Laser applications in laryngology: a review of the evidence and recent advances

Abstract

Laser technology has revolutionized surgical management in laryngology, establishing itself as a versatile, precise, and innovative tool for treating benign and malignant conditions, as well as in upper airway surgery. Its ability to be used both in the operating room and in-office under local anesthesia has significantly expanded the therapeutic arsenal available to laryngologists. In benign lesions such as vocal fold polyps, cysts, nodules, Reinke’s edema, and recurrent respiratory papillomatosis (RRP), photoangiolytic lasers (KTP, thulium) and the blue TruBlue laser have demonstrated high effectiveness, enabling selective, minimally invasive resections with rapid functional recovery, especially in outpatient settings. For ear- ly-stage malignant disease, such as glottic carcinoma, the CO₂ laser allows for precise resec- tions with laryngeal preservation, lower complication rates, and reduced costs compared to radiotherapy. In the field of upper airway surgery, lasers have shown favorable outcomes in posterior glottic stenosis, idiopathic subglottic stenosis, and bilateral vocal fold paralysis. These procedures enable safe and effective adhesion lysis, scar tissue removal, and airway enlargement with reduced recurrence rates and morbidity. The choice of laser type should be individualized based on the pathology, anatomical site, availability and therapeutic goals. Overall, lasers represent a key technology in contemporary laryngeal surgery, offering adap­table solutions across diverse clinical scenarios.