Transoral microsurgery for treatment of laryngeal and pharyngeal cancers.

Minimally invasive surgery has evolved over the last two decades to encompass all fields of surgery, including curative intent cancer surgery of the head and neck. Much evidence is in favor of routine use of transoral laser resection, which can be considered the method of choice for treatment of early laryngeal carcinomas (T1-T2) of the glottis and the supraglottis on the basis of oncologic, functional, and cost considerations. The results of transoral laser microsurgery in patients with moderately advanced (T3) supraglottic cancer are comparable to those of open supraglottic laryngectomy with regard to local control and survival rates, and they are superior to those of primary radiotherapy with respect to organ preservation. Transoral laser microsurgery as a unique treatment should also be considered as an alternative to other organ preservation protocols in the early stages (I-II) of hypopharyngeal and oropharyngeal carcinomas.