Biomaterial Database

Transoral laser microsurgery for laryngeal cancer: a primer and review of laser dosimetry. 2011

Marc Rubinstein, and William B Armstrong

Department of Otolaryngology - Head and Neck Surgery, University of California Irvine, 101 The City Drive S, Orange, CA 92868, USA.

Transoral laser microsurgery (TLM) is an emerging technique for the management of laryngeal and other head and neck malignancies. It is increasingly being used in place of traditional open surgery because of lower morbidity and improved organ preservation. Since the surgery is performed from the inside working outward as opposed to working from the outside in, there is less damage to the supporting structures that lie external to the tumor. Coupling the laser to a micromanipulator and a microscope allows precise tissue cutting and hemostasis; thereby improving visualization and precise ablation. The basic approach and principles of performing TLM, the devices currently in use, and the associated dosimetry parameters will be discussed. The benefits of using TLM over conventional surgery, common complications and the different settings used depending on the location of the tumor will also be discussed. Although the CO(2) laser is the most versatile and the best-suited laser for TLM applications, a variety of lasers and different parameters are used in the treatment of laryngeal cancer. Improved instrumentation has lead to an increased utilization of TLM by head and neck cancer surgeons and has resulted in improved outcomes. Laser energy levels and spot size are adjusted to vary the precision of cutting and amount of hemostasis obtained.

