Every advancement since the direct laryngoscope in the meantime has historically enhanced surgical precision, said James Burns, MD, the moderator of the panel. So from about the 1920s on, improvements in general anesthetics, the introduction of the operating microscope in the 1960s, and the expanding use of lasers from the 1970s on have contributed to current treatment strategies of larynx cancer. So the question becomes: Is endoscopic management of laryngeal cancer oncologically safe?
Should the procedure be total or partial? How much of a role should preservation of voice function play and how should the prospects for voice function be analyzed? What is the role of imaging, and how should the patient be staged? What should be done surgically and what should be attempted through radiation therapy?
The devil is in the details a bit here, said Dr. Burns, a laryngeal surgeon at the Center for Laryngeal Surgery and Voice Rehabilitation at Massachusetts General Hospital and an Assistant Professor in the Department of Surgery at Harvard Medical School.