Transoral laser surgery for anterior commissure involvement: a study in canines.

OBJECTIVE: To present laser surgery techniques to address anterior commissure involvement and evaluate recovery. METHODS: Twelve canines were divided into three groups. In group A the right ventricular band and vocal fold, the anterior third of the left vocal fold, and anterior commissure were cauterized. In group B cauterization was extended to the thyroid cartilage and a 5 mm x 5 mm area of the anterior commissural to half the cartilage thickness. In group C the 5 mm x 5 mm window was extended through the thyroid cartilage. Surgical lesions were observed after surgery and at 1 and 4 weeks post-surgery. RESULTS: Post-operative gross examination confirmed target scopes. One week after surgery, the lesions in group A were completely covered by neo-mucosa, while group B and C wounds were only partially covered. After 4 weeks, a laryngeal web was seen at the anterior commissure and the vocal fold length was shortened. Lesions in all three groups were completely covered by neo-mucosa. Collagen proliferation was most prominent in group C with limited scarring in group A. There were no major complications. CONCLUSIONS: The three operative methods demonstrated satisfactory outcomes; the lesions recovered well over the course of 4 weeks, and no severe complications occurred. The laser surgery protocol was successfully extended into the thyroid cartilage.

[Efficacy and safety of Mizolastine in the treatment of perennial allergic rhinitis].

OBJECTIVE: To investigate the efficacy and safety of Mizolastine in the treatment of perennial allergic rhinitis. METHOD: Multicentric random Double-blind parallel-controlled study was adopted, and compared with placebo and Cetirizine. Patients (n = 177) were grouped, seventy-two in Mizolastine group, sixty-nine in Cetirizine and thirty-six in placebo group. RESULT: In the seventh curative day symptomatic and sign marks in Mizolastine group and Cetirizine group were lower, but the mark in Mizolastine group reduced more than in Cetirizine group and placebo group. Mizolastine group is better than Cetirizine group in improvement of nasal obstruction and itching with Visual analogue scale. In the twenty first curative day reduction of symptomatic and sign marks in Mizolastine group was lower than Cetirizine group, but no statistic difference. There were 27 adverse events, no serious adverse events in 177 patients during experimental period. Most adverse events were headache and dryness in mouth and eyes. There were 10 cases adverse events in Mizolastine group, one case was related with experiment and four cases might be related with experiment. There were 14 cases adverse events in Cetirizine group, one case was related with experiment and four cases might be related with experiment. There were three cases adverse events in placebo group. CONCLUSION: Generally speaking the efficacy of Mizolastine in treatment of perennial allergic rhinitis is better than Cetirizine, Bad events are less. It is safe.

[Preventing recurrent laryngeal nerve lesions by anastomosing it during thyroid surgery].

OBJECTIVE: To study how to prevent recurrent laryngeal nerve (RLN) lesions by anastomosing it during thyroid surgery. METHOD: In the present study 517 patients with thyroid diseases underwent thyroid surgery from January 1993 to May 2005, with RLNs of 163 cases (187 sides, A group) anatomized and RLNs of 354 cases (438 sides. B group) not anatomized. The RLN in B group were protected generally during thyroid surgery. RLNs of A group were anatomized partly or totally. RESULT: (1) In A group RLNs of 123 cases were partly anatomized and 64 totally. None of all RLNs was injuried. (2) B group 3 sides of 3 cases of all RLNs was injuried. The rate of RLN's lesion is 0.7%, which is significantly higher in A group than in B group. CONCLUSION: Anastomosing RLN during thyroid surgery may prevent its lesions. The length of anatomized RLN must vary with the area and position of thyroid pathological changes. The RLN needn't be anatomized in these patients with the benign thyroid pathological changes which is far away trachea-oesophagus channel.

[Glottic measurement and vocal evaluation after three surgical techniques in the treatment of bilateral vocal cord paralysis].

