Healing process following laser cordectomy of early glottis carcinoma from endoscopic view

Lasers Surg Med. 2016 Jul;48(5):483-9. doi: 10.1002/lsm.22492. Epub 2016 Feb 22.

Abstract

Background and objective: Transoral laser surgery is useful for treating early glottic carcinoma. Wound areas after carbon dioxide (CO2 ) laser surgery are not covered by flaps, delaying healing. The healing process following laser cordectomy is not well understood. In this study, laryngoscopes were used to monitor the normal healing process after laser cordectomy and to determine if there was residual or recurrent disease.

Materials and methods: This prospective case study included 36 patients who underwent CO2 laser surgery for early glottis carcinoma between January 2011 and June 2014 at a university tertiary referral center. Postoperative complications, oncologic results, and mucosal stabilization time were analyzed. Vocal fold stabilization was defined as an absence of gross changes during two consecutive follow-up examinations.

Results: The 3-year overall survival rate was 100% and the 3-year local control rate was 94%. Vocal cord stabilization was observed in 29 patients at a mean 88.1 days, with stabilization associated with the type of cordectomy (P < 0.05). During the wound-healing process, two patients experienced local recurrences. One had a persistent white patch for over 4 months and the other presented with a new mass in a non-operated area. Biopsies of both lesions showed recurrent disease. Postoperative complications included granulation in two patients and anterior commissure adhesion in one.

Conclusion: CO2 laser microsurgery is an effective treatment for early glottis carcinoma. Close attention should be paid to delays in healing process after laser surgery. Interventions should be considered for patients with abnormal laryngoscopic appearance or overly prolonged healing. Lasers Surg. Med. 48:483-489, 2016. © 2016 Wiley Periodicals, Inc.

Keywords: carbon dioxide laser surgery; early glottic carcinoma; healing process; laser cordectomy.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma in Situ / diagnostic imaging
  • Carcinoma in Situ / surgery*
  • Female
  • Follow-Up Studies
  • Glottis / diagnostic imaging
  • Glottis / surgery*
  • Humans
  • Laryngeal Neoplasms / diagnostic imaging
  • Laryngeal Neoplasms / surgery*
  • Laryngoscopy*
  • Lasers, Gas / therapeutic use*
  • Male
  • Middle Aged
  • Prospective Studies
  • Surgical Wound / diagnostic imaging*
  • Treatment Outcome
  • Wound Healing*