Abstract
Objectives:
Determine the surgical, oncological, and functional outcomes of patients treated with the flexible CO2 laser for head and neck lesions without robotic assistance.
Methods:
Retrospective case review of patients treated with the Omniguide® Flexible CO2 laser in the head and neck unit of a university teaching hospital.
Results:
21 patients underwent 24 procedures from January 2009 to January 2013. 15 procedures involved confirmed invasive carcinoma (T1 to T3). 5 patients underwent further surgery due to involved margins/early local recurrence. 6 month disease free survival was 77%. Other pathology included squamous papilloma, lymphoid hyperplasia, vascular lesions and severe dysplasia. Anatomic sites included larynx (n = 15), base of tongue (n = 8), and postnasal space (n = 1). One case required semi-elective intraoperative tracheostomy, nasogastric tube and a 21 day stay. All other patients returned to oral intake prior to discharge (mean length of stay 1.5 days). No other airway complications were reported.
Conclusions:
Our experience using a CO2 phototonic bandgap laser fiber in head and neck disease without robotic assistance provides the first published oncological and functional outcomes for this new modality. Our data is representative of the diverse cases selected for this technique in our unit. Our 3 cases of T3 squamous cell carcinoma represent patients who declined laryngectomy. All other patients had anatomy which precluded accessing the lesions with a straight-line CO2 laser. The cost per case is a significant factor (approximately GBP £500), but may be offset by reduced length of stay and improved morbidity compared with open resection.
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