Zusammenfassung
Bei der Chirurgie maligner Kehlkopftumoren ist es das Ziel, dass die Patienten
postoperativ eine möglichst hohe Lebensqualität zurückerlangen. Unter
onkologischem Aspekt ist einerseits so radikal wie nötig und andererseits so
funktionserhaltend wie möglich zu behandeln. Dieser Beitrag soll einen Überblick
über die Chirurgie bei Malignomen des Larynx und den derzeitigen Stand der
transoral-endoskopischen Kehlkopfoperationen geben.
Abstract
This article is intended to give an overview of the surgery for laryngeal
malignancies and the current state of transoral endoscopic laryngeal surgery.
The current therapy concepts in transoral endoscopic laryngeal surgery are
presented in combination with the various possibilities of reconstruction. The
adequate oncological treatment under functional aspects described plays the
decisive role here: treatment goals beyond the cure of the tumor disease are the
functional maintenance of the larynx with simultaneous preservation of the
voice. In general, the diagnosis and treatment of (pre-) cancerous lesions of
the laryngeal mucosa is demanding and requires a great deal of experience of the
attending laryngologist. Updated classification systems support level-based
categorization. In transoral endoscopic laryngeal surgery, resection using cold
instruments and the CO2 laser are currently among the traditional
methods, although newer methods such as the angiolytic laser can be used to
ablate these lesions. Transoral endoscopic laryngeal surgery is a highly
endoscopic-microscopic procedure in (pre-) cancerous lesions, which may
presumably continue to evolve from the microlaryngoscopic approach over the next
few years due to the introduction of new instruments and high-resolution imaging
techniques. Robot-assisted surgery has also found its way into the transoral
endoscopic treatment of laryngeal carcinoma. Only in the next few years,
however, will it become clear to what extent this technique can supplement,
replace or clarify surgical methods, since the individualized surgical strategy
currently has a priority position for every single patient.
Schlüsselwörter
Larynxkarzinom - Glottis-Chirurgie - rekonstruktive Verfahren - transorale Larynxchirurgie - Larynxendoskopie
Key words
Laryngeal carcinoma - transoral endoscopic laryngeal surgery - laryngeal reconstruction - robot-assisted surgery
