Risk of late fatal secondary hemorrhage in laser surgery of the larynx

Objectives: Since 1979, a number of publications have appeared regarding complications of laser surgery of the larynx. Most publications focus on complications such as accidental burns, rouse of the ventilation tube, anesthesiologic problems, edema of the mucosa, and abnormal scar formation. Secondary hemorrhage has played a subordinate role and cases demanding postoperative treatment have only been reported sporadically. All cases occurred within the first postoperative week, and no case resulting in death has been reported. The aim of the article is to draw attention to the fact that after laser surgery of the larynx, late lethal secondary hemorrhage may occur. Material and Patients: We review the literature and describe a patient in whom a lethal secondary hemorrhage occurred 10 days after laser supraglottic laryngectomy. The case is analyzed and similarities to hemorrhages associated with tonsillectomy and laser surgery of the lingual tonsil are shown. Results and Conclusions: The risk of very late severe secondary hemorrhage after laryngeal laser surgery is considered to be very seldom and comparable with that after tonsillectomy. Due to the increase in laser application in the treatment of laryngeal carcinoma, secondary hemorrhage may be encountered. Consequences for preoperative information and postoperative control of the patients have to be discussed.