Initial Efficacy of Transoral Coblation Microsurgery for Head and Neck Tumors

  Objective  To investigate the initial efficacy of transoral coblation microsurgery (TCM) for head and neck tumors.

  Methods  A total of 93 patients treated with TCM at Peking Union Medical College Hospital from May 2008 to October 2011 were retrospectively reviewed. Among them, 43 patients were with stage T1-T2 laryngeal cancers, 14 with laryngeal benign tumors, 10 with oro-hypopharyngeal cancers, 4 with benign tumors in the oro-hypopharynx, 13 with vallecular cysts, and 9 with benign tumors in the parapharyngeal space. Eleven patients had recurrent primary tumors following endoscopic or open-neck resections. Three patients had neck dissections, and 18 patients with stage T2 laryngeal cancers or oro-hypopharyngeal cancers received adjuvant radiotherapy.

  Results  Total resection was achieved endoscopically in all the patients. Among 53 cases with malignant neoplasms, 51 cases underwent one-stage resection, and 2 cases underwent subsequent extended local resection according to the pathological results from the one-stage resection. As for the 40 cases with benign tumors, one-stage resection was achieved in all cases. The complications included postoperative hemorrhage in 3 cases, subcutaneous emphysema in 2 cases, dehiscence of the pharyngeal wounds in 4 cases, and laryngeal web or granulation in 10 cases. Patients with laryngeal cancers were followed up 2-40 months (median, 14.5 months), and 2 patients suffered local recurrence. Patients with pharyngeal malignant neoplasms were followed up 6-40 months (median, 19 months), 1 patient was lost and the others were disease-free. Patients with benign tumor in larynx, pharynx, and the parapharyngeal space were followed up 2-37 months (median, 17 months), and 3 patients with laryngeal papilloma suffered local recurrence.

  Conclusion  TCM is a safe and effective treatment alternative for selected early malignant neoplasms at stage T1-T2 or benign tumors of head and neck.