OBJECTIVE: To evaluate postoperative glottic area and vocal quality of three various surgical techniques for treating bilateral vocal cord paralysis, including laser arytenoidectomy (Group A, 24 cases), reinnervation of the posterior cricoarytenoid muscle by phrenic nerve (Group B, 9 cases) and arytenoidectomy accompanying lateral cordopexy by extralaryngeal approach (Woodman's procedure, Group C, 13 cases). METHODS: 46 cases suffered from bilateral recurrent laryngeal nerve injury were included in our study. The pre-postoperative glottic measurement and vocal acoustic parameters were analyzed. RESULTS: The decannulated cases in group A and group B and group C were 22, 8, 13 respectively. The post-operative mean maximal glottic area was (47.2 +/- 7.4) mm2, (78.3 +/- 16.0) mm2, (48.1 +/- 6.5) mm2 respectively. Group B cases glottic area was larger than that of group A and group C (t value were 4.46 and 3.85, P value were 0.000 and 0.001). No significant difference was found between group A and group C (t = 1.68, P = 0.101). After surgery, in group A, 17 cases voice quality was the same compared with that of before surgery, and 7 cases voice quality had become worse; In group B, the voice quality had become better in 5 cases, completely recovered in 1 case, and had not change in 3 cases; In group C, the voice quality had become deteriorated in 10 cases and no change in 3 cases. And in group B, ipsilateral diaphragm paralysis in 9 cases after surgery, whose vital capacity and forced vital capacity had decreased to 72%-84%, 76%-84% of that before the surgery respectively; and the diaphragm mobility had recovered by 35%-76% respectively, while vital capacity and forced vital capacity had become 93%-97%, 91%-98% of that before the surgery. In Group B, all cases' pulmonary function was normal half a year postoperatively. CONCLUSIONS: Reinnervation of the posterior cricoarytenoid muscle by phrenic nerve seems to be best procedure with better post-operative voice and larger glottic area. Although the sufficient airway for decannulation can be acquired in Group A and Group C, but most of patients in Group A had pre-operative vocal level and badly abnormal in Group C.

[Study on the sense neuropeptides of nasal mucosa in the allergic rhinitis animal model].

OBJECTIVE: To explore the roles of the sense neuropeptides in allergic rhinitis by observing their changes in the nasal mucosa after cutting the nasal autonomic nervous. METHOD: (1) Twelve rabbits were divided into two groups: group A (sensitized) and group B (control). Four rabbits were killed respectively in one and four weeks in group A after being sensitized . Two rabbits were killed respectively at the same time in group B. Their nasal mucosa were collected for detecting substance P (SP) and calcitonin gene-related peptide (CGRP) by immunohistochemistry. (2) Twenty-four rabbits were divided into two groups: group A (sphenopalatine nerve was cut), group B (sympathetic nerve was cut). Four rabbits were killed respectively in one, two, and four weeks in group A and B. Their nasal mucosa were collected for immunohistochemistry examination. RESULT: (1) SP and CGRP were apparently higher in allergic rabbits than non-allergic ones. (2) SP and CGRP decreased apparently in one and two weeks in group A and appeared no difference in four weeks. There were no apparently difference in group B among four weeks. CONCLUSION: SP and CGRP are correlative with the occurring and developing of all allergic rhinitis.

[The distribution of nerves in inferior turbinate].

OBJECTIVE: The distribution of nerve in inferior turbinate was observed to provide anatomy evidence for inferior turbinate surgery by measuring and dissecting corpses. METHOD: Inferior turbinate was dissected under the microscope in 20 heads of corpses. RESULT: (1) The posterior inferior nasal nerve marched down between the mucosa and the periosteum, and entered the inferior turbinate at the site 6 to approximately 13 mm before the end of inferior turbinate. (2) The antierethmoid nerve went to the inferior turbinate 2.0 to approximately 4.6 mm behind the beginning of the inferior turbinate. CONCLUSION: Selective cut of the nerves of the inferior turbinate under the nasal endoscope is feasible.

[Display of different injuries of recurrent laryngeal nerve in laryngeal electromyography].

OBJECTIVE: To study the display of different types injuries of recurrent laryngeal nerve (RLN) in laryngeal electromyography (LEMG). METHODS: LEMGs of one hundred and forty-seven patients (147 sides) with traumatic unilateral vocal cord paralysis (UVCP) were studied. After LEMGs, the RLNs exploration operations were performed. The condition of RLNs injury and laryngeal muscles was observed and recorded during the operation. RESULTS: The severe injuries of RLNs were found during operation. The types of injuries were listed as ligation (58 cases), adhesion (28 cases) and cut (61 cases). The waveform morphology of LEMG was recorded less in the patients with the RLNs cut than that in the patients with the RLN ligation or adhesion, respectively. 75.4% RLNs cut showed spontaneous waveform while 96.4% RLNs adhesion and 94.8% RLNs ligation. When the RLN was cut off, single pattern was showed oftener. When the RLN was adhered or ligated, mixed pattern was showed oftener. 92.9% RLN adhesion showed misdirect-regeneration-potentials while 70.7% RLN ligation and 24.6% RLN cut. There were significant difference between two types, but the compound muscular active potential (CMAP) amplitude wasn't significantly different. Evoked amplitude could be recorded in 91.4% patients with ligation and its amplitude was (23.6 +/- 8.1)%, in 85.7% patients with adhesion and its amplitude (16.3 +/- 5.2)%, in 29.5% patients with cut and its amplitude (2.6 +/- 4.2)%. CONCLUSIONS: The display of different injuries of RLN in LEMG presents significant difference. If RLN was cut off, the CMAP might be recorded in most cases. The clinical injury of RLN often is followed by sub-clinic reinnervation.

