Background The objective of the study is to compare the conventional microlaryngeal surgery and the CO2 laser in the treatment of cysts of vocal folds, regarding the postoperative quality of voice. This study was conducted on 53 cases with vocal fold cysts. The cases were randomly allocated into two groups: group 1 (27 cases) was operated by the conventional technique, and group 2 (26 cases) was operated with CO2 laser microlaryngeal operation. At 3-month postoperative, evaluation was done by stroboscopic evaluation of vocal folds, grade of hoarseness, roughness, breathiness, asthenia, and strain (GRBAS) scale and Arabic version of Voice Handicap Index (VHI). Results The stroboscope assessment revealed that glottic closure was complete, symmetrical motion, the reappearance of the mucosal wave, normal amplitude, and periodicity in all patients. There is insignificantly different between either group as regards the postoperative scores on VHI and GRBAS scale. Conclusion There is insignificantly different when comparing laser to conventional microlaryngeal surgery for excision of vocal fold cysts regarding the quality of voice.

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