Early Glottic Cancer

Symptoms and Risk Factors

Symptoms of early glottic cancer may include:

• Hoarseness or a change in voice
• Pain or difficulty swallowing
• A persistent cough
• A lump or mass in the neck

Risk factors for early glottic cancer include:

• Smoking
• Excessive alcohol consumption
• Exposure to certain chemicals

Early glottic cancer is more common in men than in women. It can occur in younger patients and nonsmokers. Examination of the larynx by an ear, nose and throat (ENT) specialist is needed to diagnose this cancer.

Transoral Laser Microsurgery (TLM)

Transoral laser microsurgery (TLM) is a minimally invasive technique that has revolutionized the treatment of early glottic cancer. TLM uses a carbon dioxide (CO2) or potassium titanyl phosphate (KTP) laser to precisely remove cancerous tissue from the vocal cords. The surgery is performed during a laryngoscopy, a procedure that uses a small tube to closely examine the larynx. TLM is typically a same-day surgery.

Benefits of TLM:

• High Local Control Rates: Successfully removes the tumor with success rates of 90 to 94 percent for early-stage tumors.
• Voice Preservation: Helps preserve the larynx, offering better long-term functional outcomes, including best voice quality.
• Minimal Morbidity: Results in lower postoperative complications, shorter hospital stays and fewer complications, compared to traditional surgery or radiation.
• Precision: Allows for precise tissue cutting and less bleeding to minimize damage to surrounding healthy tissue.

In-Office KTP Laser Photoablation

A KTP laser targets tissues with a high blood vessel content, precisely removing cancerous tissue while preserving as much healthy vocal cord tissue as possible. This treatment can typically be done without anesthesia.

Importance of Subspecialist Evaluation

For the best treatment plan, it’s important to be evaluated by a subspecialist with extensive experience in transoral laser microsurgery. "The success of TLM and other minimally invasive techniques heavily depends on the surgeon’s expertise and the careful selection of patients,” says N. Scott Howard MD, MBA, FACS, Director of the UH Voice, Airway and Swallowing Center, “A subspecialist who regularly performs these procedures can provide the most appropriate treatment plan, ensuring the best possible voice outcomes and laryngeal preservation.”

Long-Term Prognosis and Follow-Up

Early glottic cancer is highly curable, with 90 to 95 percent of patients still in remission five years later. Regular follow-ups with a subspecialist are essential to monitor for any signs of recurrence and to address any symptoms.