Laryngeal Surgery by Diode Laser 980nm

Abstract

Background:Diode Lasers are a relatively recent addition to laryngeal surgery Objectives:provide some reliable evaluation of the use of diode laser in laryngeal diseases, with some clue about parameter and outcome. • Methods: Prospective study carried out fromDecember 2017-April 2018in Aldoha ENT Specialized Hospital, with incorporation of 10 patients who had laryngeal pathology that need laser surgical intervention, intra operative and postoperative result evaluated . Results: Patientsinvolved in this study their age ranged between 10 to 75 years. Male to female ratio 1:1. Regarding the symptoms ,shortness of breath(S.O.B) is commonest laryngeal symptoms (80%),Commonest Clinical finding and pathology was masses or swelling found in 5 patient )50%(. Type of surgeries done by laser in this study was total excision of carcinoma in situ, debulking of transglottic tumor, biopsy taken after debulking by laser for large hypopharyngeal mass that extend to larynx, removal of vocal cord fullness after completion of radio chemotherapy, removal of benign subglottic mass , excision of laryngeal web, right and left partial arytenoidectomy to patients with bilateral vocal cord paralysis , removal of subglottic stenosis and adhesion, , removal of respiratory papillomatosis. Parameter used in diode laser with wavelength 980 nm was power ranging from (8-12) watt ,8 w used for vocal cord pathology, 10 w used for surrounding soft tissue and muscle, 12 w for vaporization of arytenoids cartilage, 9 w for fibrosed tissue after radiotherapy, 7 w for web removal.The diode laser was utilized mainly

in the”in contact” modality, all procedure done under general anesthesia,fiber diameter usedwas 300 μm . Evaluation to outcome after follow up of 3month , there good breathing for laryngeal web patient ,no recurrence for patient with carcinoma in situ, disappearance of s.o.B in patient with benign subglottic mass, reaching to diagnosis after enough biopsy,decannulation of tracheostomy after partial arytenoidectomy ,recurrence of respiratory papillomatosis ,failure of weaning from tracheostomy after debulking to patient of laryngeal tumor and failure of weaning of patient of subglottic stenosis.

Conclusions:980 nm diode laser seems to be a promising laser device fortransorallaryngeal laser microsurgery Recommendations: It’s recommended for long-term multicenter prospective research to know more about ideal parameter and outcome in use of 980 nm diode laser in laryngeal pathology.