Contact endoscopy of the larynx as an auxiliary method to the surgical margins in frontolateral laryngectomy.

Contact laryngomicroscopy is in vivo laryngeal mucosa microscopic examination and rigid telescopy is a non-invasive technique that enables the systematic observation of many details in the large area of vocal fold mucosa. These are performed during laryngomicroscopy. This study was performed in order to evaluate the use of rigid and contact endoscopy effectiveness in establishing the margins in patients undergoing frontolateral laryngectomy. Ten patients with glottic squamous cell carcinoma underwent frontolateral laryngectomy from 2000 to 2003. Eight were staged as T1bN0M0, whereas two were staged as T2N0M0. During the frontolateral approach, the lesion and its limits were carefully defined, the surgical margins were established under the rigid telescope and the patients' margins were studied under contact endoscopy after methylene blue staining. Frozen section examination of the margins was performed and the histopathological analysis was compared to the surgical and endocopic findings. The infraglottic region and the surgical margins were free of disease in all cases and there was a 100% correlation with the histopathological examination. All patients are alive with no evidence of disease after a minimum of 5 years' follow-up. In conclusion, rigid and contact laryngoscopy is effective in establishing the disease-free surgical margins in patients submitted to frontolateral laryngectomy.