Laser surgery

Laser surgery is surgery that uses a beam of laser light, rather than other instruments, to cut, dissect, remove, and so forth. The beam of light has advantages over other cutting instruments, such as scalpel or scissors. First, at the same time that it cuts, it tends to seal off tiny blood vessels and reduce bleeding. Second, it may be especially useful in endoscopic surgery, where there is not a lot of room for instruments. Third, it is very precise. Both the microspot carbon dioxide laser and the RevoLix laser used at our practice have minimum spot sizes of about 1/5 of a millimeter.


Photos of laser surgery:

Laser surgery for Bilateral Vocal Cord Cancer

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squamous cell carcinoma

Squamous cell carcinoma (1 of 6)

This man developed hoarseness across a few months. Biopsy elsewhere revealed squamous cell carcinoma, seen here on both vocal cords. Based upon a friend’s experience, he rejected radiotherapy, opting for laser resection, knowing it could be very hard on voice.
Tumor on the vocal cords

Tumor on the vocal cords (2 of 6)

At closer range and under narrow band (blue-green) light to accentuate the vascular abnormalities associated with this tumor.
superficial laser cordectomy

Granuloma delays voice recovery (3 of 6)

Six weeks after superficial laser cordectomy, the larynx is almost healed with the exception of a small granuloma, left vocal cord (right of photo). When healing includes granulation, voice recovery is delayed as the granuloma resolves.
granuloma prevents vibratory closure

Closer view of granuloma (4 of 6)

He has hoarse but functional voice, but under strobe light, the granuloma prevents vibratory closure. Note the medial-to-lateral capillary reorientation so typical after laser cordectomy.
Granuloma on vocal cord

Granuloma is smaller (5 of 6)

Now 3 ½ months from surgery, voice has improved further and he considers it “75%” of original...One can see that the granuloma is smaller.
ranuloma no longer prevents vibratory closure

Granuloma doesn't impede voice (6 of 6)

Note that the granuloma no longer prevents vibratory closure and this explains further improvement of voice. Compare with photo 4.














Videos:

Thulium laser
This video gives an example of office-based thulium laser ablation of residual laryngeal papilloma.