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Healing after transoral carbon dioxide laser surgery for early glottic cancer

Published online by Cambridge University Press:  31 January 2022

N Jabbour Open the ORCID record for N Jabbour [Opens in a new window] ,
J C Tracy ,
E Du  and
L F Tracy
N Jabbour*
Affiliation:
School of Medicine, Boston University, USA
J C Tracy
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, USA
E Du
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, University of Massachusetts, Worcester, USA
L F Tracy
Affiliation:
School of Medicine, Boston University, USA Department of Otolaryngology – Head and Neck Surgery, Boston Medical Center, USA
*
Author for correspondence: Dr N Jabbour, Department of Otolaryngology – Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, 830 Harrison Avenue, Boston 02118, USA E-mail: njabbour@bu.edu
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Abstract

Objective

This study aimed to evaluate the clinical significance of granulation tissue after endoscopic carbon dioxide laser surgery for glottic cancer.

Method

This was a retrospective review of 36 patients who underwent endoscopic carbon dioxide laser surgery for T1 and T2 glottic cancer. Post-operative, endoscopic examinations were rated by three blinded otolaryngologists for time to heal and presence of granulation. Patient and surgical factors were compared with time to heal and granulation.

Results

A total of 16 of 36 wounds (44 per cent) developed granulation tissue, and 24 wounds (67 per cent) healed without requiring surgical intervention. A total of 7 of 8 wounds biopsied more than 3.5 months after surgery had persistent cancer versus 1 of 4 wounds biopsied at equal to or less than 3.5 months (85.7 per cent vs 25 per cent; p = 0.03). Biopsy at more than 3.5 months was associated with 28-fold increased odds of cancer in biopsy compared with biopsy at equal to or less than 3.5 months (odds ratio, 28.0; 95 per cent confidence interval, 1.088–373.3).

Conclusion

After carbon dioxide laser surgery for glottic cancer, development of granulation tissue is common. Granulation that persists for more than 3.5 months necessitates biopsy because of increased risk of persistent cancer.

Keywords

Laryngeal NeoplasmsGranulation TissueSurgical WoundBiopsyLaser Therapy
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 2 , February 2023 , pp. 205 - 212
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr N Jabbour takes responsibility for the integrity of the content of the paper

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