Laser Partial Arytenoidectomy as an Office Procedure.

Area of Science:

• Otolaryngology
• Laser Surgery
• Airway Management

Background:

• Bilateral vocal fold paralysis causes significant airway compromise, voice impairment, and swallowing difficulties.
• Current treatments for glottal widening require general anesthesia and operating room settings.
• A minimally invasive, office-based approach is needed for improved patient access and reduced healthcare burden.

Observation:

• A novel technique utilizing a Thulium laser fiber through a nasopharyngoscope was employed.
• The procedure involved a posterior cordectomy and partial resection of the vocal process of the arytenoid.
• Specific laser parameters included pulsed mode, 3.5-4.5 W power, and 70-300 ms duration.

Findings:

• The office-based laser partial arytenoidectomy was successfully performed in an unsedated patient.
• The patient tolerated the procedure well and was decannulated three weeks post-intervention.
• This demonstrates the feasibility of laser arytenoidectomy as an outpatient treatment.

Implications:

• Unsedated, office-based laser arytenoidectomy presents a viable alternative to traditional surgical glottal widening.
• This approach may enhance safety and reduce costs for patients with bilateral vocal fold paralysis.
• Further studies are warranted to establish the long-term efficacy and broader applicability of this technique.