The precision afforded by the CO2 laser for incision, excision and ablation of
soft -tissue in the oral cavity and oropharynx is second to no other surgical
technology. The advanced laser systems and delivery devices from Lumenis
are designed for work in these sometimes vascular and hard to reach tissue
areas. Some accessories are designed to work with Lumenis free-beam CO2
lasers, which have an articulated arm. The new FiberLase flexible CO2 fiber
with the AcuPulse™ 40WG laser system is also ideal for work in this area,
particularly when the surgery is multi-level.
Leukoplakia, benign and malignant lesions
Leukoplakia is a pre-cancerous white-appearing lesion that can be local or diffuse in presentation.
The CO2 laser is ideally suited for excision and ablation of leukoplakia. Individual patches can be
easily excised according to lesion geometry and depth.
Tissue samples are sent to the pathologist when leukoplakia, benign and malignant lesions are
removed. The CO2 laser works efficiently, while enabling tissue samples with good margins, good
hemostasis and preservation of maximum healthy tissue.
When enlarged size contributes to obstructive sleep disordered breathing, a partial glossectomy
can be performed to reduce the size of the tongue. Visualization is enhanced because of microvascular
hemostasis. Patient recovery may be easier and faster because of reduced trauma to
Tonsils are units of lymphatic tissue, situated in the pharynx near the openings to the airway.
When present, the palatine tonsils can be seen laterally in the oropharynx. The lingual tonsil is
located at the base of the tongue near the epiglottis and is generally not visible without a mirror or
endoscope. The pharyngeal tonsils (adenoids) are located in the nasopharynx above the soft
palate and near the eustachian tubes. Enlarged tonsils can interfere with breathing, particularly
while lying down at night. The condition associated with periodic episodes of apnea followed by
snoring or episodic gasping for air is termed Obstructive Sleep Apnea (OSA). OSA interferes with
quality of life because affected individuals may be tired, sleepy, cranky and even have problems
In an outpatient setting, under local anesthesia, the CO2 laser is sometimes used on adults to
perform a partial palatine tonsillectomy (subtotal or capsular tonsillectomy). The same procedure
may be performed under general anesthesia in the operating room. The Kamimi tonsil tip attached
to the Oral Pharyngeal and Nasal Handpiece or FiberLase CO2 fiber can be used for this application.
The free-beam Oral Pharyngeal and Nasal Handpiece with 90° angled-mirror tip can be used to
reflect the laser beam onto the adenoids or the lingual tonsil. The flexible CO2 fiber can also be
used with various FiberLase handpieces, depending on the condition, patient anatomy and
Enlarged palate, uvula
Laser-Assisted Uvulopalatoplasty (LAUP) may be performed in the office under local anesthesia for
treatment of snoring or obstructive sleep apnea (OSA). Studies have shown that when the CO2
laser is used, many patients experience reduced swelling and discomfort.
The free-beam Oral Pharyngeal and Nasal Delivery System includes a Backstop tip designed especially
for this procedure. Alternatively, the flexible CO2 fiber can be used with a FiberLase rigid or
Multi-Level Obstructive Sleep Disorder
Chronic obstructive sleep apnea (OSA) adversely affects quality of life because lack of sleep saps
energy, stamina and the ability to concentrate mentally. When left untreated, OSA can lead to
other chronic cardiac and blood pressure conditions. The site of obstruction can be in a single or
multiple locations. A variety of surgical procedures may be necessary, depending on the overall
condition – some might involve the use of the CO2 laser and others would require traditional
reconstructive techniques. Only specially trained physicians can make this determination.
The CO2 laser works well to reduce the size of overly large organs in OSA, nasal turbinates,
tonsils, tongue, soft palate and uvula, etc. The AcuPulse 40WG CO2 laser with the FiberLase
flexible CO2 laser fiber offers the greatest utility and ease-of-use for surgical treatment of multilevel
obstructive sleep disease.