Abstract
Dysphonia is a common symptom in benign and pre malignant lesions of larynx affecting vocal cords. Surgical excision is the main stay of treatment. Only a limited number of studies have compared the efficacy of microdissection versus CO2 laser surgery in the larynx. In the present study we have compared conventional micro-laryngeal surgery and carbon dioxide laser assisted microsurgical technique in the management of these lesions. A randomized prospective study was conducted in 88 cases of benign and pre malignant lesions affecting vocal cords were divided randomly to undergo surgery either by conventional micro dissection or CO2 laser assisted techniques in a tertiary care hospital. The groups were assessed through vocal cord morphological observation by videostroboscopy and subjective voice assessment parameters GRBAS score and VHI10 index preoperatively and 2 weeks and 3 months postoperatively by a panel of blinded viewers and listeners. Surgical and recovery times were compared between the two groups. Intraoperative blood loss was compared by gauze visual analogue. Patients recovered remarkably well following both the techniques as denoted by the voice parameters. Peroperative bleeding was observed to be significantly reduced in the laser excision group; operating time was significantly increased in this group. Duration of hospital stay was similar in both groups. No differences in clinical outcomes are identified when comparing microdissection with laser excision of benign lesions.
Similar content being viewed by others
References
Ya Z, Liang G, Sun Na, Linlin G et al (2015) Comparison of CO2 laser and conventional laryngomicrosurgery treatments of polyp and leukoplakia of the vocal fold. Int J Clin Exp Med 8(10):18265–18274
Keilmann A, Biermann G, Hörmann K (1997) CO2 laser versus conventional microlaryngoscopy in benign changes of the vocal cords. Laryngo Rhino Otologie 76(8):484–489
Wuyts FL, De Bodt MS, Molenberghs G et al (2000) The dysphonia severity index: an objective measure of vocal quality based on a multiparameter approach. J Speech Lang Hearing Res 43:769–809
De Jonckere PH, Crevier-Buchman L, Marie JP et al (2003) European research group on the larynx. Implementation of the European Laryngological Society (ELS) basic protocol for assessing voice treatment effect. Rev Laryngol Otol Rhinol (Bord). 124:279–283
Andrews AH, Moss AW (1974) Experience with CO2 laser in the larynx. Ann Otol Rhino Laryngol 83:462–470
Zeitels SM, Casiano RR, Gardner GM, Hogikyan ND et al (2002) Management of common voice problems: com mittee report. Otolaryngol Head Neck Surg 126:333–348
Czerwonka L, Jiang JJ, Tao C (2008) Vocal nodules and edema may be due to vibration-induced rises in capillary pressure. Laryngoscope 118(4):748–752
Sataloff RT, Spiegel JR, Hawkshaw MJ (1991) Strobovideolaryngoscopy: results and clinical value. Ann Oto Rhino Laryngol 100:725–727
Woo P (1996) Quantification of videostroboscopic findings: measurements of the normal glottal cycle. Laryngoscope 106(Suppl 79):1–27
Alessi D, von Leden H (1992) Stroboscopy and phonosurgery. Arch Otolaryngol Head Neck Surg 118:1003–1005
Bennett S, Bishop SG, Lumpkins SMM (1989) Phonatory characteristics following surgical treatment of severe polypoid degeneration. Laryngoscope 99:525–532
Strong MS, Jako GJ (1972) Laser surgery in the larynx: early clinical experience wjth continuous CO2 laser. Ann Otol Rhino Laryngol 81:791–798
Shapshay SM, Wang Z, Rebeiz EE et al (1996) A combined endoscopic CO2 laser and external approach for treatment of glottic cancer involving the anterior commissure: an animal study. Laryngoscope 106:273–279
Benninger MS (2000) Microdissection or microspot CO2 laser for limited vocal fold benign lesions: a prospective randomized trial. Laryngoscope 110:1–17
Yan Y, Olszewski AE, Hoffman MR et al (2010) Use of lasers in laryngeal surgery. J Voice 24(1):102–109
Mizuta M, Hiwatashi N, Kobayashi T, Kaneko M, Tateya I, Hirano S (2015) Comparison of vocal outcomes after angiolytic laser surgery and microflap surgery for vocal polyps. Auris Nasus Larynx 42(6):453–457
Xu W, Han D, Hou L, Zhang L, Yu Z, Huang Z (2007) Voice function following CO2 laser microsurgery for precancerous and early-stage glottic carcinoma. Acta Otolaryngol 127(6):637–641
Funding
None.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical Approval
Permission taken from institutional ethical committee for doing this study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Dutta, A., Vallur, S. A Study on Comparison of Conventional Micro Laryngeal Micro Dissection Surgery with Carbon Dioxide Laser in Management of Benign Lesions of Larynx. Indian J Otolaryngol Head Neck Surg 74 (Suppl 2), 1936–1941 (2022). https://doi.org/10.1007/s12070-020-01923-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12070-020-01923-9