Surgical options for Glottic Cancers

As is apparent from the treatment algorithms, many surgical options can achieve clear margins and preserve laryngeal function

Surgical options include:

• Transoral endoscopic microsurgery (cold steel)
• Transoral microscopic CO2 laser surgery
• Laryngofissure cordectomy
• Vertical partial laryngectomy (Hemilaryngectomy)
• Supracricoid laryngectomy
• Near total laryngectomy
• Total laryngectomy

Type of surgery depends on

• Tumour factors
  • Site
  • Cartilage invasion
  • Stage
  • Involvement of arytenoid complex

• Prior therapy
  • Radiation
  • Partial laryngectomy

• Patient factors
  • Pulmonary status (tolerate aspiration)
  • Cognitive status

• Institutional support
  • Surgical expertise
  • Availability of CO2 laser / transoral microsurgery
  • Speech and swallowing support
  • Tracheo-oesophageal speaking valves

Index: Clinical Practice Guidelines for Glottic Cancer

Resource Appropriate Glottic Cancer Guideline Scenarios