ENDOSCOPIC LASER EXCISIONAL BIOPSY FOR SELECTED GLOTTIC CARCINOMAS

From January 1988 to December 1990, 44 previously untreated patients w ith squamous cell carcinomas (SCCs) of the true vocal cord (33 T1a, 11 Tis) underwent carbon dioxide laser excision. The mean follow-up was 28 months (range, 12 to 44 months). Endoscopic excisional biopsy was t he primary treatment in 38 of the 44 patients, whereas postoperative r adiotherapy was added in 6 cases in which the pathology report showed positive margins. Recurrent vocal cord SCC developed in 8 (18%) of the cases, with an average interval of 17.8 months. Re-treatment consiste d of a second laser excision in 4 cases, radiotherapy in 1, hemilaryng ectomy in 1, and total laryngectomy in 2. The definitive cure rate wit h endoscopic excisional biopsy for the patients originally treated wit h laser excision alone was 94.7% (36/38). Endoscopic laser treatment f or selected glottic SCC proves to be an excellent alternative to radio therapy or open neck surgery.