Transoral
laser microsurgery (TLM) was pioneered in the early 1970s as an approach to treat laryngeal pathology with precision and minimal thermal damage to the vocal cords. Over the last four decades, TLM has become an integral part of the treatment paradigm for patients with
laryngeal cancer. TLM is one of the primary treatment options for early-stage laryngeal
tumors. However, in recent years, surgeons have begun to develop TLM into a more versatile approach which can be used to address advanced laryngeal
tumors. Although functional outcomes following TLM for advanced
laryngeal disease are scarce, survival outcomes appear to be comparable with those reported for organ preservation strategies employing external beam
radiation therapy (EBRT) and
chemotherapy. In addition, TLM plays an important role in the setting of recurrent
laryngeal cancer following primary irradiation. TLM has been demonstrated to decrease the need for salvage total
laryngectomy resulting in improved functionality while retaining comparable oncologic outcomes. The aim of this review is to elucidate the indications, techniques, and oncological outcomes of TLM for advanced
laryngeal cancers.