[Mucosal pathologic and ultrastructure changes of experimental maxillary sinusitis in rabbits].

OBJECTIVE: To investigate mucosal pathologic and ultrastructure changes relate to experimental maxillary sinusitis process in rabbits. The demarcation of acute and chronic maxillary sinusitis will be determined according to pathologic effects. METHOD: Thirty New Zealand white rabbits have been induced sinusitis will be divided into different groups according to the time of process. The pathologic changes are observed by microscope, scanning electric microscope and transmission electric microscope. RESULT: Within 3 weeks to induce infection the inflammation mainly show in acute style while after 3 weeks the main manifestation are chronic changes. In epithelium layer cilia shedding increased, the number of goblet cell added, squamous epithelium metaplasia and epithelia necrosis were observed during inflammatory process. In lamina propria glands metaplasia and decreased, the fibrosis is densed. CONCLUSION: The pathologic changes of maxillary mucosa are related to process. The borderline of acute and chronic experimental maxillary sinusitis is 3 weeks.

[The clinical study of multi-slice helical CT three-dimensional reconstruction in the sphenopalatine foramen].

OBJECTIVE: Used multi-slice helical CT to observe the reconstruction of the surface structure of nasal lateral wall "sphenopalatine foramen" and compared with anatomical specimens to verify the dependability of 3D data. METHOD: The position, shape, size and their correlational data of sphenopalatine foramen of 5 cadaver heads (10 sides) in adults fixed with formalin were dissected and measured. RESULT: Multi-slice helical CT has more rapid speed of 3D reconstruction and clearer imaging. The technique of Shade surface display and Volume rendering can give very clear structure of nasal lateral wall "sphenopalatine foramen". The 3D data makes no statistic difference with anatomical measurement. The 3D data can instruct the clinic directly. CONCLUSION: Multi-slice helical CT three-dimensional reconstruction can be used to orientation of surgery.

[Glottic measurement and vocal evaluation before and after adult arytenoidectomy].

OBJECTIVE: To study minimal glottic area which can acquire sufficient airway for decannulation and maximal glottic area which can maintain preoperative vocal function on adult bilateral vocal cord paralysis with unilateral arytenoidectomy. METHODS: Sixteen adult received microscopic right arytenoidectomy with Diomed-25 laser under general anaesthesia and sustained laryngoscope from September 1998 to February 2003. The pre-postoperative glottic measurement and vocal acoustic parameters were analyzed. RESULTS: The postoperative maximal glottic area, maximal posterior glottic width and maximal opening angle between bilateral vocal cords of the 15 decannulated cases were (45.93 +/- 6.56) mm2, (4.97 +/- 0.73) mm and (24.34 +/- 4.74) degrees respectively. Compared with preoperative period, there were significant difference. Pre-postoperative acoustic parameters (Jitter, Shimmer, harmonics-noise ratio) were analyzed and no significant difference were found (P > 0.05, but there are significant difference in NNE (normalized noise energy) and MPT (maximum phonation time) (P < 0.05). Except for three cases whose postoperative glottic area were more than 50. 1 mm2, there were no significant difference in pre and postoperative NNE (P > 0.05). The minimal glottic area decannulated was 38.0 mm2. The more opening maximal glottic area, the greater of NNE because of bigger closing gap. Noticeable increase of NNE was observed when maximal opening glottic area was up to 50.1 mm2. CONCLUSIONS: The minimal glottic area for decannulation should be 38.0 mm2, and the maximal glottic area for maintaining preoperation vocal function should be 50.1 mm2 on adult bilateral voca cord paralysis with laser aryntenoidectomy.

[The study of microdissection of endoscopic transnasal surgery in the sphenopalatine foramen].

