Endoscopic management of premalignant, stage I and some stage II laryngeal carcinomas can be done using an operative microscope, appropriate laryngoscope and microlaryngoscopy instruments (Figure 9-17). The CO2 laser can be easily attached to facilitate excision or ablation of appropriate lesions. Lesions that are on the suprahyoid epiglottis, aryepiglottic fold, true vocal cords, or other areas perpendicular to the laryngoscope are readily removed.30 Surgery is performed as an outpatient procedure in most cases. Reports of endoscopic surgery for more extensive lesions have been reported but have not gained widespread popularity in the United States.30,31
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