Classic techniques used in laser microsurgery of chronic diseases of the larynx: a literature review

Abstract

The topicality of the issue of treating chronic diseases of the larynx is beyond dispute. Given the increased load on the vocal apparatus, no downward trend in disease incidence is observed. The percentage of patient visits to an otorhinolaryngologist with complaints of prolonged changes in voice timbre, vocal fatigue, and difficulties with voice control is 7–12%. Chronic productive formations of the larynx account for up to 55–70% of pathologies in the proliferative upper respiratory disease pattern. If not treated promptly, chronic diseases of the larynx can significantly affect a person’s ability to speak, swallow and breathe normally. Today, various methods for surgical treatment of chronic diseases of the larynx are used: both classical cold instruments and high-energy laser systems. The history of laser medicine dates from the late 1960s and is associated with the introduction of a high-intensity device emitting a photon stream in the infrared range into medical practice. The first carbon dioxide lasers were difficult to use (they were large in size and had complex technical settings), but at the same time they showed high resection and coagulation qualities, and it earned them their popularity. Over 3 thousand new laser devices representing a practical interest for laryngeal surgery have appeared on the medical market for more than 60-year period. Despite the fact that fundamental research demonstrates the positive results of phonosurgery with high-power devices, many otolaryngologists continue be in awe of lasers. The article presents the results of the use of traditional devices in phonosurgery for chronic diseases of the larynx and draws conclusions about the effectiveness and safety of high-power devices.