Use of the Endoscopic Microdebrider in the Management of Airway Obstruction from Laryngotracheal Carcinoma

Endoscopic debridement of obstructing laryngotracheal carcinoma with the microdebrider is an alternative to CO2 laser excision or emergency tracheotomy. This is a retrospective study of 27 patients with advanced laryngotracheal carcinoma treated with the microdebrider for airway obstruction from 1998 to 2002. In 26 patients, the carcinoma was debrided successfully and tracheotomy was safely avoided. Postoperative bleeding was encountered in 1 patient with a coagulopathy. Two of the patients later required tracheotomy during radiotherapy secondary to radiation-induced laryngeal edema. Both were safely managed without acute airway compromise. Laryngeal debridement provided up to 3 months of stable airway until definitive oncological treatment was performed. Endoscopic microdebridement of obstructing carcinoma is a relatively simple and highly accurate approach to restoring a stable airway. It provides extra time for preoperative oncological, psychological, and nutritional planning.

Laryngocele Associated with Squamous Carcinoma in a 20-Year-Old Nonsmoker

A laryngocele associated with squamo us cell carcinoma of the larynx is reported in a 20-yea r-old man without a history of smoking. This is the youngest reported case of carcinoma associated with laryngocele in the literature. This association is supported by the patient's young age and his nonsmoking status. However, this case does not appear to support the conclusion that laryngoceles predispose to the development of squamous cell carcinoma. The clinical history supports the tumor obstruction theory, whereby a laryngocele developed from an obstructing carcinoma of the ventricle.