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Scientific Oral Presentations

Head and Neck Surgery

Session: Scientific Oral Presentations 6 - Head and Neck Surgery

Transoral Laser Microsurgery Effects on Salvage Total Laryngectomy Rates

Monday, October 13, 2025
3:18 PM - 3:24 PM EDT
Location: 127
Introduction: Transoral Laser Microsurgery (TLM) has emerged as an innovative technique primarily used for early-stage laryngeal or hypopharyngeal cancer. TLM may reduce treatment resistance compared to radiation, decreasing the need for salvage laryngectomy. Despite its benefits, the availability of skilled surgeons limits the use of this procedure, adding to rural urban amongst other disparities in head and neck cancer (HNC) outcomes. This study examines the impact of TLM on salvage total laryngectomy (salvage TL) rates at a tertiary safety net hospital in a predominantly rural state.

Methods: An IRB approved retrospective chart review was conducted on patients who received TLM or TL at University of Mississippi Medical Center between 2013 and 2023, with TLM data from 2020-2023. Patient demographics, cancer characteristics, and outcomes were analyzed to evaluate affect of TLM and salvage TL procedures.

Results: Among TLM patients (n=39), majority were were male (82%) and Non-Hispanic Black (49%). By comparison TL patients (n=311) were 82% male and 57% Non-Hispanic Black. TLM was mainly used for glottic cancers (79.5%), whereas TL treated predominantly supraglottic (49.6%) and glottic (47.4%) cancers. Prior radiation was less common in TLM patients compared to TL (28.2% vs 44.1%; p=0.059). The average number of TL procedures from 2013-2020 was 26.25 per year while post 2020 it was 33.33. However, the annual average of salvage TLs decreased from 13.1 per year pre-TLM (2013-2020) to 10.67 per year post-2020. The proportion of salvage TLs performed in 2013-2020 was 50% and decreased to 32% of all TLs from 2021-2023 (p=0.002).

Conclusions: The initiaion of TLM at a tertiary safety net hospital correlates with a reduction in salvage TL, suggesting improved organ preservation and patient quality of life outcomes. Expanding access to endoscopic organ preservation surgery could enhance equitable care and quality of life for HNC patients. Ensuring patients have the option of TLM or radiation for early-stage laryngeal cancer is essential for comprehensive care.

    Presenting Author(s)

  • John A. Ligon, Other

    Medical Student
    UMMC
    Oxford, MS, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Brooke C. Fowler, MD

    Resident
    University of Mississippi Medical Center
    Jackson, MS, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Chappel C. Pettit, BS

    Medical Student
    University of Mississippi Medical Center
    Jackson, MS, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Gina D. Jefferson, MD

    Professor
    University of Mississippi Medical Center
    Jackson, Mississippi, United States

    Disclosure information not submitted.

  • LJ

    Lana Jackson, md

    Lana Jackson
    University of Mississippi Medical Center
    Jackson, Mississippi, United States

    Disclosure information not submitted.

  • OP

    Oishika Paul, MPH

    University of Mississippi Medical Center, Department of Otolaryngology Head and Neck Surgery, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • Anne C. Kane, MD FACS

    Associate Professor
    University of Alabama - Birmingham, Department of Otolaryngology Head and Neck Surgery
    Birmingham, AL, United States

    Disclosure information not submitted.