Oliva Dominguez*, Jorge Roquette Gaona**
* Otolaryngologist, ** Professor of Otolaryngology
Institution: Hospital Universitario de Puerto Real (Cadiz) Spain
patient is presented with a T1 epidermoid carcinoma of the right
true vocal cord caused by smoking. Video demonstration of C02 laser
resection of the lesion is presented.
treatment of a 53 year old patient with a 1.5 to 2 pack per day
smoking habit. The patient presented with hoarseness and a T1
epidermoid carcinoma on the left true vocal cord was found.
procedure begins by placing a piece of wet cotton in the subglottis
to protect the lower respiratory tract from laser damage.
The laser mode is set to repeated superpulse. This means that in
every shot, the laser delivers high energy for a very short period
of time. The tissues around the incision line do not sustain
significant thermal damage.
With the help of a suction probe or Bouchayer microforceps, the
excision will encircle the suspicious lesion including a margin of a
few milimeters and.
Notice that the laser incision is completely bloodless. Lasers can
seal small vessels. By defocusing the laser, bleeding from larger
vessels can also be controlled.
The pathology study of the removed tumor was an epidermoid carcinoma
with the margins free of tumor. The patient was discharged from the
hospital the next day and he did not require radiation or
chemotherapy. Five years later, the patient’s voice was good and the
larynx was completely normal on laryngoscopic exam.
The CO2-laser surgery has shown to be very useful in treating
laryngeal malignancies. It avoids a tracheotomy in most cases. The
patient usually stays only 1-2 days in hospital. In our hospital, we
have used the laser surgery for the treatment of glottic and
supraglottic tumors. Even advanced tumors can be treated with
similar results to traditional open surgery. Complications, mainly
postoperative hemorrhages, may occur in large supraglottic tumors
(T4) involving the tongue base.
M. Oliva, J. Bartual, J. Roquette, J. Bartual. Resultados del
tratamiento del cancer laringeo supraglotico mediante cirugía
endoscopica con laser CO2. Acta Otorhinolaryngol Esp. 2003;