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[Treatment of glottic cancer with CO2 laser].

OBJECTIVE
To discuss the indications, surgical technique and complications of CO2 laser in the treatment of glottic cancer.


METHODS
Sixty cases of glottic cancer (T1 = 52, T2 = 8) operated with CO2 laser between 2003 and 2006 were retrospectively analyzed.


RESULTS
All patients had remarkable hoarseness after the surgery. Their voice improved progressively in the process of the postoperative healing. Most of our patients had a near normal voice or only had a mild hoarseness in a year. None of our patients had tracheotomy during and after the operation. No aspiration occurred as well. Except adhesion of anterior commission occurred in two cases of T1b tumors who underwent bilateral vocal cords resection, no other complications occurred in this series. Among 60 cases of glottic carcinoma, 54 cases were followed up postoperatively from 2 to 5 years without recurrence. Four cases had local recurrences. One patient had salvage surgery with CO2 laser and was followed up for 2 years without recurrence. Other three cases had salvage total laryngectomy. One patient followed up for 2 years without recurrence, while another two cases died of recurrence. Two cases were lost during the follow up. Three-year and five-year overall survival rate were 100.0% and 91.5%, respectively.


CONCLUSIONS
CO2 laser surgery is a minimally invasive, effective and safe procedure for T1 and T2 glottic cancer. Satisfactory exposure, good surgical skill and appropriate surgical indication are fundamental for the success of treatment.