Serial endoscopic analysis of the glottis following laser cordectomy: from an oncological perspective.
From the oncological point of view, discrimination between the normal healing process and a pathological condition following laser surgery of the larynx is important in the management of possible residual/recurrent disease. However, the wound-healing process following laser surgery of the larynx is not well understood, especially regarding the gross morphological changes over time. The aims of this study were to analyze the serial temporal changes in the laryngeal endoscopic findings following laser cordectomy and to define the process involved in stabilization of the laryngeal mucosa. The study group comprised 46 consecutive patients with early glottic cancer undergoing laser cordectomy using the CO(2) laser. All outpatient clinic endoscopic examinations were documented and archived, and were examined serially in a semiquantitative manner to assess the dynamic change and the process involved in stabilization of the laryngeal mucosa. Clinical parameters affecting the healing process were analyzed. Mucosal stabilization was achieved at a median of 57 days. The laryngeal mucosa was stabilized within 100 days following the surgery in 80.4% of the patients. Tumor base width was significantly correlated with healing time. Early healers (≤40 days) had smaller tumors and had undergone a less-extensive procedure. Recurrences were observed in 33% of the patients with delayed healing for over 100 days. Healing of the laryngeal mucosa took no more than 100 days following laser cordectomy in the majority of the patients. Therefore, cautious waiting for up to 3 months (100 days) may be warranted to discriminate between the normal healing process and a pathological condition in order to establish a proper management plan and avoid unnecessary biopsy.
Department of Otorhinolaryngology-Head & Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam, 463-707, Korea.
Woo-Jin
WJ
Jeong
Heejin
H
Kim
Jae-Cheul
JC
Ahn
Myung-Whun
MW
Sung
Kwang Hyun
KH
Kim
Soon-Hyun
SH
Ahn
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005931:Glottis / Q000473:pathology / Q000601:surgery; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007828:Laryngoscopy / Q000379:methods; D054020:Lasers, Gas / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D062326:Re-Epithelialization; D020545:Respiratory Mucosa / Q000473:pathology; D013997:Time Factors; D014827:Vocal Cords / Q000473:pathology / Q000601:surgery