Laser Vocal Cord Surgery

Lasers are commonly used within otolaryngology for management of disease processes. Previously the use of lasers was limited to the operating room. However, recent technological advances permit the use of lasers in the office setting, with a patient awake.

The word laser stands is an acronym that stands for

Light
Amplifcation by
Stimulated
Emission of
Radiation

Essentially a compound, such as carbon dioxide is excited, and the energy is harvested and targeted towards tissue. The carbon dioxide laser is the most commonly used laser in otolaryngology and is typically used to cut tissue.

Lasers can be transmitted through air and target tissues that may be hard to reach with traditional instruments. A carbon dioxide laser targets water molecules which are plentiful in the body and may function as a “hemostatic scalpel” – cutting tissue and simultaneously heating it to prevent bleeding. Lasers for this purpose are used in the throat for resection of tissues such as in cancer or papilloma, and in the mouth for treatment of sleep apnea.

A limitation of the carbon dioxide laser is the laser beam must directly be targeted on the tissue of interest. This may be difficult to do in the deep corners of the larynx and throat. The fact that the energy can’t be bent around corners does limit its use.

Other lasers more recently used in otolaryngology target hemoglobin, or blood. These lasers, KTP and pulsed dye laser, may be used in a fashion to treat diseases without necessarily “cutting them out”. Because these lasers can be transmitted through a fiber, they also overcome the limitation of the carbon dioxide laser.

In the last five years, the traditional carbon dioxide laser can be transmitted through a fiber, allowing the laser to ‘turn around corners’ which has increased its applicability.

In common, each of these lasers transmit energy through a fiberoptic bundle. This is important as the energy can be pased through a channel of a laryngoscope and directedon onto the area of interest be it the nose, throat, larynx, or trachea. Each laser preferentially targets a specific type of molecule. For example energy from a carbon dioxide is preferentially absorbed by water molecules which is plentiful in the body.