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- Title
The Utility of Second Look Microlaryngoscopy after Trans Oral Laser Resection of Laryngeal Cancer.
- Authors
Shenoy, Ashok M.; Prashanth, V.; Shivakumar, T.; Chavan, Purushottam; Akshay, S.; Kumar, Rekha V.; Devi, Saraswati
- Abstract
In the past few decades more and more number of tumors of the glottis and supraglottis are been treated with single stage transoral laser microsurgery (TOLS). TOLS for the treatment of glottic and supraglottic carci-noma with anterior commissure (A-com) and/paraglottic space involvement is associated with a high rate of recur-rence. We prospectively evaluated the outcomes of laser microsurgery and the impact of second look operation in these patients. Twenty-three patients with glottic and supraglottic carcinoma underwent transoral laser micro resection of the lesions. Subsequently five patients under-went second look microlaryngeal evaluation 6-8 months later for non-satisfactory healing, poor voice, and or sus-picion of recurrent disease. Patients with A-com involve-ment and or paraglottic space involvement were followed up longitudinally for the effectiveness and timing of second look microsurgery. After initial transoral laser micro resection, all patients achieved microscopically clear resection margins. At second look microlaryngeal evalua-tion, local recurrence was found in four of 23 patients. Of these, two patients were salvaged by second look surgery and are disease free, whereas in two others, the larynx had to be subjected to open surgical intervention. One of two had extensive local recurrent tumor and underwent total laryngectomy with neck dissection followed by post-operative radiotherapy. Tracheohyoidopexy was done with successful functional and oncologic outcome for another patient who had local recurrence for the third time. Only the patient who underwent total laryngectomy with neck dissection was subjected to adjuvant post-operative radio-therapy. Finally, larynx was saved in 21 out of 23 patients.
- Subjects
LARYNGOSCOPY; LARYNGEAL cancer; LASER surgery; MICROSURGERY; ONCOLOGIC surgery; FOLLOW-up studies (Medicine); HEALTH outcome assessment
- Publication
Indian Journal of Otolaryngology & Head & Neck Surgery, 2012, Vol 64, Issue 2, p137
- ISSN
2231-3796
- Publication type
Article
- DOI
10.1007/s12070-012-0496-7