Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics (대한후두음성언어의학회지)

The Korean Society of Laryngology, Phoniatrics and Logopedics. (대한후두음성언어의학회)
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Update on Angiolytic Laser Laryngeal Surgery

혈관용해 레이저를 이용한 후두미세수술 최신 지견

  • Kang, Min Seok (Department of Otorhinolaryngology, Korean Armed Forces Capital Hospital) ;
  • Lim, Jae-Yol (Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine)
  • 강민석 (국군수도병원 이비인후과) ;
  • 임재열 (연세대학교 의과대학 강남세브란스병원 이비인후과학교실)
  • Received : 2021.06.15
  • Accepted : 2021.07.27
  • Published : 2021.08.31
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Abstract

There are several lasers available for office-based or suspension microlaryngoscopy laser procedures in the treatment of laryngeal diseases. Each has advantages and disadvantages given the depth of penetration per unit of power, absorption in water, spectral absorption characteristics, mode of delivery, safety, and cost. It is important to note that while the proper selection of indication of treatment based on a laser wavelength is critical, of equal importance is selecting the appropriate power setting, focal length (or spot size), and time of exposure. The photoangiolytic lasers precisely target hemoglobin within the microcirculation of the highly vascularized tissue and may have better hemostatic effects and preservation of surrounding normal tissue than the CO2 laser. Although the choice of laser is purely theoretical and cannot be accurately concluded which parameters of laser (wattage and pulse width) were best to use, photoangiolytic laser surgery is safe and effective for specific laryngeal lesions. In this review, indications for photoangiolytic laser procedures for various laryngeal diseases, laser settings and surgical techniques for specific laryngeal lesions including sulcus vocalis, laryngeal dysplasia, and recurrent respiratory papillomatosis will be introduced. Pros and cons of in-office laser surgery using photoangiolytic laser and flexible CO2 laser will also be addressed.

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