Supraglottic laryngectomy for endoscopic resection: proposal of a new classification


  • Kuauhyama Luna-Ortiz Departament of Head and Neck Surgery at the Instituto Nacional de Cancerologia, Mexico
  • Antonio Gomez-Pedraza Departament of Head and Neck Surgery at the Instituto Nacional de Cancerologia, Mexico
  • Dorian Y. Garcia-Ortega Surgical Oncology Department at the Instituto Nacional de Cancerologia, Mexico
  • Philippe Pasche Department of ENT and Cervicofacial Surgery at the Centre Hospitalier Universitaire Vaudois, Switzerland



Supraglottis, Laser resection, Robotic laser resection. Cancer, Classification


Proposal of a new classification, which includes six types of resections, for supraglottic laser surgical treatment. Our classification defines precisely Type Ia excision as an en bloc procedure. Aside, the lateral supraglottic resections are described in detail, with type Ib, II and III modalities, which encompass excision of lateral supraglottic structures and partial paraglottic space excision, due to the potential for extension to this space present on laterally located tumors. Type IV resection refers to a complete supraglotic laryngectomy, which addresses the preepiglottic spread potential of midline supraglottic lesions. Type Va resection or arytenoidectomy is introduced, leaving types Vb and Vc as previously described cordectomies. A new concept of palliative procedures types VIa and VIb is presented, according to invasion to supraglottic structures and/or tongue base extension in T3-T4 lesions. A classification should be understandable, reproducible and easy to interpret, so that it facilitates comparison of results and potentially translates into better oncologic outcomes. Laser resection of the supraglottis must not be consider curative for all patients, objective are different according to the stage, so the present classification include: Partial,, Extended and Palliative Delbulking Resection.

Author Biography

Kuauhyama Luna-Ortiz, Departament of Head and Neck Surgery at the Instituto Nacional de Cancerologia, Mexico

Head and Neck Surgery


Alonso JM. Conservative surgery of cancer of the larynx. Trans Am Acad Ophthalmol Otolaryngol. 1947;51:633-42.

Vaughan CW. Transoral laryngeal surgery using the CO2 laser: laboratory experiments and clinical experience. Laryngoscope. 1978;88:1399-420.

Motta G, Villari G, Motta GJ, Ripa G, Cesari U. Il laser a CO2 nella microchirurgica laringea. Acta Otorhinolaryngol. Ital 1984;4:49-68.2

Rudert HH, Werner JA. Endoscopic resections of glottic and supraglottic carcinomas with the CO2 laser. Eur Arch Otorhinolaryngol. 1995;252:146-8.

Steiner W. Experience in endoscopic laser surgery of malignant tumors of the upper aerodigestive tract. Adv Otorhinolaryngol. 1998;39:135-44.

Agrawal A1, Moon J, Davis RK. Southwest Oncology Group. Transoral carbon dioxide laser supraglottic laryngectomy and irradiation in stage I, II, and III squamous cell carcinoma of the supraglottic larynx: report of Southwest Oncology Group Phase 2 Trial S9709. Arch Otolaryngol Head Neck Surg. 2007;133:1044-50.

Byrd JK1, Duvvuri U. Current trends in robotic surgery for otolaryngology Curr Otorhinolaryngol Rep. 2013;1:153-7.

de Almeida JR, Li R, Magnuson JS. Oncologic Outcomes After Transoral Robotic Surgery : A Multi-institutional Study. JAMA Otolaryngol Head Neck Surg. 2015;141:1043-51.

Remacle M, Eckel HE, Antonelli A. Endoscopic cordectomy. A proposal for a classification by the working committee, European laryngological society. Eur Arch Otorhinolaryngol. 2000;257:227-31.

Remacle M, Hantzakos A, Eckel H. Endoscopic supraglottic laryngectomy: a proposal for a classification by the working committee on nomenclature, European Laryngological Society. Eur Arch Otorhinolaryngol. 2009;266:993-8.

Carrillo JF, Frías-Mendívil M, Lopez-Graniel C, Beitia AI, Ochoa-Carrillo FJ. The impact of preoperative tracheotomy on T3 transglottic carcinomas of the larynx. Eur Arch Otorhinolaryngol. 1999;256:78-82.






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