Lasers in ENT :-

State of the art of electronics and advanced technologies are not new to medicine. Machines have aided man throughout the ages. Otolaryngology’s and head and neck surgeons have realized the potential for the laser very early. The perception of the laser has moved from the laboratory into everyday conventional surgery.

KKR ENT Hospital is forerunner in introducing this technology and is among the first to offer the Head and Neck surgeries using CO₂ Laser.

The introduction of laser into routine ear, nose and throat surgery has gradually given way to a more balanced and realistic attitude to its uses and limitations. The major advantage of laser is its precise incision, homeostasis achieved and reduced post operative fibrosis and scarring..

The CO₂ laser is used extensively in most ENT lesions. The spot size has been reduced to less than 1 mm diameter, which greatly reduces any damage to the surrounding areas. Laser surgery for the oral cavity and the larynx has an extremely good precision because of the facility for the attachment of the laser beam to the microscope in ENT disease.

Common indications for laser in ENT

1 Oral leucoplakia: Leucoplakia is strikingly responsive to the CO₂ laser. Recurrence of new patches of leucoplakia after laser treatment is also less likely. The operating microscope enables one to see much more of the targeted field. The reduced ground tissue reaction adds to the advantage of laser.

2 Oral Verrucous carcinoma: Lesions, which are 2 cms or less, are amenable to laser treatment. The results of treating small-circumscribed oral verrucous carcinomas are excellent, especially if adjacent epithelial dysplasia is limited.

3 Oral carcinomas: Removal of intra-oral carcinomas by CO₂ laser is much preferred these days due to the more rapid and less painful process. Some surgeons do advocate leaving the wound open to facilitate better healing and reduced pain.

Other conditions where laser has been advocated in diseases of the Oral cavity are

• Oral and Oropharyngeal haemangiomas.
• Pleomorphic adenomas.
• Tonsillectomy
• Uvulo-palato-pharyngoplasty.

KKR ENT Hospital introduced CO₂ LASER in the year 1998 and since then have completed a series of head and neck surgeries using this technology. The results are outstanding when compared to conventional technique.

Nasal indications: Listed are some of the commonly encountered indications in the nose which can be dealt very effectively with laser.

Nasopharyngeal Angiofibromas: These are extremely aggressive and vascular tumours of the nose and paranasal sinuses. The CO₂laser attains markedly reduced blood loss and precise incision.

Familial haemorrhagic telangiectasia: This disease has lesions which cause bleeding in the nose due to capillary dilatations. Ablation of the mucosa by laser is extremely useful to control the bleeding. However, there have been some cases of recurrence after laser.

Choanal atresia: The major advantage of the CO₂ laser in these conditions in infants is the minimal tissue trauma and the bleeding. The laser beam is directed along the axis close to the floor of the nose using the inferior turbinate as a landmark. The bleeding is usually minimal and an indwelling elastic or polyvinylchloride tube can be used to prevent contraction of the new orifice. The surgery may need to be repeated at times.

Nasal polyposis: Polyps in the nose are usually a vascular and have a restricted area of the disease. Ethmoidal polyps have a high recurrence rate and laser surgery is very useful to reduce it.

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