Laser interventions in otorhinolaryngology – Current techniques and future developments

Abstract

Following the rapid pace at which laser applications and interventions evolved during the 1980s and 1990s, laser systems are now being used extensively in all fields of otorhinolaryngology. Surgical techniques have been refined and adapted to standards of minimally invasive operations. As long-term results are now widely available, especially in endolaryngeal and endopharyngeal laser surgery for malignant lesions, the indications for laser interventions versus conventional surgery are more clearly defined and have become less controversial. The original diversity of laser systems has now been concentrated into fewer systems for which the clinical experience is equally widespread. Current developments are focused on the application of laser energy and intelligent laser power control. This allows surgeons to concentrate on the actual resection task at hand. Future developments include precise non-thermal ablation techniques with femtosecond and picosecond lasers but also feedback-controlled systems which rely on diagnostic parameters that are evaluated automatically during the resection process. Another field of application is the non-destructive stimulation of inner ear hair cells or auditory neurons which has opened up new perspectives for the development of hearing aids or cochlear implants.