OBJECTIVE: To provide anatomy evidence for endoscopic transnasal surgery in the sphenopalatine foramen by measuring and dissecting corpses. METHOD: The position, shape, size and their correlational data of sphenopalatine foramen of 40 sides skulls in adults were measured. RESULT: Classification of the sphenopalatine foramen were as three types: I 35%; II 5%; III 60%. The mean distance from upper edge of the sphenopalatine foramen to the base of the sphenopalatine sinus was male (1.75 +/- 1.10) mm, female (1.13 +/- 0.55) mm, and to the apertura sphenopalatine sinus was male (9.80 +/- 3.27) mm, female (8.30 +/- 3.45) mm. The mean distance from the posterior edge of the sphenopalatine foramen to the rhinopharynx was male (11.12 +/- 3.30) mm, female (10.85 +/- 3.12) mm. The mean distance from the anterior edge of the sphenopalatine foramen to the apertura maxillaris was male (18.50 +/- 6.80) mm, female (14.57 +/- 5.07) mm, and to the apex of nose was male (69.54 +/- 6.98) mm, female (66.57 +/- 5.07) mm, and to the nasospinale was male (56.69 +/- 5.70) mm, female (53.25 +/- 8.80) mm. The horizontal diameter of the sphenopalatine foramen was female (4.61 +/- 1.80) mm, male (5.12 +/- 2.05) mm. The vertical diameter was male (5.37 +/- 2.67) mm, female (0.35 +/- 0.07) mm. The surface diameter of the sphenopalatine artery and nerves was male (2.12 +/- 0.66) mm, female (1.61 +/- 0.70) mm, and male (0.65 +/- 0.49) mm, female (0.35 +/- 0.07) mm. The mean angle from the sphenopalatine foramen to the horizontal plate of palatine bone was male (22.83 +/- 4.71) degrees, female (22.73 +/- 3.81) degrees. Nasal lateral walls were controlled by lateral posterior nasal arteries and nerves, which were classified into three types: I 70%, II 20%, III 10%. CONCLUSION: The observation and survey about the sphenopalatine foramen will supply clinic with anatomy homological.

[Nerve exploration and decompression for traumatic recurrent laryngeal nerve injuries induced by thyroid gland surgery].

OBJECTIVE: To show the findings of recurrent laryngeal nerve injury exploration and find out therapeutic effects, indications and timing of nerve decompression for traumatic recurrent laryngeal nerve injury induced by thyroid gland surgery. METHODS: In this study there were 87 patients with recurrent laryngeal nerve injury, including 65 for nerve exploration and 22 for nonsurgical treatment. During nerve exploration, the types, severity of laryngeal nerve injuries and laryngeal muscular mass were studied. Nerve decompression was performed in these 14 patients whose compressing sutures or compression due to cicatricial hypertrophy were received nerve decompression. RESULTS: Injuries caused by thyroid gland operations mostly are of suture ligation (43%) and nerve severance (48%); simple scar compression was found only in 6 cases (9%). Atrophy of the laryngeal muscles was not very serious in patients with a course less than 6 months. In 10 patients with a course less than three months, nerve decompression restored normal functional abductor and abductor motion of the vocal cord in 9 patients and had no effects in one. Although functional motion of vocal cord was not seen in one case with a course less than 3 months and 4 cases between 3 and 5 months, the mass and tension of the reinnervated vocal cord became much the same as the contralateral normal vocal cord, thus resuming symmetric vibration of the vocal cords and physiological phonation. Although nonsurgical treatment improved severe hoarseness, it didn't restore normal functional motion of the vocal cord and normal voice. CONCLUSIONS: Nerve exploration showed a primary rule for recurrent laryngeal nerve injury induced by thyroid gland surgery. Early and mid-stage recurrent laryngeal nerve exploration and decompression may restore normal motion of the glottis, and it suggested laryngeal delayed reinnervation may help patients with a course more than 6 months.

[Enlarged translabyrinthine resection of recurrent acoustic neuroma after suboccipital resection].

