Transoral laser surgery in the larynx

This is an exciting, developing area of Head and Neck Cancer treatment. Up until more recent years the mainstay for treatment of laryngeal cancer included options such as radiotherapy, total or partial laryngectomy (removal of the voice box) or a comination. The use of the laser has now added an extra option to the treatment arms available to a patient and as it does not require a major open operation can be very attractive to the patient.

The laser is a precise cutting tool that can be used with an operating microscope for magnification to accurately excise a cancer in the larynx. The benefit of this can be that a relatively simple procedure can be used to excise a laryngeal cancer in one or two visits to the operating theatre.

The patient must however, be carefully counselled with regards to the chances of success of resection and the complications that can ensue from the operation. Clearly removing part of the larynx can have an effect on voice production, if the cancer is small this effect is not often too significant but equally so for these cancers treatment with radiotherapy can also have an effect on voice. Which is better for voice is being investigated at the present time by a number of institutes around the world. Too much of a resection in the larynx may also affect the protective function of the voice box (increase the risk of aspiration) it is for this reason that discussion with a speech and language therapist is always prudent.

Whatever, the risks and benefits, transoral laser surgery is certainly an option of treatment for a laryngeal cancer that should not be overlooked and with the increasing development of robotic surgery this area of Head and Neck Cancer surgery could improve even further.

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