DOI: https://doi.org/10.36347/sasjs.2025.v11i05.014

Pages: 520-529

Objective: The aim of our work was to study the different aspects of transoral CO Laser surgery in the treatment of laryngeal cancer, ranging from indications and surgical techniques to functional and oncological results. Maerial and Methods: This is a retrospective descriptive study of 30 cases of laryngeal cancer that underwent transoral CO Laser microsurgery over a 5-year period from 2018 to 2023. The Kaplan-Meier method was used to estimate survival function and Voice handicap index-30 was used for voice function assessment. Results: The average age of our patients was 60 years with a clear male predominance (90%). Tumors were classified as Tis in 23.3% of cases, T1a in 63.3% of cases, T1b in 13.4% of cases according to the 2017 UICC TNM classification of head and neck tumors. The type of cordectomy used was classified as type I according to the European Laryngological Society classification in 3.3% of cases, type II in 46.6% of cases, type III in 30% of cases, type IV in 13.4% of cases and type V in 6.6% of cases. Margins were histologically negative in 93% of cases and positive in 7% of patients. Lymph node metastasis was found in only 1 case requiring lymph node dissection. According to the Kaplan-Meier method, overall survival and 5-year specific survival were 93% and 100%, respectively. The rates of local control with laser only and preservation of the larynx were 90% and 100% respectively. Functionally, we noted a modest improvement in the VHI-30 score at 6 months and a marked improvement at 12 months. Conclusion: Transoral laser microsurgery is an effective therapeutic alternative in the treatment of early-stage squamous cell carcinomas in terms of oncological outcomes. It offers low morbidity, excellent local control and preservation of the larynx. However, careful patient selection is necessary to achieve good results.