This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on Web of Science (1)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Oncology  • Head & Neck Cancer  • Dermatology  • Laryngology/ Speech/ Language Pathology  • Neoplasms of Head & Neck  • Voice Disorders  • Surgery  • Laser Surgery  • Melanoma  • Prognosis/ Outcomes  • Alert me on articles by topic  Social Bookmarking   What's this?

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.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?