Primäre CO₂-Laser-Chordektomie beim Stimmlippenkarzinom*

Abstract

A study was performed with laryngo-microscopic CO2 laser surgery on 55 patients suffering from histologically verified glottic cancer. They were treated by either "superficial laser chordectomy", or "partial cordectomy", "total chordectomy", or "extended chordectomy" in stages Tis = 7, T1a = 34, T1b = 11, and T2 = 3. All patients with Tis remained free of tumours, in stage T1a 88% (30/34) of the patients after laser chordectomy and 2 patients after partial- and total laryngectomy. In stage T1b the recurrence rate was higher (3/11 = 27%), but 2 patients after partial laryngectomy, and one patient after radiotherapy have become tumour-free, and thus all patients in this group are free from tumours. One of the 3 patients in stage T2 developed a local tumour recurrence, but after partial laryngectomy he is free from tumour and hence all 3 patients are still alive. Laser chordectomy proved a sufficient therapeutic procedure in 47 (85%) of 55 patients; eventually 95% of the patients became tumour-free. The authors emphasise that CO2 laser chordectomy is a modern and useful surgical method in the therapy of a vocal cord carcinoma, provided adequate follow-up and the possibility of "salvage" surgery are available.

Minimally invasive surgery for posterior glottic stenosis

“…One of the great advantages of our surgical technique is that wound surfaces can be kept apart for a longer period, until the healing is complete. In our experience the minimal period for laterofixation is approximately 6 to 8 weeks because this is the duration of the complete mucosal reepithelialization after laser glottic surgery 11 …”

“…July 1999 the minimal period for laterofixation is approximately 6 to 8 weeks because this is the duration of the complete mucosal reepithelialization after laser glottic surgery. 11 When the lateralization is suspended, the innervated vocal cord movement can be reestablished even after a longer period, as was proven in cases 2, 3, and 5. Hence, with a narrow (female) larynx we recommend the temporary bilateral vocal cord laterofixation, even in cases of type I or II stenosis.…”

Controversies and Advances in Head and Neck Surgery

“…the minimal period for laterofixation is approximately 6 to 8 weeks because this is the duration of the complete mucosal reepithelialization after laser glottic surgery. 11 When the lateralization is suspended, the innervated vocal cord movement can be reestablished even after a longer period, as was proven in cases 2, 3, and 5. Hence, with a narrow (female) larynx we recommend the temporary bilateral vocal cord laterofixation, even in cases of type I or II stenosis.…”