CO_2 Laser Laryngeal Microsurgery for Benign and Malignant Lesions of the Larynx / 听力学及言语疾病杂志

ABSTRACT

Objective To evaluate the effectivene ss of CO 2 laser laryngeal microsurgery for benign and malignant laryngeal lesion s. Methods From January 1999 to June 2003, a total of 313 pa tients with benign or malignant laryngeal lesions underwent CO 2 laser laryngea l microsurgery in our hospital. There were 186 men and 127 women. The mean age w as 43.5 years ( range from 14 to 76 ) . Vocal cord polyps were found in 236 pati ents ( including 9 cases with Reinke's edema), vocal cord nodules in 30 cases. T h e vocal cord polyps or nodules were cut or vaporized using the CO 2 laser. Ther e were 27 cases with leukoplakia,ke-ratosis, or hyperplasia of the vocal cords, and 20 cases with T1a glottic cancer. The leukoplakia, keratosis, or hyperplasia lesions were excised with the method of demucosation,and the T1a glottic cance r were removed with the methods of demucosation or cor-dectomy using the CO 2 laser.Results All the lesions were removed in one procedure.Th ere was no or less bleeding during operation and the operating fields were clear. No severe complications such as dyspnea, bleeding occurred after operati on. CO 2 laser provided exquisite precision in laryngeal microsurgery. The woun ds of the larynx were healing well after CO 2 laser surgery. The effective rate s were 100% for the vocal cord polyps or nodules, and 92.6% for leukoplakia, ker atosis, or hyperplasia lesions. The recurrence rate was 10% for the T1a glottic cancer at 6 months after operation.Conclusion CO 2 laser laryngeal microsurgery has the ad vantages of less bleeding, clear operating fields, high effective cure rate, and increasing the surgical precision. It also broaden the indications for laryngea l microsurgery and should be used widely.