Clinical Feasibility Of CO₂Laser And Coblation For Early Laryngeal Carcinoma And Precancerous Laryngeal Lesions

Objection：To investigate the Clinical feasibility of CO₂laser andcoblation for removal of early laryngeal carcinoma and precancerous lary-ngeal lesions.Methods: Follow up observation on47patients with earlylaryngeal carcinoma and42patients with precancerous laryngeal lesionstreated by microendoscopic CO₂laser and transoral endoscopic coblationoperation and32patients with early laryngeal carcinoma treated bylaryngofission from January2008to December2011. Results: In our study,for the47cases of early laryngeal cancer patients treated by micro-traumaticsurgery,1-year survival rate was100%（47/47）,2-year survival rate was97.3%（37/38）,3-year survival rate was92.6%（25/27）.The rates of localcontrol3years after one micro-traumatic operation for the glottic carcinomawere100%（4/4）for the T_is,95.5%（21/22）for the T_1a,85.7%（18/21） for theT1b. The rates of local control for precancerous laryngeal lesions was83.3%（35/42）after one micro-traumatic operation. Those recurrent cases are alsowell controlled after salvage therapy.For the32cases of early laryngeal cancerpatients treated by laryngofission,1-year survival rate was100%（32/32）,2-year survival rate was95.6%（22/23）,3-year survival rate was84.6%（11/13）.The rates of local control3years after one84.6%（11/13）for theglottic carcinoma were100%（2/2）for the T_is,100%（11/11）for the T1a,89.5%（17/19） for the T_1b.Conclusions:The CO₂laser and coblationmicro-traumatic surgery for the removal of early glottic carcinoma Tis,T1andprecancerous laryngeal lesions is effective and secure．Comparing to theconventional surgery, patients after this sort of micro-traumatic operation weresimilarly cured and less injured and their laryngeal function were better protected. However it is vital to evaluate the depth and range of the tumorbefore every surgery. Early Glottic Cancer with Anterior Commissure Lesionsand precancerous laryngeal lesions with atypical hyperplasia should becompletely removed and paid more attention during the operation andFollow-up period. Those patients with local recurrence still can acceptmicro-traumatic operation again to be effectively cured.