The CO2 laser in the laryngeal microsurgery.

Area of Science:

• Otolaryngology
• Laser Surgery
• Laryngeal Pathology

Background:

• The CO2 laser has emerged as a surgical tool for laryngeal pathologies.
• Traditional surgery has been the standard treatment for many laryngeal conditions.

Purpose of the Study:

• To evaluate the efficacy and advantages of CO2 laser treatment for various laryngeal pathologies.
• To compare CO2 laser surgery with traditional surgical methods.

Main Methods:

• A retrospective analysis of 636 patients treated with CO2 laser for laryngeal pathologies.
• Detailed assessment of outcomes for specific conditions including vocal nodules, polyps, dyskeratoses, amyloidosis, papillomatosis, cancer, paralysis, and stenoses.

Main Results:

• CO2 laser offers precise excision for voluminous polyps, Reinke's edema, dyskeratoses, amyloidosis, papillomatosis, T1/T2 glottic cancers, and vocal cord paralysis.
• Advantages for cancer treatment include endoscopic removal, avoidance of tracheotomy, shorter hospital stay, and better voice quality.
• No significant advantages for vocal nodules; potential for reactive nodules/scars.
• Effective for laryngeal stenoses, often requiring T-tube placement post-vaporization.

Conclusions:

• The CO2 laser is a valuable alternative surgical tool for specific laryngeal pathologies when indications are precise and technique is correct.
• It provides greater precision, a bloodless field, and improved functional outcomes in select cases.
• Careful preoperative evaluation and postoperative management are crucial for optimal results, especially in cancer and stenosis cases.