Vergleichende Untersuchung zwischen Lasertherapie und konventionell chirurgischer Therapie des T2-Glottiskarzinoms

Abstract

T2-Tumors of the anterior glottic area should preferably be approached by conventional surgery (external approach), particularly when endoscopical visualization is difficult. In contrast, T2-tumors of the medial and posterior glottic area should be resected endolaryngeally with the laser.

Comparison of CT and MRI in Diagnosis of Laryngeal Carcinoma with Anterior Vocal Commissure Involvement

“…Radiotherapy is less effective in treating this area 15 . Surgery by transcervical approaches with resection of suspectedly invaded cartilage is recommended to avoid relapse 14 . Despite the guarantee of low recurrence rate, the conservative surgical strategy brings many sequelae and side effects 16 .…”

“…Transoral carbon dioxide (CO 2 ) laser surgery is a good therapeutic strategy for early staged glottic carcinomas 10 11 12 . However, when it comes to AVC involvement, transoral CO 2 laser surgery is usually followed by a higher recurrence rate than open surgery is 13 14 , mainly because of difficulties in (1) preoperative assessement of thyroid cartilage involvement, (2) intraoperative exposure of AVC itself, and (3) en-bloc resection of the suspectedly involved thyroid cartilage. Thus, accurate pre-treatment assessment of AVC and thyroid cartilage involvement is the key point to avoid improper treatment planning and insufficient treatment.…”

Endoscopic laser surgery of early glottic cancer: Involvement of the anterior commissure

“…Some investigators believe that laser surgery should be avoided in case of anterior commissure involvement because of a high rate of recurrence 47, 48, 65–67. Other authors recommend endoscopic laser surgery in case of anterior commissure involvement only for tumors spreading “superficially” at the level of the glottis without extension to the supraglottis or subglottis,68, 69 and/or if exposition of the anterior glottic region poses no difficulties 70. Other investigators15, 71, 72 demonstrated that early glottic cancer extending into the anterior commissure can be treated successfully by endolaryngeal microlaryngoscopic resection, even in cases with radiotherapy failures.…”