To the Editor.—In their article "Endoscopic Laser Surgery,"1 McGuirt and Koufman assert that small carcinomas of the vocal cord can be managed by marginal resection or cordectomy, using the carbon dioxide laser, with excellent vocal results as long as the anterior commissure is not involved. They state that vocal quality is comparable with that following radiation therapy, and imply that even when a bulky mass is removed, laryngoplasty or Teflon vocal cord augmentation can be done to correct the breathy voice.
This is a critical issue, which requires some amplification. Is the determination of vocal quality in their patients made by an unbiased observer, or by the surgeons themselves? What criteria do they use?
Only with objective data, scientifically designed parameters of observation, and a sufficient sample of patients, can this contention be proved. If so, I would agree that laser vaporization of these small lesions will eventually
GREENE DA. Vocal Quality After Endoscopic Laser Surgery. Arch Otolaryngol Head Neck Surg. 1987;113(11):1238. doi:10.1001/archotol.1987.01860110104019
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