Quantifying the shrinkage of laryngeal laser excisions: a case control study.

[OBJECTIVE] Heat from transoral laser microsurgery can cause tissue shrinkage, impacting the surgical margin. This study aimed to compare shrinkage between cold steel and carbon dioxide laser resections of laryngeal lesions.

[METHODS] A European Laryngological Society type II resection was performed on 10 mm 'lesions' marked on both the true and false folds of fresh-frozen human larynxes; specifically, laser resection was performed on the right side and cold steel resection on the left side.

[RESULTS] Twenty-eight larynxes were included. Tissue shrinkage was significantly higher in laser resection (35-45 per cent) compared to cold steel resection (8-14 per cent) ( < 0.0001). In most cases, there was no significant difference in shrinkage between true and false fold sites.

[CONCLUSION] This study demonstrates that specimen shrinkage is significantly higher in laser resections. This shrinkage will affect the size of the surgical margin; surgeons and pathologists should be aware of this when considering positive and close margins.