Endoscopic Supraglottic Laryngectomies. Results on 45 Cases

Abstract

Objective The aim of this study was to evaluate long-term results of transoral CO2 laser-assisted surgery for supraglottic carcinoma. Methods From 1992 to 2004, 45 patients including 38 males and 7 females with a mean age of 62 years and showing a supraglottic squamous cell carcinoma (2 Tis, 9 T1N0, 27T2N0, 2T2N1, 1T2N2, 4 T3N0) underwent different types of endoscopic partial supraglottic laryngectomies according to the European Laryngological Society (ELS) proposal of classification (3 limited excision-type I; 29 medial without resection of the pre-epiglottic space-type II; 4 medial with resection of the pre-epiglottic space-type III; 11 lateral-type IV) in combination with neck dissection performed during the same session. Frozen sections were performed on the laryngeal margins after tumoral resection. No patient had tracheostomy perioperatively. Results Overall survival was 93 ± 4% after 3 years and 89 ± 6% after 5 years. The minimum follow-up was 3 years. Frozen sections were negative in 40 cases and presented only dysplasia in 5 cases. N0 nodes were positive in 8 cases (18%). Two postoperative bleedings were controlled by electrocautery. All of them relearned undisturbed deglutition within 5 days to 3 weeks from surgery. Two patients presented aspiration pneumonia. Mean duration of hospitalization was 12.5 days. Conclusions Endoscopic partial laryngectomies according to the ELS proposal of classification for selected supraglottic SCC prove to be an excellent alternative to radiotherapy and open neck surgery for selected supraglottic carcinoma.