Advantages of Transoral Endoscopic Diode Laser Microsurgery for the Treatment of Early-Stage Glottic Laryngeal Cancers

Abstract

Background: Transoral laser microsurgery (TLM) has become the preferred and standardized method for the early treatment of many laryngeal carcinomas, due to the good treatment results, together with the scarcity of local complications. Objectives: The aim of this study is to investigate the advantages of TLM (diode laser) in the treatment of patients with early-stage (T1-2) glottic laryngeal cancer (GLC). Methods: In the present study, 228 patients, who were diagnosed with early-stage GLC between 2007 and 2013 and treated with diode TLM in our clinic, were analyzed retrospectively. Results: During the 5-year follow-up period of the patients, it was found that 5.2% of the patients had therapeutic neck dissection and 2.6% had a tracheostomy. The mean hospitalization period was 24 hours and their speech and swallowing functions were satisfactory. Eight percent of the patients developed local relapse. In addition, the 5-year disease survival 100%, disease-free survival was 92%, and laryngeal preservation was 98.7%. Conclusions: The TLM method is a minimally invasive treatment for early-stage GLCs and gives treatment results similar to radiotherapy and open surgery methods. However, it is more advantageous than other methods in terms of reducing hospitalization period, low complication rate, preserving speech-swallowing functions, and its re-application in cases of relapse. TLM is a safe and reliable surgical technique with less morbidity that can be repeated in selected tumor recurrence. Anterior commissure monitoring must be important in the treatment of TLM. Especially in anterior commissure, tumors with a tendency to spread in the vertical plane should be monitored for local recurrence. Diode (gallium-arsenide) 980-nm laser has advantages over the standard CO2 laser, and TLM treatment stands out in early-stage GLCs.