The use of laser in Ear/Nose/Throat surgery: is there any evidence?

Surgical lasers have been used in ear, nose, and throat (ENT) surgery for several decades. The main advantages of the use of surgical lasers are:

1. Rigid and flexible endoscopic application of a high-energy incisional/ablative source in very small spaces
2. Precise incision in tissues while diffuse hemorrhage is controlled
3. Minimal thermal damage spread if correct technique is used
4. Vaporization of small lesions
5. Precise excision in muscular tissue (tongue) without diffuse bleeding and muscle contraction

In humans, CO2 laser is a standard tool for several ENT procedures, including vocal cord lesions and laryngeal tumors. In companion animals, limited data exists on the use of diode laser for partial arytenoidectomy,¹ excision of tongue lesions,^2,3 laryngeal⁴ and tracheal tumors,^5,6 and deroofing of nasopharyngeal sialoceles via retroflexed flexible endoscopy,⁷ showing feasibility and efficacy of laser surgery in these locations (Figure 1). There is increasing evidence of the efficacy of laser surgery in treatment of more often encountered pathology, such as brachycephalic obstructive upper airway syndrome. CO2 laser staphylectomy is comparable in effectiveness and complications to standard incisional technique.^8–10 However, it is faster, bloodless, and suturing is not necessary. Furthermore, laser facilitated the development of an additional procedure to reduce nasal airway resistance: Laser assisted turbinectomy.^11–14 [...]