Three hundreds fifty nine patients who suffered from several laryngeal pathologies have been treated with the CO2 laser for the last 5 years of the severance hospital. Five hundreds eighteen cases of CO2 laser laryngeal micorsurgery were reviewed
for
the evaluation of the CO2 laser is surgical tool in larygeal microsurgery. The results obtained from this analysis confirm that this instrument is a valid alternative surgical tool, because it allows the possibility carring out removal of the
lesion
with greater precision and effect.
@ES The results are as follows:
@EN Vocal polyp and Rinke's edema (116 patients, 119 cases) are removed safely with traditional procedures, whereas the CO2 laser allows a more acurate excision of voluminous polyp with minimal trauma and bloodless operative field:
Vocal nodule (78 patients, 79 cases): Some degree of advantage is offered by the CO2 laser due to more precise removal without trauma to surrounding tissue; Laryngeal Web(6 patients, 7 cases) is removed effectively by the CO2 laser vaporization
and
keel
insertion:
Other benign lesions(35 patients, 37 cases) such as laryngeal granuloma, intubation granuloma, contact granuloma, cyst vocal cord synechia, laryngeal tuberculosis and laryngeal actinomycosis are easily removed with minimal trauma and functional
impairments using the CO2 laser:
Laryngeal amyloidosis(2 patients, 4 cases): Advantages are offered by the CO2 laser, considering the relatively diffuse laryngeal infiltration;
Precancerous lesions (32 patients, 35 cases) such as hyperkeratosis and erythroplasia; Better functional results can be obtained suing the CO2 laser, but postoperative follow-up evaluation is necessary to detect carcinomatous degeneration:
Laryngeal papilloma (43 patients, 115 cases): The CO2 laser makes it possible to achieve complete recovery if radical excision, avoidance of accidental laryngeal damage and postoperative serial control:
Laryngeal cancer(15 patients, 19 cases): When clinical indications are correct, the main CO2 laser advantages in the treatment of T1 and T2 glottic cancers are the endoscopic removal of the lesion, avoidance of tracheotomy, short hospital stay
and
better quality of voice;
Bilateral cord palsy(4 patients, 5 cases): The CO2 laser arytenoidectomy improve dyspnea in most cases;
Laryngotracheal stenosis(32 patients, 100 cases): The CO2 laser with T-tube insertion and/or augumentation made in possible to decanulate in 14 cases(43%);
In a small percentage of cases, complications such as recurrence, reactive hyperplasia, scar formation, misdirected burn in the anterior tracheal wall and endotracheal ignition were noted. But these complications could be avoid when clinical
indications
are exact and the surgical procedure is performed attentively.
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