Objective:

Transoral laser microsurgery (TLM) for laryngeal cancer has some complications that are being reported more frequently as its use has become widespread. Anterior commissure (A-com) involvement of the laryngeal cancer carries some disadvantages such as inadequate exposure in some cases and high recurrence rate following surgery. We evaluated TLM of glottic cancers in terms of complications and A-com involvement.

Methods:

Sixty-two patients with biopsy proven, previously untreated T1, T2 and T3 glottic cancer were enrolled int the study. Mean follow-up period was 35.3 months. All cases were treated with diode laser. A-com involvement and its impact on local recurrence, utility of second look operations and complications of TLM were investigated.

Results:

A-com involvement was seen in 13 patients (22%). Local recurrence was more frequent in patients with A-com involvement (15%) compared to those without A-com involvement (6%), with no statistical significance (p>0.05). The most frequent complication of TLM was granulation tissue formation. The ratio of second-look operations was higher for cases with A-com involvement (61%), than those without A-com involvement (11%)

Conclusion:

TLM for glottic cancers involving A-com carries a higher local recurrence rate in this series. Second look operations have the advantages of detecting and treating recurrences earlier.

Keywords: Transoral laser microsurgery, glottic cancer, anterior commissure, second look operation, complication