Transoral Laser Microsurgery in Carcinomas of the Oral Cavity, Pharynx, and Larynx

Jochen A. Werner, MD, Anja A. Dünne, MD, Benedikt J. Folz, MD, Burkard M. Lippert, MD

Disclosures

Cancer Control. 2002;9(5) 

In This Article

Indications for Laser Applications in Tumor Resection

Similar to the decision-making process in conventional surgery, determining the appropriate laser application for surgical resection of carcinomas of the upper aerodigestive tract, especially advanced carcinomas, is based on thorough preoperative diagnostic criteria. When invasion of deeply located structures or extralaryngeal tumor spread is evident on computed tomography scans or magnetic resonance images, a laser surgical approach is appropriate, but only in the hands of experienced surgeons. Compared with the surgical skill needed to resect a tumor through an open approach with an open surgical field and excellent exposure, a higher level of expertise is required to achieve good oncologic results in resecting inaccessible carcinomas or advanced laryngeal and pharyngeal carcinomas through a progressively narrow endoscope. This skill level is particularly necessary if the tumor must be resected endoscopically in several portions. These cases illustrate the need for intensive training in endoscopic laser surgery in order to achieve sound oncologic results with laryngeal and pharyngeal laser microsurgery. The functional and oncologic outcomes obtained with this technique closely correlate to the experience of the surgeon. A conventional surgical approach should be chosen if the tumor is too difficult to expose or the surgeon has only limited experience with laser surgery in advanced carcinomas.

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