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Benign lesions of the larynx: Should the laser be used?
Author(s) -
Shapshay Stanley M.,
Rebeiz Elie E.,
Bohigian R. Kirk,
Hybels Roger L.
Publication year - 1990
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 - 10.1288/00005537-199009000-00008
Subject(s) - larynx , medicine , recurrent respiratory papillomatosis , laryngeal diseases , stroboscope , laser surgery , dissection (medical) , laryngoscopy , surgery , laser , intubation , optics , physics
The use of the carbon dioxide (CO 2 ) laser in the treatment of patients with benign laryngeal lesions, excluding respiratory papillomatosis, has been questioned because of potential adverse thermal effects on surrounding tissue. We question whether wound healing and subsequent quality of voice would be better if the surgeon used the “cold technique” with microlaryngeal instruments. Since the advent, in 1987, of a small‐spot (0.3 mm) CO 2 laser micromanipula‐tor and more precise microlaryngeal instruments, we have redefined our use of the CO 2 laser for benign laryngeal lesions. Over the past 4 years, in a series of 68 consecutive patients with vocal cord nodules, polyps, polypoid changes, or granulomas, the CO 2 laser was useful for mucosal micro‐flap dissection techniques and for vascular lesions. Smaller pedunculated lesions, such as vocal cord nodules, were more efficiently removed with the new microlaryngeal instrumentation. The combined selective use of a microspot CO 2 laser at low‐power settings (1 to 3 W), with 0.1‐second pulses, and with precise microlaryngeal instruments will give the best results.