Optimizing Settings for Office-Based Endoscopic CO2 Laser Surgery Using an Experimental Vocal Cord Model

被引:6
|
作者
Schimberg, Anouk S. [1 ]
Klabbers, Tim M. [1 ]
Wellenstein, David J. [1 ]
Heutink, Floris [1 ]
Honings, Jimmie [1 ]
Van Engen-Van Grunsven, Ilse [2 ]
Verdaasdonk, Rudolf M. [3 ]
Takes, Robert P. [1 ]
Van den Broek, Guido B. [1 ]
机构
[1] Radboud Univ Nijmegen, Med Ctr, Dept Otorhinolaryngol & Head & Neck Surg, Philips van Leydenlaan 15, NL-6525 EX Nijmegen, Netherlands
[2] Radboud Univ Nijmegen, Med Ctr, Dept Pathol, Nijmegen, Netherlands
[3] Univ Twente, Dept Sci & Technol, Enschede, Netherlands
来源
LARYNGOSCOPE | 2020年 / 130卷 / 11期
关键词
Flexible endoscopic CO2 laser; vocal cords; thermal effects; LASER-SURGERY; FIBER;
D O I
10.1002/lary.28518
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Objectives/Hypothesis To provide insight in the thermal effects of individual laser settings in target tissues to optimize flexible endoscopic CO2 laser surgery treatment. Study Design Experimental laboratory study. Methods Thermal effects of the CO2 laser using a fiber delivery system were visualized using the color Schlieren technique in combination with a polyacrylamide gel tissue model. Variable settings were used for emission mode, power, laser fiber distance, and laser duration, which were evaluated in every possible combination. Collateral thermal expansion and incision depth were measured. To validate the model, the results were compared to histology after CO2 laser irradiation of ex vivo human vocal cords, and the intraclass correlation coefficient was calculated. Thermal damage and incision depth were measured by a blinded pathologist. Results Of all parameters studied, duration of laser irradiation had the greatest effect on thermal expansion. Increased distance between laser tip and target tissue resulted in significantly reduced incision depth and increased thermal expansion. Pulsed emission modes led to increased incision depths. The intraclass correlation coefficient for consistency between the model setup and the ex vivo human vocal cords was classified as "fair." Conclusions By using high-intensity pulsed lasers at minimal distance to the target tissue, exposure times and subsequent damage to surrounding tissue can be reduced. If an evaporation technique is used, lower power in continuous wave at a larger distance to the target tissue will lead to superficial but broader thermal effects. The model setup used in this study is a valid model to investigate laser-induced thermal effects in vocal cord tissue. Level of Evidence NA Laryngoscope, 2020
引用
收藏
页码:E680 / E685
页数:6
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