UI	MeSH Term	Description	Entries
D007822	Laryngeal Neoplasms	Cancers or tumors of the LARYNX or any of its parts: the GLOTTIS; EPIGLOTTIS; LARYNGEAL CARTILAGES; LARYNGEAL MUSCLES; and VOCAL CORDS.	Cancer of Larynx,Laryngeal Cancer,Larynx Neoplasms,Cancer of the Larynx,Larynx Cancer,Neoplasms, Laryngeal,Cancer, Laryngeal,Cancer, Larynx,Cancers, Laryngeal,Cancers, Larynx,Laryngeal Cancers,Laryngeal Neoplasm,Larynx Cancers,Larynx Neoplasm,Neoplasm, Laryngeal,Neoplasm, Larynx,Neoplasms, Larynx
D007825	Laryngectomy	Total or partial excision of the larynx.	Laryngectomies
D007828	Laryngoscopy	Examination, therapy or surgery of the interior of the larynx performed with a specially designed endoscope.	Laryngoscopic Surgical Procedures,Surgical Procedures, Laryngoscopic,Laryngoscopic Surgery,Surgery, Laryngoscopic,Laryngoscopic Surgeries,Laryngoscopic Surgical Procedure,Laryngoscopies,Procedure, Laryngoscopic Surgical,Procedures, Laryngoscopic Surgical,Surgeries, Laryngoscopic,Surgical Procedure, Laryngoscopic
D008866	Microsurgery	The performance of surgical procedures with the aid of a microscope.
D009367	Neoplasm Staging	Methods which attempt to express in replicable terms the extent of the neoplasm in the patient.	Cancer Staging,Staging, Neoplasm,Tumor Staging,TNM Classification,TNM Staging,TNM Staging System,Classification, TNM,Classifications, TNM,Staging System, TNM,Staging Systems, TNM,Staging, Cancer,Staging, TNM,Staging, Tumor,System, TNM Staging,Systems, TNM Staging,TNM Classifications,TNM Staging Systems
D010778	Photochemotherapy	Therapy using oral or topical photosensitizing agents with subsequent exposure to light.	Blue Light Photodynamic Therapy,Photodynamic Therapy,Red Light PDT,Red Light Photodynamic Therapy,Therapy, Photodynamic,Light PDT, Red,PDT, Red Light,Photochemotherapies,Photodynamic Therapies,Therapies, Photodynamic
D006258	Head and Neck Neoplasms	Soft tissue tumors or cancer arising from the mucosal surfaces of the LIP; oral cavity; PHARYNX; LARYNX; and cervical esophagus. Other sites included are the NOSE and PARANASAL SINUSES; SALIVARY GLANDS; THYROID GLAND and PARATHYROID GLANDS; and MELANOMA and non-melanoma skin cancers of the head and neck. (from Holland et al., Cancer Medicine, 4th ed, p1651)	Cancer of Head and Neck,Head Cancer,Head Neoplasm,Head and Neck Cancer,Head and Neck Neoplasm,Neck Cancer,Neck Neoplasm,Neck Neoplasms,Neoplasms, Upper Aerodigestive Tract,UADT Neoplasm,Upper Aerodigestive Tract Neoplasm,Upper Aerodigestive Tract Neoplasms,Cancer of Head,Cancer of Neck,Cancer of the Head,Cancer of the Head and Neck,Cancer of the Neck,Head Neoplasms,Head, Neck Neoplasms,Neoplasms, Head,Neoplasms, Head and Neck,Neoplasms, Neck,UADT Neoplasms,Cancer, Head,Cancer, Neck,Cancers, Head,Cancers, Neck,Head Cancers,Neck Cancers,Neoplasm, Head,Neoplasm, Neck,Neoplasm, UADT,Neoplasms, UADT
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D053685	Laser Therapy	The use of photothermal effects of LASERS to coagulate, incise, vaporize, resect, dissect, or resurface tissue.	Laser Knife,Laser Scalpel,Surgery, Laser,Vaporization, Laser,Laser Ablation,Laser Knives,Laser Photoablation of Tissue,Laser Surgery,Laser Tissue Ablation,Nonablative Laser Treatment,Pulsed Laser Tissue Ablation,Ablation, Laser,Ablation, Laser Tissue,Knife, Laser,Knifes, Laser,Knive, Laser,Knives, Laser,Laser Knifes,Laser Knive,Laser Scalpels,Laser Surgeries,Laser Therapies,Laser Treatment, Nonablative,Laser Treatments, Nonablative,Laser Vaporization,Nonablative Laser Treatments,Scalpel, Laser,Scalpels, Laser,Surgeries, Laser,Therapies, Laser,Therapy, Laser,Tissue Ablation, Laser
D054020	Lasers, Gas	Lasers in which a gas lasing medium is stimulated to emit light by an electric current or high-frequency oscillator.	Argon Ion Lasers,CO2 Lasers,Carbon Dioxide Lasers,Copper Vapor Lasers,Gas Lasers,Gold Vapor Lasers,Helium Lasers,Helium Neon Gas Lasers,Metal Vapor Lasers,Nitrogen Lasers,Xenon Ion Lasers,HeNe Lasers,Lasers, Argon Ion,Lasers, CO2,Lasers, Carbon Dioxide,Lasers, Copper Vapor,Lasers, Gold Vapor,Lasers, Helium,Lasers, Helium Neon Gas,Lasers, Metal Vapor,Lasers, Nitrogen,Lasers, Xenon Ion,Argon Ion Laser,CO2 Laser,Carbon Dioxide Laser,Copper Vapor Laser,Dioxide Laser, Carbon,Dioxide Lasers, Carbon,Gas Laser,Gold Vapor Laser,HeNe Laser,Helium Laser,Ion Laser, Argon,Ion Laser, Xenon,Ion Lasers, Argon,Ion Lasers, Xenon,Laser, Argon Ion,Laser, CO2,Laser, Carbon Dioxide,Laser, Copper Vapor,Laser, Gas,Laser, Gold Vapor,Laser, HeNe,Laser, Helium,Laser, Metal Vapor,Laser, Nitrogen,Laser, Xenon Ion,Lasers, HeNe,Metal Vapor Laser,Nitrogen Laser,Vapor Laser, Copper,Vapor Laser, Gold,Vapor Laser, Metal,Vapor Lasers, Copper,Vapor Lasers, Gold,Vapor Lasers, Metal,Xenon Ion Laser