Comparison of Microdissection Microlaryngeal Surgery with Carbon Dioxide Laser in Management of Benign and Premalignant Lesions of Larynx

Abstract

Introduction
 Dysphonia is caused by voice misuse and various environmental factors. It is manifested as varied pathological lesions of the vocal cords. Surgical excision of these lesions is mainly by conventional cold steel or laser assisted microsurgical techniques. Both modalities have seen extensive advancements and refinement in technologies in the recent past. In this study we have compared the microdissection microlaryngeal treatment and microspot superpulsed beam carbon dioxide (CO2) laser assisted surgical techniques for the management of benign and precancerous lesions of the vocal cords.
 Material and Methods
 A total of 36 cases of benign lesions of vocal cord, were divided randomly to undergo surgery either by microdissection or CO2laser assisted techniques. The groups were assessed through vocal cord morphological observation and subjective voice assessment parameters GRBAS score and VHI10 index.
 Results
 Peroperative bleeding was observed to be significantly reduced in the laser excision group. However, operating time was significantly increased in this group. Patients recovered remarkably well following both the techniques as denoted by voice parameters. No difference was observed in duration of hospital stay. 
 Conclusion
 Both surgical techniques give satisfactory results in their management of benign and precancerous lesions of the vocal cords. Both techniques have their advantages and disadvantages. After a learning curve, laser surgery with its precision and cleaner surgical fields will be more effective in the management of such cases.