OBJECTIVE: To evaluate the technique and the outcome of enlarged translabyrinthine removal of recurrent acoustic neuromas after a suboccipital resection. METHOD: Five patients were proved to have recurrent acoustic neuromas after previous suboccipital removal procedures. Revision surgery was accomplished in these patients using the enlarged translabyrinthine approach by sufficiently removing petrous temporal bone to enlarge exposed sight during the operation. RESULT: The sizes of the recurrent tumors ranged from 2.5 to 4.0 cm. Total removal was achieved in all patients, with no death and other major complications such as intracranial infection and cerebrospinal fluid leakage. The facial nerve function was the same as pre-operative condition. There was no residual tumor showed in CT scans and MRI examinations after operation. The cerebel and brainstem resumed to normal position in each patient. No second recurrences had occurred to date at follow-up of 6 months to 2 years and 7 months. All patients recuperated and came back to work. CONCLUSION: Acoustic neuroma recurs frequently after the suboccipital surgery because there is a residual tumor inside the internal acoustic canal (IAC). The enlarged translabyrinthine approach is the most direct access to acoustic neuroma and the brainstem by which recurrent tumor can be removed is avoided during the second operation. Moreover, it is praisable that there are several advantages such as slight invasion and convenience of facial nerve orientation so as to excellent outcome of facial nerve preservation in the enlarged translabyrinthine surgery.

[Comprehensive prognostic value of spontaneous and evoked electromyography in laryngeal paralysis].

OBJECTIVE: To determine the comprehensive prognostic value of spontaneous and evoked electromyography (EMG) in laryngeal paralysis. METHODS: The characteristics of laryngeal EMG of 91 cases with unilateral vocal cord paralysis (VCP) after thyroid surgery were assessed. All cases were divided into four groups according to the interval of laryngeal EMG after onset, which were group one (2 months shorter, n = 13), group two (2 to 4 months, n = 23), group three (4 to 6 months, n = 36), group four (6 months longer, n = 19). The waveform morphology and the amplitude of laryngeal EMG and the highest evoked compound muscular active potential (CMAP) of thyroarytenoid muscles were examined and analyzed during voluntary tasks. The potential amplitude was showed by the percentage of that of the healthy lateral. The criterion of evaluation on evoked potential was attained by calculating statistical confidence interval. RESULTS: The highest evoked CMAP in group one was significantly lower than that of the others (P < 0.05), but no significant difference was observed between group two and group three (P > 0.05), so group two and group three were analyzed together. There were 2 recovered cases and 11 unrecovered cases in group one. On the basis of this criterion that a positive prognosis for laryngeal recovery was indicated when the evoked CMAP presented and there was no misdirect generated potential, correct prognostic rate was 92% (12/13). There were 11 recovered cases and 48 unrecovered cases in group two and three. The highest evoked CMAP was much higher in the recovered than in the unrecovered, significant difference was observed between them (P < 0.001). On the basis of the criterion that a positive prognosis for laryngeal recovery was indicated when the highest evoked CMAP was higher than 26. 4%, correct prognostic rate was 90% (53/59). On the basis of the criterion that a positive prognosis for laryngeal recovery was indicated when there was no misdirect generated potential and the highest evoked CMAP was higher than 26.4%, correct prognostic rate was 93% (55/59). When the interval from onset to laryngeal EMG recovering was longer than 6 months, none of these patients had return of vocal cord mobility whatever were the outcomes of laryngeal EMG. CONCLUSIONS: Correct prognostic rate can be improved if the prognosis of VCP in different courses is judged respectively by analyzing comprehensively spontaneous and evoked EMG.

[Long-term follow-up of autogenous fat injection for unilateral vocal cord paralysis].

OBJECTIVE: To study the long-term results of autogenous fat injection for unilateral vocal cord paralysis. METHODS: Twenty cases with unilateral vocal cord paralysis were treated by autogenous fat injection into the thyroarytenoid muscle to achieve medialization. The patients were divided into 3 groups by hoarse degree before operation, all of them were followed more than 12 months with serial video laryngoscope and voice evaluation. The ratio between paralyzed vocal cord upper surface and that of the normal vocal cord were adopted as the measurement for the vocal cord volume changes before and after operation. RESULTS: 1. The volume of paralyzed vocal cord was increased. The degree of hoarse and normalized noise energy (NNE) were evaluated by objective methods after operation. 2. The hoarse symptom was less severe after operation than that before operation. The cure cases 3 to 6 months and over 12 months after operation were nearly the same. 3. NNE of over 12 months and 3 to 6 months after operation were not significantly different, but the postoperative NNE were different with that before operation. CONCLUSIONS: Autologous fat injection was an effective method for treating unilateral vocal cord paralysis, and the long term effects were reliable.

[The clinical feature of laryngeal neuroendocrine neoplasms].

