The laryngofissure approach for near-infrared photoimmunotherapy in laryngeal cancer: A novel larynx-preservation strategy.

Near-infrared photoimmunotherapy (NIR-PIT) is an innovative cancer treatment modality that employs a conjugate composed of an antibody and a photoabsorber, combined with NIR light exposure. Although its clinical efficacy has been demonstrated in head and neck squamous cell carcinoma, applying NIR-PIT to laryngeal cancer remains challenging due to limited accessibility for laser light delivery, particularly to subglottic or posterior tumors. Here, we propose the "laryngofissure approach" for NIR-PIT as a strategy to preserve the larynx. A 67-year-old male patient presented with a chief complaint of hoarseness and was diagnosed with laryngeal cancer staged as cT2N2bM0, Stage IVA. Two years after concurrent chemoradiotherapy, local recurrence was detected in the subglottic and posterior regions of the laryngeal lumen. Using the laryngofissure approach for NIR-PIT, the patient was successfully treated and achieved larynx preservation. The ability to observe the tumor in an open surgical field provides flexibility in selecting light delivery methods-such as frontal, side-fire, or cylindrical diffusers-in NIR-PIT. The laryngofissure approach utilizing NIR-PIT may represent a valuable alternative modality for achieving functional larynx preservation in recurrent laryngeal cancer.