En Bloc Resection of Supraglottic Carcinomas with Transoral Laser Microsurgery

Abstract

Objective:Complete en bloc supraglottic tumor excision with transoral laser microsurgery (TLM) can be achieved with good postoperative outcomes. We report surgical feasibility and the postsurgical outcomes of en bloc resection of supraglottic laryngeal squamous cell carcinomas (LSCC) with TLM.Methods:Seventeen patients who underwent TLM for supraglottic laryngeal cancer were included in the study. Demographic and pathological data, clinic and follow-up outcomes of the patients were reviewed and analyzed.Results:Type 1 TLM was performed in three patients, type 2a in one patient, type 3b in 12 patients, and type 4b in one patient. Negative surgical margins were achieved in all of the cases. Re-excision or any adjuvant treatment for positive resection margins was not required in any of the cases. Eight patients received adjuvant radiotherapy due to lymph node metastasis. Mean follow-up time was 33.8±15.7 months (range: 10–65 months). None of the patients had recurrence or distant metastasis.Conclusion:The transoral approach with the use of CO2 laser and microscopy offers complete tumor excision for treating supraglottic LSCC. The three-dimensional structure of the supraglottis can be achieved with adequate exposure. En bloc resection is possible with safe margins.

Keywords

• larynx carcinoma
• partial laryngectomy
• supraglottic carcinoma
• transoral laser microsurgery
• squamous cell carcinoma