Combined use of endoscopic CO2 laser excision of a marginal laryngeal tumor, radical neck dissection, and perioperative laterofixation of the opposite vocal cord

We report the use of endoscopic laser excision of a marginal laryngeal tumo r, radical neck dissection, and laterofixation of a paralyzed vocal cord in a 66-year-old man who had an early-stage right supraglottic endolaryngeal tumor and ipsilateral neck metastasis. He had a left vocal cord paralysis a fter a left pneumonectomy that was performed 5 years previously. The primar y laryngeal turner was excised by endoscopic CO2 laser resection, and a sim ultaneous radical neck dissection was carried out. Postoperatively, severs inspiratory dyspnea developed because of the surgical intervention on the r ight side causing moderate laryngeal edema and limited movement of the righ t vocal cord in addition to the paralyzed left side. An endolaryngeal later ofixation of the paralyzed left vocal cord was performed to provide the pat ient with an adequate airway instead of tracheostomy. This patient had a 2 years' follow-up without recurrence of tumor. In the meantime movement of t he right vocal cord has returned, so that the patient's voice was socially acceptable and he has a functioning larynx.