Vocal outcomes after laser resection of early-stage glottic cancer with adjuvant cryotherapy.
OBJECTIVE
To evaluate the vocal outcomes of patients with early-stage glottic carcinoma undergoing laser resection with adjuvant cryoablative therapy.


METHODS
Retrospective review.


METHODS
Tertiary care center. Patients Twenty patients with early-stage glottic carcinoma. Intervention Treatment of early-stage glottic carcinoma with endoscopic carbon dioxide laser resection in conjunction with cryoablation.


METHODS
Disease-free survival and subjective and objective measures of posttreatment voice quality, based on serial videolaryngostroboscopy.


RESULTS
There was 1 local treatment failure, with an overall mean disease-free follow-up of 32.6 months (range, 3-93 months). Carbon dioxide laser resection and cryoablative therapy were associated with a significant improvement in subjective voice quality (P<.001). Long-term dysphonia was uniformly improved vis-à-vis the pretreatment condition, even among patients with the most advanced disease undergoing the widest resections. Posttreatment web formation was not noted among 4 patients with anterior commissure involvement.


CONCLUSIONS
Endoscopic laser laryngeal surgery performed in conjunction with cryotherapy for early-stage glottic carcinoma yielded excellent primary site control, while improving subjective and objective measures of voice quality. Combined laser surgery and cryotherapy is a possible alternative to radiotherapy for selected patients with early-stage glottic carcinoma who desire curative therapy, while optimizing vocal outcomes.
Knott
P Daniel
PD
Head and Neck Institute and Voice Center, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Milstein
Claudio F
CF
Hicks
Douglas M
DM
Abelson
Tom I
TI
Byrd
Michael C
MC
Strome
Marshall
M
D003452:Cryosurgery; D018572:Disease-Free Survival; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D053685:Laser Therapy; D010699:Phonation / Q000502:physiology; D012189:Retrospective Studies; D014833:Voice Quality