Carbon dioxide laser debulking for obstructing endolaryngeal carcinoma: A 10-year experience

The results of the carbon dioxide (CO2) laser debulking procedure for obstr ucting endolaryngeal carcinoma were analyzed in terms of efficiency, compli cations, secondary tracheotomy rate, and peristomal recurrence rate in a se ries of 50 patients consecutively managed at our department. The CO2 laser was used to reestablish a safe airway without resorting to tracheotomy and without performing a transoral resection. Our series included 42 patients i n a pre-definitive treatment group (group 1) and 8 patients in a palliation group (group 2). Complications included death, pneumonia from inhalation, and cutaneous bums in 2 patients, 1 patient, and 1 patient, respectively. T hirty-two percent of patients required a repeat laser treatment, to maintai n the airway. Overall success rates of 92.8% and 87.5% were achieved in gro up 1 and group 2 patients, respectively. None of the variables under analys is could predict the success of the CO2 laser debulking procedure. The over all incidences for secondary tracheotomy were 4.7% and 0% in group 1 and gr oup 2 patients,respectively. Peristomal recurrence was not encountered in p atients managed with definitive therapy with curative intent.