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An Alternative in Laryngeal Cancer Treatment

W. Frederick McGuirt, MD; James A. Koufman, MD

Arch Otolaryngol Head Neck Surg. 1987;113(5):501-505.

Abstract
• Thirty-three patients with newly diagnosed laryngeal carcinoma underwent endoscopic treatment with the carbon dioxide laser under microscopic control and venturi jet ventilation. Ten of these patients underwent emergency tumor debulking to relieve airway obstruction and to avoid emergency tracheotomy for airway control, and 23 had definitive treatment of superficial or frankly invasive carcinoma. Among the first group, all had an adequate airway after tumor debulking and could be treated with elective laryngectomy with or without radical neck dissection once their metabolic conditions had improved and they had been appropriately evaluated. Among the second group, two died of lung carcinoma but were free of laryngeal disease and two were lost to followup at one year. With a minimal three-year follow-up, six of the remaining 19 patients underwent additional laser procedures. None have required external laryngeal surgery or radiation therapy. Endoscopic laser therapy appears preferable to a more radical approach for carcinoma in situ, microinvasive carcinoma, or superficially invasive carcinoma of the larynx.

(Arch Otolaryngol Head Neck Surg 1987;113:501-505)

Author Affiliations
From the Section on Otolaryngology, Department of Surgery, Wake Forest University Medical Center, Bowman Gray School of Medicine, Winston-Salem, NC.

Footnotes
Accepted for publication Dec 1, 1986.

Presented at the University of Iowa Alumni Reunion honoring Brian F. McCabe's 25th anniversary as Chairman of the Department of Otolaryngology, Iowa City, Iowa, May 9, 1986.

Reprint requests to Section of Otolaryngology, Bowman Gray School of Medicine, 300 S Hawthorne Rd, Winston-Salem, NC 27103 (Dr McGuirt).

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