medigraphic.com
Anales de Otorrinolaringología Mexicana

2012, Number 4

<< Back Next >>

Otorrinolaringología 2012; 57 (4)

Use of KTP laser for fonomicrosurgical treatment of glottic cancer and other benign lesions of larynx: a comparative analysis with CO2 laser

Zubiaur GFM, García PR, Garza HH

Language: Spanish
References: 18
Page: 189-195
PDF size: 325.15 Kb.


ABSTRACT

Background: CO2 laser has been the laser of choice in laryngology for decades and has served as a reference for the development of new types of laser.
Objectives: To analyze the characteristics of CO2 and other types of available lasers, as well as to demonstrate de usefulness of photoangiolytic lasers, specifically KTP, for microphonosurgery.
Material and methods: We reviewed medical literature searching for the otolaryngologic applications of the different types of available lasers, primarily in the field of laryngology. A comparative analysis was then conducted: between CO2 and photoangiolytic lasers and between the two most commonly used photoangiolytic lasers: PDL vs KTP. The practical use of these lasers was demonstrated with clinical cases.
Results: CO2 laser has a high absorption affinity for water, for that it is highly effective for fine tissue cutting and bloc resections. Photoangiolytic lasers, specifically KTP laser, have a high absorption affinity for oxyhemoglobin, so they are a useful alternative for vascular and tumoral lesions that are in intimate contact with the delicate vocal fold epithelium.
Conclusions: Photoangiolytic lasers, specifically KTP, must be considered a useful alternative in vascularized laryngeal lesions. This particular type of laser offers great advantages over CO2 laser, as lowering the risk of inadequate scarring as well as maintaining the integrity of vocal fold epithelium and superficial lamina propria (SLP).


REFERENCES

  1. Simpson GT, Shapshay SM. The use of lasers in otolaryngologic surgery. Otolaryngol Clin North Am 1983;16:737-827.

  2. Ossoff RH, Coleman JA, Courey MS, Duncavage JA, et al. Clinical applications of lasers in otolaryngology-head and neck surgery. Lasers Surg Med 1994;15:217-248.

  3. Yan Y, Olszewski AE, Hoffman MR. Use of lasers in laryngeal surgery. J Voice 2010;24:102-109.

  4. Strong MS. Laser management of premalignant lesions of the larynx. Can J Otolaryngol 1974;3560-3563.

  5. Vaughan CW, Strong MS, Jako GJ. Laryngeal carcinoma: transoral treatment utilizing de CO2 laser. Am J Surg 1978;136:490-493.

  6. Jako GJ, Vaughan CW, Strong MS, Polanyi TG. Surgical management of malignant tumors of the aerodigestive tract with carbon dioxide laser microsurgery. Int Adv Surg Oncol 1978;88:1399-1420.

  7. Anderson RR, Parrish JA. Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science 1983;220:524-527.

  8. Anderson RR, Jaenicke KF, Parrish JA. Mechanisms of selective vascular changes caused by dye lasers. Lasers Surg Med 1983;3:211-215.

  9. Zeitels SM, Akst LM, Burns JA, Hillman RE, et al. Office-based 532 nm pulsed KTP laser treatment of glottal papillomatosis and dysplasia. Ann Otol Rhinol Laryngol 2006;115:679-685.

  10. Burns JA, Zeitels SM, Akst LM, et al. 532 nm pulsed potassium-tytanil-phosphate treatment of laryngeal papillomatosis under general anesthesia. Laryngoscope 2007;117:1500-1504.

  11. Gray S, Pignatari SSN, Harding P. Morphologic ultrastructure of anchoring fibers in normal vocal fold basement membrane zone. J Voice 1994;8:48-52.

  12. Zeitels SM, Burns JA, Lopez-Guerra G, Anderson RR, Hillman RE. Photoangiolytic laser treatment of early glottic cancer: A new treatment strategy. Ann Otol Rhinol Laryngol 2008;117(Suppl 119):1-24.

  13. Jako GJ, Kleinsasser O. Endolaryngeal micro-diagnosis and microsurgery. Reprint from the Annual Meeting of the American Medical Association, 1996.

  14. Hirano M, Hirade Y, Kawasaki H. Vocal function following carbon dioxide laser surgery for glottic carcinoma. Ann Otol Rhinol Laringol 1985;94:232-235.

  15. Zeitels SM, Burns JA. Laser applications in laryngology: past, present and future. Otolaryngol Clin North Am 2006;39(1):159-172.

  16. Zeitels SM, Lopez-Guerra G, Burns JA, Lutch M, et al. Microlaryngoscopic and office-based injection of bevacizumab (Avastin) to enhance 532-nm pulsed KTP laser treatment of glottal papillomatosis. Ann Otol Rhinol Laryngol 2009;118(Suppl 201):1-24.

  17. Steiner W. Experience in endoscopic laser surgery of malignant tumors of the upper aero-digestive tract. Adv Otorhinolaringol 1988;39:135-144.

  18. Zeitels SM, Burns JA, Akst LM, Hillman RE, et al. Office-based amd microlaryngeal applications of a fiber-based thulium laser. Ann Otol Rhinol Laryngol 2006;115:891-896.




2020     |     www.medigraphic.com