Laser applications in laryngology: Past, present, and future

Since their introduction in laryngology over 30 years ago, lasers have facilitated critically important innovations. These advances have accommodated well to our specialty, which has led in designing minimally invasive surgical approaches since mirror-guided interventions in the nineteenth century. Lasers discussed in this article will provide new platform technologies that will likely lead to the enhanced treatment of a number of benign and malignant laryngeal disorders. There is an expanding group of centers in which fiber-based technologies have already caused many procedures to be performed by means of local anesthesia in the clinic or office, especially for chronic diseases such as papillomatosis and dysplasia. This approach is likely to expand significantly because of diminished patient morbidity along with socioeconomic pressures of health-care delivery. One of the substantial roadblocks to the dissemination of these clinical advancements is the cost required to install the laser technology in institutions and surgeons' offices. Furthermore, the critical development of these new lasers is limited by the relatively small number of patients with laryngeal disorders, which discourages industry from investing substantial research and development funding. To solve this problem, the present authors hope that laryngology will continue to serve as a model for high-performance minimally invasive surgery that can be translated to other mucosal diseases of the upper and lower aerodigestive tract, genitourinary organs, and the cervix. Broader use of these new lasers in other surgical disciplines should diminish costs for all surgeons and their associated institutions.