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Hans F. Mahieu, MD, PhD; Piyush Patel, MD; Albert A. Annyas, MD, PhD; Tjipko van der Laan, MD

Arch Otolaryngol Head Neck Surg. 1994;120(4):383-387.

Abstract
Objective
Presently, widely employed treatment modalities for early glottic carcinoma include radiation therapy, surgical excision, and carbon dioxide laser excision. All these treatments have good oncological results, but poor or questionable functional results in terms of quality of voice and mucosal wave patterns as seen via a laryngostroboscope. We assessed the oncological and functional results of carbon dioxide laser vaporization of the diseased mucosa as a more conservative treatment alternative.

Design
Case series.

Setting
Department of Otolaryngology–Head and Neck Surgery in a tertiary care center.

Patients
Thirty-three patients with early glottic carcinoma (carcinoma in situ and T1a squamous cell carcinoma) who were referred to our center in the period from 1986 through 1990 were selected for carbon dioxide laser vaporization treatment on the criterion of a still recognizable mucosal wave pattern of the affected vocal fold via a laryngostroboscope.

Main Outcome Measures
Local tumor control, voice quality, and a good appearance via a laryngostroboscope.

Results
Two patients were excluded from evaluation because a simultaneously diagnosed, incurable second primary tumor precluded frequent follow-up. Of the remaining 31 patients seen during a median follow-up period of 58 months, seven patients died of unrelated causes. A local recurrence of disease developed in two patients and was treated by radiation therapy. A recurrence of disease developed again in one of these patients but was successfully treated by total laryngectomy. Overall, local control of disease was achieved in all patients, with a 97% laryngeal preservation rate. Functional results in terms of voice quality were good in 97% of the patients, 75% of whom even retained a normal voice. Normal or near normal laryngostroboscopic appearance was achieved in 68% of all patients.

Conclusion:
Carbon dioxide laser vaporization is a good treatment alternative for early glottic carcinoma in terms of oncological as well as functional results.

(Arch Otolaryngol Head Neck Surg. 1994;120:383-387)

Author Affiliations
From the Department of Otolaryngology–Head and Neck Surgery, Free University Hospital, Amsterdam (Drs Mahieu and Patel), and the Department of Otolaryngology, University Hospital, Groningen (Drs Annyas and van der Laan), the Netherlands.

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