In-office laryngeal surgery with the 585-nm pulsed dye laser.

PURPOSE OF REVIEW: To describe the current support in the literature for in-office surgery using the 585-nm pulsed dye laser.

RECENT FINDINGS: There are substantial cost savings (US$5000) and patient comfort when in-office surgery is performed with the pulsed dye laser. The pulsed dye laser can be used in the office and operating room to activate aminolevulinic acid for photodynamic treatment of recalcitrant laryngeal keratosis, with long-term eradication of keratosis without the prolonged photosensitivity of previous photodynamic agents. The site of the cleavage plane created in the true vocal fold mucosa has now been elucidated.

SUMMARY: The 585-nm pulsed dye laser allows safe, medically effective and cost-effective in-office surgery for a host of laryngeal lesions such as papillomatosis, keratosis, Reinke's edema, granulomas and other vascular lesions. The pulsed dye laser can activate aminolevulinic acid for laryngeal photodynamic therapy. Of the lasers currently in use it has the longest track record of safety and, to the satisfaction of many, continues in service at 23 centers around the world.