Désobstruction laryngée au laser CO2

Options in the management of a patient with an obstructive laryngeal tumour include tracheotomy proximal to the tumour, emergency intubation followed by total laryngectomy, endoscopic laser debulking procedure. Previous tracheotomy procedures have been associated with an increased infection rate after total laryngectomy and an increased incidence of peristomal recurrence. Emergency total laryngectomy was usually carried out after a limited local, regional, metastatic and general assessment. The advent of carbon dioxide laser in the end of the 70's has permitted the development of endoscopic laryngeal debulking. This technique is now well codified and commonly utilized; it permits to secure the airway and, most of the time, to avoid emergency tracheotomy. It may be repeated if necessary, and does not jeopardize subsequent definitive treatment. Laryngeal laser debulking can be utilized as pre-treatment in the airway management, for the implementation of a chemotherapy, and a better nutritional and psychological preparation of the patient for surgery or radiation therapy. It can also be utilized as a palliative procedure avoiding tracheotomy and resulting in a better quality of life.