What is Transoral Laser Microsurgery – TLM?

The use of chemotherapy, radiation therapy, or cold knife surgery in the treatment of transoral airway cancer is associated with complications that can dramatically alter facial appearance and impact the ability to swallow, talk, eat, smell, taste, hear, and breathe normally.

Transoral laser microsurgery (TLM) is a minimally invasive surgery used for early-stage throat cancer.  No external cutting is needed for this procedure, because benign and malignant tumors are removed through an endoscope inserted through the mouth.

The surgeon uses a microscope to visualize the diseased tissue and precisely cuts it out using a specialized CO2 laser.  Unlike open surgery, CO2 lasers can remove cancer with fewer disturbances to structures, nerves, and tissue.  TLM patients are able to swallow sooner post microsurgery, and hospital stays are typically five to seven days less than for open surgery.

Physicians performing cancer surgery on or close to sensitive structures like vocal cords and large blood vessels seek to simplify the procedure while increasing its safety and effectiveness. TLM addresses these needs by targeting tumors with superb precision, safety and effectiveness in a minimally invasive fashion.


Acupulse DUO:
The CO2 laser system
used for TLM

Is TLM throat cancer treatment right for me?

Your physician will play a big role in helping determine if TLM is right for you.

TLM is recommended for early stage cancers of the throat.  Since a general anesthetic is used, you will need to be in good enough physical condition (i.e. no heart or lung disease) to tolerate the anesthetic.

If your cancer has invaded surrounding structures, such as the carotid artery, then TLM may not be right for you.  Moreover, if your neck is too stiff, or your jaw is not large enough to allow access of the endoscopic instruments, your physician may advise against TLM.

There are different laser options available depending on your specific need.  If you have early stage cancer of the voice box (larynx and vocal cords), a specially designed CO2 laser which minimizes damage to the surrounding healthy tissue will be used.

If you have a tumor in a hard to reach or distant area, a CO2 laser with a flexible fiber-optic for beam delivery may be used. Please consult with your physician to determine what the best option is for you.

Benefits of TLM

Compared to radiation therapy, the benefits of TLM for early stage throat cancer include the following:

  • Preservation of speech, swallowing and breathing functions
  • Results are equal or superior to radiation therapy
  • Faster and easier recovery with a rapid return to work and day-to-day tasks
  • A lower risk of side effects, compared to invasive surgery
  • Treatment can be repeated and other options remain open if the cancer is not completely eliminated ‒ before resorting to surgery for removal of the voice box
  • Better overall quality of life

You may be a candidate for TLM performed with the surgical CO2 laser. Only you and your physician can decide which treatment option is best for you.