Between 1981 and 1994, 34 patients with squamous cell carcinoma of the supr
aglottis were treated by transoral carbon dioxide laser resection, 12 of th
em palliatively. Additional treatment included neck dissection in 21 patien
ts and radiotherapy in 24 patients. The 3-year overall survival was 62%, an
d the actuarial survival 80%. The overall survival for T1 and T2 tumors was
71%, and that for T3 and T4 tumors was 47%. The overall 3-year survival fo
r the early stages, I and II, was 88%, and that for the advanced stages, II
I and IV, was 50%. These results are comparable to the outcome after conven
tional open partial resection. Given the significantly lower morbidity (onl
y 7 patients required tracheostomy), we do not observe an age limit anymore
. The transoral method can be recommended as curative treatment in TI and T
2 tumors and in selected T3 and T4 tumors in concert with neck dissection a
nd/or radiotherapy. In patients with advanced inoperable tumors, laser surg
ery is an excellent alternative to tracheostomy and palliative radiotherapy
. Prerequisites for successful application of the transoral carbon dioxide
laser resection are adequate resection techniques.