The erbium:yttrium aluminum garnet (Er:YAG) laser operates in the infrared spectrum at a wavelength of 2.94 microns. The absorption coefficient for water at this wavelength is approximately 10 times that of the carbon dioxide laser. It is anticipated that this laser will produce more precise surgical ablation with decreased surrounding tissue destruction. The results of impacting endotracheal tubes with the Er:YAG laser are presented. The CO2 laser was used as a reference. Metallic tape that was not perforated by the CO2 laser after 240 seconds of continuous exposure at 20 W was perforated by the Er:YAG laser with use of 15 pulses of 1 J per pulse. Silver foil tape with a Meroplicable to otolaryngology, modification of current safety standards will be necessary.
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