Carbon dioxide laser microsurgery for selected cases of supraglottic carcinomas

Twelve patients with supraglottic cancer underwent transoral laser surgery. Endoscopy excisional biopsy, simple glottectomy, enlarged epiglottectomy, horizontal supraglottic laryngectomy, or extended horizontal supraglottic laryngectomy were performed. In all cases, the specimen was excised en bloc. Four patients underwent neck dissection and one case was treated with post-operative irradiation. preventive tracheostomy was carried out in nine cases prior the surgery. A perioperative nasogastric tube was inserted in all patients. No local recurrence of disease was observed. Thus, local control was 100%. One patient with a basaloid squamous cell carcinoma developed bilateral neck metastases five months after primary surgery and was treated with bilateral functional neck dissection. There were no cases of aspiration-associated pneumonia. Finally, no patient needed a permanent nasogastric feeding tube, trachostomy, or total laryngectomy due to permanent dysphagia or aspiration.