State of art and future perspectives of laryngeal carcinoma surgery

Prof. Giorgio Peretti and Luca Guastini, UNIGE, Italy

The endoscopic treatment by CO2 laser is considered an effective alternative to the traditional therapeutic options (RT, RT + KT and open surgery) by the international scientific community. The laser is deemed as gold standard treatment for the early state carcinomas (Tis, T1-T2) and for selected glottic and supraglottic advanced carcinomas (T3). The goals of the laser surgery have been achieved thanks to the recent technological improvements: the feasibility of ultra-pulsed energy emission and the development of micro-manipulators have permitted the focalization of the laser ray on a surface with a diameter les then 300 micron with a minimal thermal damage. Future perspectives are the need to make an innovative approach not only based on the use of microscope coupled micro-manipulators but on the use of the fiber guide laser controlled by the endoscopic devices: in this way we will be able to link the better resolution of the endoscopic view with the better maneuverability and cut precision of the laser which at the present can only be used through the microscope.