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Vocal Outcomes After Laser Resection of Early-Stage Glottic Cancer With Adjuvant Cryotherapy
P. Daniel Knott, MD;
Claudio F. Milstein, PhD;
Douglas M. Hicks, PhD;
Tom I. Abelson, MD;
Michael C. Byrd, MD;
Marshall Strome, MD, MS
Arch Otolaryngol Head Neck Surg. 2006;132:1226-1230.
Objective To evaluate the vocal outcomes of patients with early-stage glottic carcinoma undergoing laser resection with adjuvant cryoablative therapy.
Design Retrospective review.
Setting Tertiary care center.
Patients Twenty patients with early-stage glottic carcinoma.
Intervention Treatment of early-stage glottic carcinoma with endoscopic carbon dioxide laser resection in conjunction with cryoablation.
Main Outcome Measures Disease-free survival and subjective and objective measures of posttreatment voice quality, based on serial videolaryngostroboscopy.
Results There was 1 local treatment failure, with an overall mean disease-free follow-up of 32.6 months (range, 3-93 months). Carbon dioxide laser resection and cryoablative therapy were associated with a significant improvement in subjective voice quality (P<.001). Long-term dysphonia was uniformly improved vis-à-vis the pretreatment condition, even among patients with the most advanced disease undergoing the widest resections. Posttreatment web formation was not noted among 4 patients with anterior commissure involvement.
Conclusions Endoscopic laser laryngeal surgery performed in conjunction with cryotherapy for early-stage glottic carcinoma yielded excellent primary site control, while improving subjective and objective measures of voice quality. Combined laser surgery and cryotherapy is a possible alternative to radiotherapy for selected patients with early-stage glottic carcinoma who desire curative therapy, while optimizing vocal outcomes.
Author Affiliations: Head and Neck Institute (Drs Knott, Abelson, Byrd, and Strome) and Voice Center (Drs Milstein and Hicks), The Cleveland Clinic Foundation, Cleveland, Ohio.
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