Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
J Voice. 2010 Jan;24(1):102-9. doi: 10.1016/j.jvoice.2008.09.006. Epub 2009 May 31.
Lasers are a relatively recent addition to laryngeal surgery. Since their invention, laser use and applications have expanded rapidly. In this article, we discuss the benefits and disadvantages of lasers for different procedures, as well as ways to overcome commonly faced clinical problems. The use of lasers in surgery has offered a time- and cost-efficient alternative to cold surgical techniques, and has been used in the treatment of numerous laryngeal pathologies, including stenoses, recurrent respiratory papillomatosis, leukoplakia, nodules, malignant laryngeal disease, and polypoid degeneration (Reinke's edema). However, lasers can incur adjacent tissue damage and vocal fold scarring. These problems can be minimized through understanding the mechanisms by which lasers function and correctly manipulating the parameters under a surgeon's control. By varying fluence, power density, and pulsation, tissue damage can be decreased and lasers can be used with greater confidence. The various types of lasers and their applications to the treatment of specific pathologies are reviewed with the intention of helping surgeons select the best tool for a given procedure. Recent applications of lasers to treat benign laryngeal lesions and severe laryngomalacia demonstrate that additional research must be conducted to realize the full potential of this surgical tool.
激光技术是喉部手术中的一种较新方法。自发明以来，激光的应用和用途迅速扩展。在本文中，我们讨论了激光在不同手术中的优缺点，以及克服常见临床问题的方法。与冷手术技术相比，激光在手术中的应用提供了一种更省时、更经济的选择，并且已用于治疗多种喉部疾病，包括狭窄、复发性呼吸道乳头状瘤病、白斑、结节、恶性喉部疾病和息肉样变性（Reinke 水肿）。然而，激光可能会导致相邻组织损伤和声带瘢痕。通过了解激光的工作机制并正确控制手术医生可控制的参数，可以最大程度地减少这些问题。通过改变能量密度、脉冲宽度，可以减少组织损伤，从而更有信心地使用激光。本文回顾了各种激光及其在特定疾病治疗中的应用，旨在帮助外科医生为特定手术选择最佳工具。最近激光治疗良性喉部病变和严重喉软化的应用表明，必须进行更多的研究才能充分发挥这种手术工具的潜力。
