Lasers in otorhinolaryngology, head and neck surgery

The first experimental application of a laser system in medicine was reported in the early 1960's. Since then laser therapy has been established for experimental and clinical purposes in almost every medical speciality. The aim of this study was to critically analyze the value of nine different laser systems for operations in the head and neck. The Ho:YAG laser could not gain acceptance for limited bleeding control. The diode laser showed satisfactory results for treatment of benign lesions of the oral cavity. Photodynamic therapy with the dye laser showed good clinical results, but side effects put a too high strain on the patients. The ruby laser worked excellently for the removal of tattoos. For stapedotomy the Erb:YAG laser was found to be very efficient. Treatment of hemangiomas and vascular malformations were handeled very well by the yellow light laser for flat lesions and by the Nd:Yag laser for voluminous lesions. The Nd:YAG laser has additionally proven to be of value in treatment of hyperplastic turbinates and for the debulking of unfavourable carcinoma recurrences. In the Fibertom-mode the Nd:YAG laser could also be used as a cutting device. The laser found to be of greatest importance for otolaryngology was without any doubt the CO2 laser, which is nowadays established in our department for surgery of limited carcinomas of the upper aerodigestive tract as well as for treatment of laryngeal papillomatosis, hyperplastic inferior turbinates and Zenker's diverticuli.