Surgical approach to organ preservation in the treatment of cancer of the larynx.

Nonsurgical approaches to preservation of the larynx in the treatment of laryngeal carcinoma include either radiation alone or chemotherapy and radiation in combination. In light of the common use of total laryngectomy, these nonsurgical approaches have often been referred to as "organ-preservation" strategies. Within the context of this old paradigm, clinicians viewed surgery as offering the patient local control, with the caveat that the price would either be the loss of the larynx or the creation of a disability in swallowing or speech. Over the last 10 years, there has been a renaissance in the surgical approaches to laryngeal preservation, as evident in the surgical literature. A new paradigm has emerged in which both the surgical and nonsurgical approaches have equal value in laryngeal organ preservation. Today, a broad spectrum of surgical organ-preservation techniques are available that result in excellent oncologic outcomes as well as excellent and consistent functional outcomes in terms of speech and swallowing. The aim of this article is to present the options for organ-preservation surgery for laryngeal cancer.