Serial endoscopic analysis of the glottis following laser cordectomy: from an oncological perspective

Abstract

From the oncological point of view, discrimination between the normal healing process and a pathological condition following laser surgery of the larynx is important in the management of possible residual/recurrent disease. However, the wound-healing process following laser surgery of the larynx is not well understood, especially regarding the gross morphological changes over time. The aims of this study were to analyze the serial temporal changes in the laryngeal endoscopic findings following laser cordectomy and to define the process involved in stabilization of the laryngeal mucosa. The study group comprised 46 consecutive patients with early glottic cancer undergoing laser cordectomy using the CO(2) laser. All outpatient clinic endoscopic examinations were documented and archived, and were examined serially in a semiquantitative manner to assess the dynamic change and the process involved in stabilization of the laryngeal mucosa. Clinical parameters affecting the healing process were analyzed. Mucosal stabilization was achieved at a median of 57days. The laryngeal mucosa was stabilized within 100days following the surgery in 80.4% of the patients. Tumor base width was significantly correlated with healing time. Early healers (≤40days) had smaller tumors and had undergone a less-extensive procedure. Recurrences were observed in 33% of the patients with delayed healing for over 100days. Healing of the laryngeal mucosa took no more than 100days following laser cordectomy in the majority of the patients. Therefore, cautious waiting for up to 3months (100days) may be warranted to discriminate between the normal healing process and a pathological condition in order to establish a proper management plan and avoid unnecessary biopsy.