Postoperative healing and clinical outcomes after transoral carbon dioxide laser microsurgery for adult epiglottic cysts: a retrospective cohort study

Background: Evidence on postoperative healing after transoral carbon dioxide (CO2) laser surgery for adult epiglottic cysts remains limited.We evaluated healing and clinical outcomes in a consecutive surgical cohort.Methods: We retrospectively reviewed 74 consecutive adults who underwent transoral CO2 laser microsurgery between January 2012 and December 2025.Treatment consisted of complete excision or laser marsupialization.We assessed perioperative events, healing at the 2-and 4-week follow-up, symptom improvement, epiglottic deformity, aspiration symptoms, recurrence, and reoperation.Results: The mean age was 55.8 ± 13.1 years, and 43 patients (58.1%) were male.Forty-seven patients underwent complete excision and 27 underwent marsupialization.No patient required postoperative airway intervention.Complete healing was noted in 54 patients (73.0%) by the 2-week follow-up and in 68 (91.9%) by the 4-week follow-up; 6 patients (8.1%) had incomplete healing beyond 4 weeks.Symptoms improved in 51 of 55 symptomatic patients (92.7%).Significant epiglottic deformity occurred in 2 patients, and aspiration symptoms in 1.Two patients had recurrence, and 1 underwent reoperation.Median follow-up was 28 months (interquartile range, 15-49).Conclusion: Among adults selected for surgery, most had complete healing by 4 weeks, and most symptomatic patients improved.Recurrence and reoperation were uncommon during follow-up.