More than Smoke and Mirrors: Expanding Technology and Use of Lasers in Otolaryngology-Head and Neck Surgery

According to Dr. Holsinger, for head and neck surgeons, training is a critical issue. We’re used to doing big operations in an open surgical field, he said. What is clear is that as a head and neck oncologic community, we need to embrace the disciplines of laryngology using the CO2 and other lasers to tackle some of these cancers.

Similarly, it can be quite daunting for clinicians to learn the appropriate application for lasers. Again, according to Dr. Woo, lasers, like all medical devices, are often marketed directly to the user.

For us practicing physicians, we go to a meeting and the instrumentation representative is the main person who tells us what a device is good for and we are then left to figure out what the truth is, he said.

Although technology subsections of societies try to properly assess and recommend the best application of a new emerging technology, he said, there is a period of experimentation with a new device that is not well regulated.

State of the Art

Lasers in otolaryngology-head and neck surgery have been used for many years with a great benefit in treating a variety of benign and malignant conditions. With more than 30 years of use, the CO2 laser remains the workhorse of all the currently available lasers. With more recent novel ways to delivery CO2 through a flexible fiberoptic laser, as well as emerging technology of pulsed dye lasers, both of which have the potential for use without general anesthesia, the use of lasers by otolaryngologists is expected to expand, particularly in office-based settings. With this, training physicians in the use of new laser technologies and the appropriate clinical applications of these technologies will need to be addressed.

©2007 The Triological Society