Vocal outcomes after laser resection of early-stage glottic cancer with adjuvant cryotherapy

Objective: To evaluate the vocal outcomes of patients with early-stage glottic carcinoma undergoing laser resection with adjuvant cryoablative therapy. Design: Retrospective review. Setting: Tertiary care center Patients: Twenty patients with early-stage glottic carcinoma. Intervention: Treatment of early-stage glottic carcinoma with endoscopic carbon dioxide laser resection in conjunction with cryoablation. Main Outcome Measures: Disease-free survival and subjective and objective measures of posttreatment voice quality, based on serial video laryngostroboscopy. Results: There was 1 local treatment failure, with an overall mean disease-free follow-up of 32.6 months (range, 3-93 months). Carbon dioxide laser, resection and cryoablative therapy were associated with a significant improvement in subjective voice quality (P <.001). Long-term dysphonia was uniformly improved vis-A-vis the pretreatment condition, even among patients with the most advanced disease undergoing the widest resections. Posttreatment web formation was not noted among 4 patients with anterior commissure involvement. Conclusions: Endoscopic laser laryngeal surgery performed in conjunction with cryotherapy for early-stage glottic carcinoma yielded excellent primary site control, while improving subjective and objective measures of voice quality. Combined laser surgery and cryotherapy is a possible alternative to radiotherapy for selected patients with early-stage glottic carcinoma who desire curative therapy, while optimizing vocal outcomes.