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Use of a Flexible CO 2 Laser Fiber Delivery System in Otolaryngology Head and Neck Surgery: Multi‐institutional Experience
Author(s) -
Abraham Rima F.,
L'official Janel,
Shapshay Stanley M.
Publication year - 2009
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.21471
Subject(s) - session (web analytics) , citation , center (category theory) , medical library , library science , medicine , computer science , world wide web , chemistry , crystallography
Objective: To examine the current applications of the flexible CO2 laser waveguide in otolaryngology-head and neck surgery. Design: Retrospective review of case data from three institutions. Methods: Flexible CO2 laser fibers were used in 264 otolaryngic cases between 11/2006 and 04/2009. Intraoperative data including surgical site, fiber type, power setting, and laser mode was analyzed. Surgeon opinions were assessed regarding the fibers’ cutting, ablating, and coagulating capacities as well as their safety and efficacy when compared with alternative modalities. After each case, the surgeon was asked whether operative time was shortened by using the flexible CO2 laser waveguide when compared with the appropriate alternative. Results: Flexible CO2 laser fibers were used in 44 head and neck, 142 otology, 47 laryngology/airway, 29 pediatric and 2 rhinology cases. The majority of surgeons agreed that the waveguide offered superior cutting and ablation to traditional modalities and better flexibility and access than the CO2 laser micromanipulator. Improved pathologic margins were obtainable because of the fibers’ precision, safety for use near vulnerable structures, and greater access to non-line of site locations. These advantages resulted in shorter operative times in most applications. Complications in our series included six fiber failures; however none compromised the safety of patients or staff. Conclusion: The flexible CO2 laser waveguide is a safe, versatile and effective tool with applications in all otolaryngic subspecialties.