Laryngeal papilloma is the most common benign tumor of the larynx and is caused by the human papilloma virus. It is often difficult to treat papilloma because it recurs or disseminates frequently. Micro laryngeal surgery is usually employed under general anesthesia, however some patients need to have the surgery repeatedly. That can be physically and mentally demanding and can lead to complications associated with general anesthesia or direct laryngoscopy. In addition, some patients have difficulty undergoing general anesthesia. We reported on 4 adult cases with laryngeal papilloma treated by surgery with a Nd-YAG laser under local anesthesia. One case had multiple and expanded papillomatosis. General anesthesia was difficult in this case because of a cervical problem due to a previous traffic accident. He underwent surgery using the Nd-YAG laser twice. The lesion has not recurred for more than 1 year. Other cases also underwent surgery with the Nd-YAG laser several times, and their lesions had not recurred for over a year. The Nd-YAG laser can be effective on exophytic laryngeal papillomas which recur because of their high tissue permeability. Operation under local anesthesia is less invasive procedure. We believe that endoscopic surgery with the Nd-YAG laser under local anesthesia plays a supplementary role in the treatment of laryngeal papilloma. It is most prudent to observe the lesions in detail and at a minimum to perform a biopsy under a microscope during the first operation.