OBJECTIVE: To study the clinical manifestation, diagnosis and treatment of laryngeal neuroendocrine neoplasms. METHOD: Three cases of laryngeal neuroendocrine neoplasms were analyzed, of which two cases were diagnosed as atypical carcinoids with radical surgery and neck dissection, another case was diagnosed as asparaganglioma through local neoplastic removal. RESULT: Two patients of atypical carcinoids are in a good condition after following up one year and another patient of asparaganglioma is with good prognosis after following up eleven years. CONCLUSION: Laryngeal neuroendocrine neoplasms are composed of a morphologically heterogeneous group of lesions. Accurate diagnosis is primarily based on clinical characteristic, microscopic and immunohistochemical examination. In some instances, it may be supported by ultrastructural studies. Difference treatment should be provided to different classified tumor.

[Clinical analysis of the application of Diomed-25 laser in treatment of vocal cord leukoplakia in 30 cases].

OBJECTIVE: To explore the effect of Diomed-25 semi-conductive laser in treatment of vocal cord leukoplakia. METHOD: From 1997 to 2001, 30 patients with vocal cord leukoplakia were operated in our hospital by Diomed-25 laser, acoustic analysis were compared and studied before and after operation. All the patients were followed up, ranging from 1 to 5 years. RESULT: There were 16 cases of simple leukoplakia and 14 cases with mild, moderate or severe atypical hyperplasia in this study. None of simple leukoplakia and mild atypical hyperplasia had malignant change, but 2 cases had malignant change who were the cases with moderate and severe atypical hyperplasia respectively. Acoustic analysis showed significant difference between preoperation and postoperation group (P < 0.05). CONCLUSION: The Diomed-25 laser was proved valuable in treating patients with vocal cord leukoplakia.

[Diagnosis and management of sulcus vocalis].

OBJECTIVE: To clarify the pathophysiology of sulcus vocalis and to develop a more rational approach to treatment. METHODS: Twenty-nine cases of sulcus vocalis patients were divided into three classification: Type I is a physiologic variant and no dysphonia (11 cases). Types II (sulcus vergeture, 13 cases) and III (sulcus vocalis, 5 cases) are characterized by severe dysphonia and loss of vibratory activity. Eighteen cases of dysphonia were treated by surgery and phonation training. The operations included fat injection into vocal cords (9 cases of types II and 1 cases of types III, including 1 case of types III of second operation), fat implantation into sulcus vergeture after incision (4 cases of types II and 1 cases of types III) and undermining of the mucosa and sulcus vocalis resection (4 cases of types III, including 1 case of second operation). Phonatory function and video laryngostroboscopic data were evaluated before and after surgery and phonation training treatment in 18 patients. The mean follow-up time was 15.3 months. RESULTS: Ten cases of types II had excellent results after fat injection into vocal cords (n = 6) and fat implantation into sulcus vergeture after incision (n = 4). Three cases of types II improved after fat injection into vocal cords. Three cases of type III had excellent results after sulcus vocalis resection. One case of type III had excellent results by Second operation (sulcus vocalis resection) after fat injection into vocal cord. One case of type III improved by Second operation (fat injection into vocal cords) after fat implantation into sulcus vergeture after incision. No postoperative complications were noted. CONCLUSION: Accurate classification of sulcus vocalis is important and then adapt treatment to different types. Fat implantation into sulcus vergeture to type II and sulcus vocalis resection to type III were the best choice methods.

[Evaluate the effect of Diomed-25 laser in treatment of early vocal cord carcinoma].

OBJECTIVE: To observe the effect of Diomed-25 laser in treatment of early vocal cord carcinoma. METHOD: Eighteen cases of early vocal cord carcinoma were treated by laser surgery. Among the cases, 7 were under local anesthesia, and 10 were under general anesthesia, 1 case was operated laryngofissure due to failure of tumor exposure. RESULT: The follow up period was from 3 to 5 years. Relapse were detected in 3 out of 18 cases of early vocal cord carcinoma after Diomed laser surgery under fiber or self-retaining laryngoscope. Of the recurrent cases, 2 T1b tumors offended the anterior commissure, another was T2 case, 1 failed to be followed-up (taken into dead), 3 year survival rate was 100.0% (18/18), 5 year survival rate was 90.9% (10/11). Except 2 cases receiving total laryngectomy, the others had their laryngeal function reserved. CONCLUSION: It has clinical value to use Diomed-25 laser in treatment of early vocal cord carcinoma, and its advantages include lower complication rate and laryngeal function well retained.