Diode Laser for Laryngeal Surgery: a Systematic Review

Abstract

Introduction The diode laser has been frequently used in the management of laryngeal disorders. The portability and functional diversity of this tool make it a reasonable alternative to conventional lasers. However, whether diode laser has been applied in transoral laser microsurgery, the ideal parameters, outcomes, and adverse effects remain unclear. Objective The main objective of this systematic review is to provide a reliable evaluation of the use of diode laser in laryngeal diseases, trying to clarify its ideal parameters in the larynx, as well as its outcomes and complications. Data Synthesis We included eleven studies in the final analysis. From the included articles, we collected data on patient and lesion characteristics, treatment (diode laser's parameters used in surgery), and outcomes related to the laser surgery performed. Only two studies were prospective and there were no randomized controlled trials. Most of the evidence suggests that the diode laser can be a useful tool for treatment of different pathologies in the larynx. In this sense, the parameters must be set depending on the goal (vaporization, section, or coagulation) and the clinical problem. Conclusion: The literature lacks studies on the ideal parameters of the diode laser in laryngeal surgery. The available data indicate that diode laser is a useful tool that should be considered in laryngeal surgeries. Thus, large, well-designed studies correlated with diode compared with other lasers are needed to better estimate its effects.

Diode Laser for Laryngeal Cancer: “980 nm” and Beyond the Classic CO2

“…The light emitted is in the nearinfrared range (800-1100 nm) and 3 wavelengths have been used since the development of this type of laser: 810, 940, and 980 nm 2 . Energy output can be set between 3 and 60 W, 1 although most clinical applications require a level of power between 5 and 25 W. 6 An accepted cutting mode of soft tissues is achieved with an energy output of 5 to 10 W and the laser set in continuous contact mode, whereas good vaporization is achieved between 10 and 15 W in continuous noncontact mode. 6 Finally, sufficient hemostasis requires 5 to 10 W of power intensity in noncontact continuous mode.…”

“…5 Due to light absorption by melanin and hemoglobin, as well as the penetration depth of the laser beam in body tissue, photocoagulation is ideal and superior compared to the CO 2 laser. 1 Its most unique feature is flexibility and, by extension, the ability to be directed around corners, therefore rendering it an excellent alternative to the standard CO 2 laser in patients with difficult laryngoscopy due to anatomical or other pathological reasons. 7 Disadvantages include an occasional delayed repair of large lesions and creation of charring tissue in smaller lesions compared to the use of other conventional tools, such as scalpels.…”

“…Lasers have been used in otolaryngology for over 40 years, when carbon dioxide (CO 2 ) laser was introduced into the Ear Nose and Throat (ENT) world. 1 The most commonly used ones, other than CO 2 , are argon and yttrium aluminum garnet lasers. [2][3][4][5] Excision and tissue vaporization are their main utilities and many types of laser have been developed since.…”

“…[2][3][4][5] Excision and tissue vaporization are their main utilities and many types of laser have been developed since. 1 Advantages such as excellent hemostasis, precision, minimal tissue edema and scar, and reduction in surgical time and in postoperative pain 2 have made them an extremely popular instrument in laryngeal surgery for both benign and oncological work.…”

Lasers in Οtolaryngology: A Laser Odyssey From Carbon Dioxide to True Blue

“…5 Diode laser, KTP, and PDL cause better photocoagulation and, by extension, better hemostasis. 2,6,7 Other technical characteristics, such as flexibility and portability, make these lasers preferable and more cost-effective in some cases of laryngeal surgery. 5 KTP and PDL are no longer manufactured and more recently a new laser, the so-called true blue, has emerged in laryngeal practice, combining photoangiolytic and cutting properties.…”