New 445 nm blue laser for laryngeal surgery combines photoangiolytic and cutting properties

Abstract

Background

Photoangiolytic lasers have broadened the surgical armamentarium for many phonosurgical interventions. However, the pulse dye laser and potassium titanyl phosphate (KTP) laser have technical drawbacks and a smaller spectrum of indications.

Methods and results

The new 445 nm wavelength laser, the so-called ‘blue laser’, proves to show tissue effects comparable to the KTP laser and is also capable of treating subepithelial vessels due to its photoangiolytic properties, it can coagulate and carbonize at higher energy levels, and can be used via glass fibers in non-contact and contact mode for in-office procedures.

Discussion

In contrast to the KTP, the new 445 nm laser can also be used as a cutting laser, thus combining very much wanted properties of diode or CO2 lasers with photoangiolytic lasers. Further advantages of the new laser are the; (1) portability of the shoe box sized, shock-proof laser machine for in-office and operating room usage, (2) the selection of pulse rates from continuous wave (cw) to less than a millisecond, (3) stronger tissue effects compared to KTP with similar energy and pulse settings, (4) far better cutting properties than the KTP, and thus (5) more possibilities for usage in laryngology as well as in other fields or surgery.

Conclusion

We demonstrate the feasibility of the 445 nm laser in several laboratory experiments and show clinical cases where photoangiolysis and cutting was possible. However, this is a preliminary report and further systematic studies in greater numbers are warranted.

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Acknowledgements

The authors acknowledge the support of Nils Hofmann from A.R.C. Laser Company for providing a figure with bare fiber fluence effects.

Funding

A.R.C. Laser Company, Nuremberg, Germany supported this study with a TruBlue® laser and glass fibers. Markus Hess and Susanne Fleischer received no money or other support for this study.

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Correspondence to Markus M. Hess.

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Conflict of interest

Markus Hess and Susanne Fleischer: None. Marcel Ernstberger is employed by A.R.C. Laser Company, Nuremberg, Germany.

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Hess, M.M., Fleischer, S. & Ernstberger, M. New 445 nm blue laser for laryngeal surgery combines photoangiolytic and cutting properties. Eur Arch Otorhinolaryngol 275, 1557–1567 (2018). https://doi.org/10.1007/s00405-018-4974-8

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Keywords

  • 445 nm wavelength
  • Blue laser
  • Photoangiolysis
  • Office based surgery
  • Laser surgery
  • Phonosurgery
  • Laryngology