Quantifying the shrinkage of laryngeal laser excisions: a case control study

Abstract

Abstract Objective Heat from transoral laser microsurgery can cause tissue shrinkage, impacting the surgical margin. This study aimed to compare shrinkage between cold steel and carbon dioxide laser resections of laryngeal lesions. Methods A European Laryngological Society type II resection was performed on 10 mm ‘lesions’ marked on both the true and false folds of fresh-frozen human larynxes; specifically, laser resection was performed on the right side and cold steel resection on the left side. Results Twenty-eight larynxes were included. Tissue shrinkage was significantly higher in laser resection (35–45 per cent) compared to cold steel resection (8–14 per cent) (p < 0.0001). In most cases, there was no significant difference in shrinkage between true and false fold sites. Conclusion This study demonstrates that specimen shrinkage is significantly higher in laser resections. This shrinkage will affect the size of the surgical margin; surgeons and pathologists should be aware of this when considering positive and close margins.