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Otolaryngol Head Neck Surg. 2014 Feb;150(2):169-73. doi: 10.1177/0194599813512101. Epub 2013 Nov 7.

Treatment considerations for early glottic carcinoma: lessons learned and a primer for the general otolaryngologist.

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1
Department of Otolaryngology-Head & Neck Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania, USA.

Abstract

In this commentary, we review our experience with early glottic carcinomas in an attempt to identify points to consider when developing a treatment protocol and technical considerations in oncologic resection to maintain laryngeal function. We highlight several consistent themes: (1) difficult exposure is not always a contraindication to endoscopic resection; (2) depth of invasion may be apparent only intraoperatively; (3) radiation therapy should be offered for deeply invasive cancers requiring extensive cordectomy or for patients who cannot afford lengthy vocal downtime; however, (4) radiation therapy leads to acute dysphagia and collateral damage to the contralateral vocal fold that is avoided with surgery; (5) good voice can be obtained after healing if resection is limited to intramuscular cordectomy; (6) the key to optimal vocal results is adequate glottal closure; and (7) second look operations are occasionally necessary, and therefore preoperative counseling should include this possibility. Since both surgery and radiation therapy achieve excellent oncologic control, a patient-centered approach is preferred in management.

KEYWORDS:

endoscopic laryngectomy; glottic cancer; laryngeal dysplasia; radiation therapy; swallowing outcomes; voice outcomes

PMID:
24201059
DOI:
10.1177/0194599813512101
[Indexed for MEDLINE]
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