This review article describes the surgical technique of transoral laser microsurgery (TLM) for the piecemeal removal of tumours of the upper aerodigestive tract using carbon dioxide laser. This technique gained acceptance after Wolfgang Steiner published his paper on the treatment outcomes in 240 laryngeal cancer patients. Early-stage laryngeal cancers (T1-T2 N0), as well as advanced tumours, can be treated using TLM. Success of the surgery depends upon good visualisation of the tumour. As stated by the authors, TLM has several advantages compared to conventional open surgery or radiation: it is minimally invasive, the depth of resection can be minimised as it is assessed multiple times during resection; it is restricted to involved tissues and does not affect neighbouring structures like open surgery or radiation; and a patient can undergo open surgery or radiation, if needed, after TLM and does not require reconstructive surgery after the procedure. Today, TLM is a standard of care all over the world for tumours of the upper aerodigestive tract.
Transoral laser microsurgery (TLM)
Reviewed by Gauri Mankekar
Trans-oral laser microsurgery in the management of glottic cancer.
CONTRIBUTOR
Gauri Mankekar
Department of Otolaryngology-Head Neck Surgery, Louisiana State University Shreveport, Louisiana, USA.
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