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

Nausheen Jamal, Elazar Sofer, Dinesh K. Chhetri

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)169-173
Number of pages5
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume150
Issue number2
DOIs
StatePublished - Feb 2014
Externally publishedYes

Keywords

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

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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