Surgery of benign and tumor-like laryngeal formations using 445 nm semiconductor laser

The issues of phonosurgery remain truly relevant today since there is a high prevalence of benign and tumorlike laryngeal formations among the pathology of the upper respiratory tract (up to 55–70%). Nowadays, laser technologies are coming to the fore among the possibilities of laryngological practice. Photoangiolytic lasers, such as the KTP laser, are actively used to coagulate subepithelial vessels without destroying the superficial epithelium. A novelty among laser systems is a laser with a wavelength of 445 nm certified in 2018, which combines high hemostatic and cutting effects without the extensive zone of thermal damage to surrounding tissues. This paper presents two clinical cases where a 445 nm laser is used. The first clinical case describes a patient with an anterior commissure scar after previous surgical interventions. Treatment using a 445 nm laser made it possible to dissect the scar and restore the normal laryngeal anatomy without stent placement. 5 weeks after the operation, the patient underwent phonopedic therapy and was satisfied with the voice quality. The second clinical case describes a patient with a cystic-like neoplasm of the left vocal fold. Dissection and enucleation of the formation using a direct micro laryngoscopy was done, followed by laser coagulation of the incision edges. Within 2 weeks, the patient showed restoration of the laryngeal endoscopic state and a voice improvement with normalization of acoustic parameters. Thus, the 445 nm semiconductor laser has shown in practice highly pronounced photoangiolytic and cutting properties, which proves its effectiveness in phonosurgery.