. Most patients (41, 89%) assessed their voices after CO2 laser vaporization as normal or almost normal. Slight dysphonia was reported by five patients (11%). No serious dysphonia or aphonia occurred.
Conclusion:
Endoscopic CO2 laser vaporization, compared with radiotherapy or more extensive surgery, constitutes an adequate treatment for selected patients with small glottic laryngeal carcinomas. As a result of this treatment, it will be possible to preserve the larynx in more patients.