Transoral Partial Laryngectomies for Early Cancers: The Rationale

PROGRAM DESCRIPTION: Since its introduction in laryngeal surgery, transoral laser microsurgery (TOLM) is being widely adopted for the treatment of malignant tumors of the larynx . According to ChatGPT 4 , it can be said that transoral surgery is now the first choice of treatment for early vocal fold cancer.It is replacing open neck surgeries in the majority of the cases and authors who perform TLS report favorable oncological and functional outcomes However, the absence of uniformity between the classifications proposed by various authors rendered the comparison and pooling of results impossible. It also made teaching and reproducing the technique very difficult. For this reason, the working committee of the European Laryngological Society proposed in 2000 a simple, easy to use, classification for cordectomies based on the depth and extend of surgical resection This classification was revised in 2007 . The same committee also proposed a classification of endoscopic supraglottic laryngectomies in 2009 .
Assessment is mainly based on videolaryngoscopy , transnasal or transoral . Stroboscopy is strongly recommended to assess the infiltration of the cancer. Narrow band imaging (NBI). Ct scan is not really necessary in case of early vocal cord cancer but useful in case of supraglottic carcinoma
Surgery is mainly performed with Co2 laser , robotic surgery is a very good tool for supraglottic cancer. These procedure can be performed with tracheotomy.
From the functional point of view , voice is mainly affected in case of cordectomy and swallowing in case of supraglottic laryngectomie .
All these topics will presented by the panelists and discussed with the audience .
The issues of the margins, the postoperative care , the problem of the early recurrences and functional recovery as well as the survival rates will be also be discussed. Interaction will encouraged by with the audience with questions and answers.

OUTCOME OBJECTIVE 1: Understand the different types of transoral cordectomies and supraglottic laryngectomies according to the European Laryngological society classification.

OUTCOME OBJECTIVE 2: Know how to assess the lesion and choose the type of transoral surgery.

OUTCOME OBJECTIVE 3: Know the place of transoral surgery in the armamentarium for the treatment for early laryngeal cancer.

BACKGROUND STATEMENT: More information is necessary for spreading the use of The European Laryngological Society classifications for cordectomies and supraglottic laryngectomies aiming at the standardization of theses transoral surgical techniques .

Comprehensive Otolaryngology Track Statement : According to the experience of the panelists, radiotherapy is too frequently considered as the first choice treatment for early larynx cancers in non academic or tertiary reference center . Information about this surgical approach is necessary.