Transoral laser surgery for anterior commissure involvement: A study in canines

• Published in: Auris, nasus, larynx nasus, larynx, 2010-10, Vol.37 (5), p.601-608
• Main Authors: Sun, Guangbin, Tang, Haihong, Sprecher, Alicia J, MacCallum, Julia K, Sun, Na, Fang, Qin, Liang, Gengtian, Zhou, Shuimiao
• Format: Article
• Language: English
• Subjects: Animals; Anterior commissure; Canine; Dogs; Female; Laryngeal Neoplasms - pathology; Laryngeal Neoplasms - surgery; Laryngectomy - instrumentation; Laryngectomy - methods; Laryngoscopy - methods; Larynx - pathology; Laser; Laser Therapy - instrumentation; Laser Therapy - methods; Lasers, Semiconductor - therapeutic use; Male; Microsurgery - methods; Minimally Invasive Surgical Procedures - methods; Neoplasm Invasiveness; Otolaryngology; Partial laryngectomy; Recovery; Surgical Instruments; Thyroid Cartilage - pathology; Thyroid Cartilage - surgery; Vocal Cords - pathology; Vocal Cords - surgery; Wound Healing - physiology
• ISSN: 0385-8146; 1879-1476
• DOI: 10.1016/j.anl.2010.01.011

Abstract Objective To present laser surgery techniques to address anterior commissure involvement and evaluate recovery. Methods Twelve canines were divided into three groups. In group A the right ventricular band and vocal fold, the anterior third of the left vocal fold, and anterior commissure were cauterized. In group B cauterization was extended to the thyroid cartilage and a 5 mm × 5 mm area of the anterior commissural to half the cartilage thickness. In group C the 5 mm × 5 mm window was extended through the thyroid cartilage. Surgical lesions were observed after surgery and at 1 and 4 weeks post-surgery. Results Post-operative gross examination confirmed target scopes. One week after surgery, the lesions in group A were completely covered by neo-mucosa, while group B and C wounds were only partially covered. After 4 weeks, a laryngeal web was seen at the anterior commissure and the vocal fold length was shortened. Lesions in all three groups were completely covered by neo-mucosa. Collagen proliferation was most prominent in group C with limited scarring in group A. There were no major complications. Conclusions The three operative methods demonstrated satisfactory outcomes; the lesions recovered well over the course of 4 weeks, and no severe complications occurred. The laser surgery protocol was successfully extended into the thyroid cartilage.