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LONG-TERM VOICE AND SWALLOWING OUTCOMES AFTER TRANSORAL LASER MICROSURGERY FOR EARLY-STAGE GLOTTIC LARYNGEAL CANCER AT HO CHI MINH CITY EAR NOSE THROAT HOSPITAL
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Abstract
Background: Transoral laser microsurgery (TLM) has become a key organ-preserving treatment option for early-stage glottic squamous cell carcinoma. Objective: This study aims to evaluate long-term voice and swallowing outcomes in patients with T1–T2N0M0 glottic squamous cell carcinoma treated by TLM, and to describe postoperative complications that may impact laryngeal function. Methods: A cross-sectional study was conducted on 96 patients with T1–T2N0M0 glottic squamous cell carcinoma treated exclusively with TLM at Ho Chi Minh City ENT Hospital between 2018 and 2020, with a minimum follow-up of 5 years. Surgical procedures were classified according to the European Laryngological Society (ELS) system for endoscopic cordectomies. At final follow-up, voice quality was assessed clinically and categorized as normal, mildly–moderately dysphonic, or severely dysphonic. Voice and swallowing functions were assessed at the end of the follow-up period based on clinical examination and subjective qualitative classification. Results: At 5-year follow-up, 35.4% of patients retained normal voice quality, while 52.1% had only mild to moderate dysphonia; severe dysphonia was observed in 12.5% of cases. All patients maintained full oral intake, and none required permanent tracheostomy or long-term feeding tube placement. Postoperative complications were infrequent and manageable: surgical site bleeding occurred in 4.2% of patients, subcutaneous emphysema in 3.1%, granulation tissue in 14.6%, and clinically relevant laryngeal stenosis in 7.3%, with severe cases treated surgically. In the same cohort, oncologic outcomes were favorable, with 5-year local control, overall survival, and disease-specific survival rates of 91.7%, 89.6%, and 100%, respectively. Conclusions: TLM for T1–T2N0M0 glottic squamous cell carcinoma provides good long-term laryngeal function, with the majority of patients achieving clinically acceptable voice quality and preserved swallowing function, and a relatively low rate of function-impairing complications.
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Keywords
Transoral laser microsurgery, Early glottic cancer, Organ preservation.
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