Steven M Zeitels1, James A Burns. 1. Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, MA 02114, USA. zeitels.steven@mgh.harvard.edu
Abstract
PURPOSE OF REVIEW: Office-based laryngeal laser surgery is a recent innovation. It is emerging as a reliable and practical method of treating a number of laryngeal lesions, which is increasingly popular in the US and abroad. The 532-nm pulsed-potassium-titanyl-phosphate laser has become our laser of choice in treating vocal-fold lesions and diseases for a number of transparent and practical reasons. RECENT FINDINGS: Fiber-based lasers and distal-chip flexible endoscopy have facilitated a new style of surgery. Epithelial diseases such as dysplasia and papillomatosis are well suited for this treatment. Although the initial angiolytic laser used in the larynx was a 585-nm pulsed-dye laser, the solid-state 532-nm pulsed-potassium-titanyl-phosphate laser has been demonstrated to be more effective clinically, more reliable structurally and less expensive. SUMMARY: Technologies to enhance laryngoscopic imaging and lasers, along with socioeconomic forces, should lead to increasing numbers of laryngeal procedures being done in the office with local anesthesia. The 532-nm pulsed-potassium-titanyl-phosphate laser has emerged thus far as the optimal technology for treating phonatory mucosa although further development is likely.
PURPOSE OF REVIEW: Office-based laryngeal laser surgery is a recent innovation. It is emerging as a reliable and practical method of treating a number of laryngeal lesions, which is increasingly popular in the US and abroad. The 532-nm pulsed-potassium-titanyl-phosphate laser has become our laser of choice in treating vocal-fold lesions and diseases for a number of transparent and practical reasons. RECENT FINDINGS: Fiber-based lasers and distal-chip flexible endoscopy have facilitated a new style of surgery. Epithelial diseases such as dysplasia and papillomatosis are well suited for this treatment. Although the initial angiolytic laser used in the larynx was a 585-nm pulsed-dye laser, the solid-state 532-nm pulsed-potassium-titanyl-phosphate laser has been demonstrated to be more effective clinically, more reliable structurally and less expensive. SUMMARY: Technologies to enhance laryngoscopic imaging and lasers, along with socioeconomic forces, should lead to increasing numbers of laryngeal procedures being done in the office with local anesthesia. The 532-nm pulsed-potassium-titanyl-phosphate laser has emerged thus far as the optimal technology for treating phonatory mucosa although further development is likely.
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