The use of forced ventilation during microlaryngoscopy with laser CO2.

CO2 laser is currently used in the treatment of laryngeal lesions. The technique leads to vaporisation of the tissues on which it is focused, resulting in the production of smoke that remains in the laryngoscope and in the area of the exposed larynx. The fumes can only be partially removed with an aspiration tube. As a result, the vision of the operative field becomes obscured, thus making it difficult to perform surgery. We present a method to resolve this problem consisting in forced ventilation of the air present in the laryngoscope and the exposed larynx. Simultaneous use of the forced ventilation air and the aspiration tube permits a more efficient withdrawal of fumes from the operative field and a better view of the larynx for the surgeon. Since 1986, we have performed 200 CO2 laser cordectomies in patients with early stage glottic cancer without any kind of complication.