From the operating theatre to the office: Functional outcomes, tolerability, and cost-effectiveness of the blue laser in benign laryngeal surgery.

[BACKGROUND AND OBJECTIVES] The 445 nm blue laser has expanded therapeutic possibilities in the office. However, comparative studies with laser surgery in the operating theatre are scarce. The present study aims to analyse both techniques applied to the treatment of benign laryngeal lesions in terms of efficacy, tolerability, and efficiency.

[MATERIALS AND METHODS] Prospective, non-randomised observational study of 93 consecutive patients with benign laryngeal lesions treated in the office (TNFLS) or in the operating theatre using transoral blue laser microsurgery (TOBLM), (48 TNFLS, 38 TOBLM, 7 combined cases). Vocal outcomes were assessed using the abbreviated vocal handicap index (VHI-10), a visual analogue scale (VAS) and the acoustic voice quality index (AVQI) obtained from acoustic analysis, as well as the tolerability and efficiency of the procedures. The variables were evaluated before and 3 months after surgery.

[RESULTS] Both groups showed improvements at 3 months postoperatively in VHI-10, VAS, and AVQI, with no differences between techniques. TNFLS had a high tolerability rate (95.4%) and was significantly more cost-effective, with a cost-per-point of improvement in the VHI-10 of €86.30 vs. €200.42.

[CONCLUSIONS] TNFLS with blue laser is an effective, well-tolerated, and cost-effective alternative to conventional surgery for benign laryngeal lesions. These results support its implementation in dynamic healthcare settings that prioritize efficiency.