[Our experience in CO2 laser surgery for early glottic carcinoma].
In the years 1990-2002 187 patients were treated laser microsurgery due to T1, T2 laryngeal cancer. One of the purposes of this work was analysis of resurgery cases due to recurrence of neoplasmatic process after laser cordectomy, therefore a group of 93 patients, treated in the years 1990-1997 was controlled. The local recurrence of neoplasmatic process was observed in 13 persons. The changes were once more removed in laser microsurgery in 5 patients. In 8 persons total laryngectomy was performed with subsequent radiological treatment. The best results of treatment were observed in patients in whom changes were limited to medial part of vocal cord while recurrences were the most often in patients with anterior commissure lesion. In case of recurrences after laser microsurgery all other kinds of possible treatment can be applied as, partial conventional surgery, total laryngectomy, X-ray therapy or repeated laser microsurgery. Functional evaluation of voice in 64 patients, who due to early stage of carcinoma were submitted unilateral CO2 laser cordectomy, was performed. The appearance and mobility of larynx were registered and evaluated in particular periods post surgery, the patients voices were registered and acoustic analysis submitted. Gradual voice improvement following the wound healing were observed in subjective patients evaluation as in objective one. In many cases very good functional results were obtained, which made possible for patients after CO2 laser cordectomy to continue work requiring good function of larynx. In 43 patients the psychological aspect of laser microsurgery influence was analyzed by use of anonymous questionnaires. It proofed, that in the majority of cases, the laser surgery had no influence for the social and company life of people submitted laser cordectomy. In 7 patients the views of larynx were very specific on the free edge of scar after removed vocal cord--spherical structure of 3-5 mm diameter has appeared in 2 to 6 months after laser cordectomy. In pathological examination--laryngitis chronica, granulatio--was stated. In further observation of patients no recurrences were observed. The described changes resemble granulomas and the most probably are caused by laser ray. Higher power lasers are useful, even when used at the same wattage as older models as they produce less carbonization of tissue during use.
Betlejewski
Stanisław
S
Katedra i Klinika Otolaryngologii AM im. Ludwika Rydygiera w Bydgoszczy.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002245:Carbon Dioxide; D002277:Carcinoma / Q000601:surgery*; D005260:Female; D005931:Glottis / Q000601:surgery*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011788:Quality of Life; D013997:Time Factors; D014832:Voice Disorders / Q000209:etiology
D002245:Carbon Dioxide