Emerging technology: Flexible CO2 laser WaveGuide

The carbon dioxide (CO2) laser has been a powerful tool in the armamentarium of the otolaryngologist since the early 1970s. In the past, rigid endoscopes and the micromanipulator were necessary to reflect a beam along a direct path to the treatment area. Exposure of the target area was often difficult and general anesthesia was required to gain access to target areas. Recently, OmniGuide, Inc. (Cambridge, MA) has developed a Photonic Band-Gap Fiber Assembly (PBFA) for delivery of CO2 laser energy. This new WaveGuide has the flexibility, maneuverability, and diameter requirements to access lesions and locations that would not be possible using direct visualization. The surgeon is able to apply CO2 laser energy to chosen target lesions in the outpatient clinic through flexible endoscopes. We report our initial experience with the CO2 laser WaveGuide in a case of laryngotracheal amyloidosis.