Vertical hemilaryngectomy and supraglottic laryngectomy are used for tumors limited to part of the glottis and to the supraglottis, respectively. Total laryngectomy is used primarily for large tumors or when pulmonary status is poor, since the risk of chronic aspiration may be higher after conservation surgery, especially supraglottic laryngectomy. Additionally, some surgeons use total laryngectomy for salvage of all radiation failures. The future goals of laryngeal cancer treatment are to improve survival rates and quality of life by preserving the ability to speak, eat, and breathe normally. Gene therapy, still in its infancy, is evolving and may be useful in treating laryngeal malignancies.
Photodynamic therapy holds promise for treating early laryngeal cancer.
A photosensitizing drug is administered intravenously. This creates a selectivity that makes treatment effective. Laryngeal transplantation is a fascinating issue and may be a reconstructive option for patients with advanced laryngeal cancer. Currently, it is not widely used because of the highly specialized training required to perform this surgery and concerns about immunosuppression in patients with head and neck cancer. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer.