Local anesthesia as compared with general anesthesia, in which the entire body is rendered unconscious and asensate, local anesthesia “numbs” a local area, most commonly with lidocaine injected into the tissues to be operated upon.

Thulium Laser Surgery, With Local Anesthetic Injection, to Treat Leukoplakia

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Leukoplakia, about to be treated with laser (1 of 4)

Leukoplakia of the vocal cords in a patient radiated years earlier for glottic cancer. This disease is mostly benign, but foci of carcinoma-in-situ have also been removed twice in the operating room, yet with rapid return of leukoplakia. The patient has had no glottic voice. In an effort to avoid total laryngectomy, we are managing these visual abnormalities with the thulium laser in an outpatient videoendoscopy room.

Injection of local anesthetic (2 of 4)

Since this patient cannot tolerate aggressive laser therapy with topical anesthesia alone, we are here adding injection of local anesthetic. Note the blanching of tissue surrounding the needle.

Injection of local anesthetic (3 of 4)

Further injection of the local anesthetic.

Right after thulium laser treatment (4 of 4)

At the completion of aggressive laser coagulation of abnormal tissue. Compare with photo 1. The patient will return in a month for additional laser treatment as indicated.