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

Abstract

Lasers have been used in otolaryngology for more than 40 years and are widely considered an established way of addressing laryngeal pathology, benign and malignant. Carbon dioxide (CO2) laser is considered a gold standard, but over the last 2 decades, a new technology has been developed and established in other medical specialties, not so much in Ear Nose and Throat (ENT), the diode laser. It consists of a flexible fiber that passes through a hollow guidance system and is capable of reaching certain angled spots easier than straight beam systems. Portability, lower cost, easier setup, and improved photocoagulation are just some of the many features rendering it an excellent choice for the surgeon and the patient. The few studies published worldwide for the usage and efficacy of this system show no major differences related to the oncologic outcome and survival rate of patients having an early glottic tumor between diode laser microsurgery and CO2 laser cordectomy. Nevertheless, the advantages offered by fiber-optic laser surgery render it a worthy and perhaps equal alternative for treating this kind of pathology.

Oncological Outcomes of Transoral Laryngeal Microsurgery with Fiber-Optic Diode Laser for Early Glottic Cancer: A Single-Center Experience

“…Similar to the CO 2 laser, DL TLM has short hospital stay, preservation of all treatment options and well wound healing, and lower cost comparing with open surgery and RT [10, 11]. The diode laser is delivered down by a very fine glass fiber that allows the surgeon to use it in straight or angled pencil-like holders for accurate manipulation.…”

“…Additionally, it can be used in direct contact or indirect contact to the targeted tissue, which can be varied according to the intensity of its power. An indirect or near-contact mode provides better photocoagulation and it results quite good coagulation [10, 11]. All these features written above of the diode laser enable the surgeon to work comfortably and safely in deep and difficult-to-reach areas such as subglottis, paraglottis, and anterior commissure [10, 11, 55].…”

“…An indirect or near-contact mode provides better photocoagulation and it results quite good coagulation [10, 11]. All these features written above of the diode laser enable the surgeon to work comfortably and safely in deep and difficult-to-reach areas such as subglottis, paraglottis, and anterior commissure [10, 11, 55]. Remarkably, Usumez et al [55] reported that the 980-nm diode laser accelerates the wound healing procedures via changing the expressions of PDGF and bFGF genes that are responsible for the stimulation of the cell proliferation and fibroblast growth [56].…”

“…The conventional laryngeal laser method for early glottic cancers is the CO 2 laser, with well-documented good oncological and functional results. The diode laser is a newer technology which was introduced to otolaryngology in 1990s and with some advantages [10, 11]. The initial case series of diode laser surgery was published by Ferri and Armato [12] in 2008.…”

Ruthenium-based antitumor drugs and delivery systems from monotherapy to combination therapy

“…In order to achieve a certain purpose of combination therapy, a variety of drugs or means are required in the process, including chemotherapy drugs 262 , photosensitizers 263 , lasers 264 , monoclonal antibody or antibody-coupled drugs 265,266 , genes 267 , etc. The emergence of nanodrugs provides a new idea for the realization of combination therapy and provides a platform for the combination of two or more drugs 268,3 .…”