Relationship between CO2 laser–induced artifact and glottic cancer surgical margins at variable power doses

BACKGROUND: The carbon dioxide laser can induce thermal cytologic artifacts at the margin of early glottic squamous cell carcinoma histologic specimens, which makes assessment of the margin difficult. This study assesses and correlates the depth of laser-induced thermal artifact with laser power rating. METHODS: The surgical margins of 30 patients with early glottic squamous cell carcinomas who underwent laser resection were reanalyzed retrospectively. RESULTS: Thermal damage consisted of collagen denaturation within the vocal cord lamina propria and vocalis muscle, and epithelial structural changes. There was a decrease in depth of tissue artifact with increased power rating (p > .05). The average depth of thermal damage was 380.83 ± 178.79 μm. CONCLUSION: The laser causes less thermal damage at higher power, presumably because of the increased speed of cutting and reduced contact time with surrounding cells. Knowledge of the depth of thermal artifact is important surgically when ensuring the cancer is excised with sufficient oncologic margin.