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Erbium:YAG-Laserchirurgie an Stimmlippengewebe

Erbium:YAG laser surgery on vocal fold tissue

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Zusammenfassung

Der Einsatz des Lasers in der Mikrochirurgie der Stimmlippe ist an spezielle Anforderungen gebunden. Ein leichtes Handling soll neben einer präzisen Schneidequalität und einer möglichst geringen thermischen Nekrose gegeben sein. In dieser Untersuchung sollte ein weiterer Laser, der Erbium:YAG-Laser eingesetzt werden, um sein Anwendungspotenzial an der Stimmlippe zu eruieren. Dazu wurden Stimmlippen aus Kehlköpfen von Schweinen mit der Erbiumlaserwellenlänge von 3 μm bestrahlt. In der durchgeführten Studie wurde die Abtragrate, das mechanische Schädigungspotenzial, die thermische Nekrosezone pro Pulsdauer, die Repetitionsrate und die eingestrahlte Laserenergiedichte bestimmt. Die Ergebnisse zeigen, dass der Erbium:YAG-Laser für die Anwendung an der Stimmlippe geeignet erscheint, da am Gewebepräparat lediglich eine oberflächennahe (5–20 μm) Koagulationsnekrose mit Verlust des mehrschichtigen Plattenepithels nachweisbar ist. Das Ergebnis zeigt damit die potenzielle Anwendbarkeit des Erbium:YAG-Lasers an der Stimmlippe. Weitere Untersuchungen, speziell an der Stimmlippe des Menschen, werden zeigen müssen, ob der Erbium:YAG-Laser für den klinischen Einsatz in der Phonochirurgie geeignet ist.

Abstract

The application of lasers in microsurgery of the vocal fold has very special requirements. Easy handling as well as a precise cutting quality with a small laser induced thermal necrosis zone are necessary. In this study, an Erbium:YAG laser was evaluated for phonosurgery. For this, vocal folds from the porcine larynx were irradiated with the Erbium laser wavelength of 3 μm. The ablation rate, as well as the mechanical and thermal damage were investigated as a function of pulse duration, repetition rate and laser fluence. The results show that Erbium lasers are well suited for application on the vocal fold. The laser induced thermal damage was restricted to a superficial layer of only about 20–30 μm, resulting in a loss of the multilayered epithelium. Thermal necrosis had a range of about 5 μm. Further investigations on the vocal folds of humans must be performed to determine whether this laser is qualified for clinical applications.

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Literatur

  1. Andrews AH, Moss HW (1974) Experiences with the carbon dioxide lasers in the larynx. Ann Otol Rhinol Laryngol 83: 462

    PubMed  Google Scholar 

  2. Davis RK, Kelly SM, Hayes J (1991) Endoscopic CO2 laser excisional biobsy of early supraglottic cancer. Laryngoscope 100: 680–683

    Google Scholar 

  3. Davis RK, Shapshay SM, Strong SM (1983) Transoral partial supraglottic resection using the CO2-laser. Laryngoscope 93: 429–432

    PubMed  Google Scholar 

  4. Eysholdt U, Rosanowski R, Hoppe U (2003) Measurement and interpretation of irregular vocal cord fold vibrations. HNO 51(9): 710–716

    Article  PubMed  Google Scholar 

  5. Grossenbacher R (1980) Der CO2-Laser in der Hals-Nasen-Ohren-Chirurgie. Schweiz Med Wochenschr 110: 790–796

    PubMed  Google Scholar 

  6. Herdman RC, Charlton A, Hinton AF, Freemont AJ (1993) An in vitro comparison of the Erbium: YAG laser and the carbon dioxide laser in laryngeal surgery. Laryngol Otol 107 (10): 908–911

    Google Scholar 

  7. Högele A, Ziolek C, Lubatschowski H et al. (1997) FTIR-Q-switched 3 erbium lasers for application in laser surgery. Laser Optoelektron 29(2): 45–51

    Google Scholar 

  8. Jako GJ (1972) Laser surgery of the vocal cords. An experimental study with carbon dioxide lasers on dogs. Laryngoscope 82: 2204–2215

    Article  PubMed  Google Scholar 

  9. Jones C, Huberman E, Cunningham M, Peak M (1987) Mutagenesis and cytotoxicity in human epithelial cells by far and near ultraviolet radiations. Action Spectra Radiat Res 110: 244–254

    Google Scholar 

  10. Kaftan H, Huttenbrink KB, Bornitz M (2003) Thermal stress on the healthy laryngeal mucosa caused by CO2 laser treatments. HNO 51(11): 880–885

    Article  PubMed  Google Scholar 

  11. Kempf HG, Storkel S (2005) Choriostoma in the vocal fold. HNO 53(4): 361–363

    Article  PubMed  Google Scholar 

  12. Lubatschowski H, Högele A, Lohmann S et al. (1996) Erbium-laser photoablation of the Cornea. Proc SPIE 2930: 2–8

    Article  Google Scholar 

  13. Lubatschowski H, Hetzel U, Kermani O et al. (1997) Photoablation of the cornea with a switched Er: YAG Laser. Proc SPIE 3192: 175–179

    Article  Google Scholar 

  14. Luerssen K, Lubatschowski H, Ursinus K et al. (2006) Optical coherence tomography in the diagnosis of vocal folds. HNO 54(8): 611–615

    Article  PubMed  Google Scholar 

  15. Mihashi S, Hirano M, Jako GJJ et al. (1980) Interaction of CO2-laser and soft tissue. The basic mechanism of the carbon dioxide laser irradiation of the soft tissue. Kurume Med J 27(3): 157–165

    PubMed  Google Scholar 

  16. Motta S, Moscillo L, Imperiali M, Motta G (2003) CO2 laser treatment of bilateral vocal cord paralysis in adduction. J Otorhinolaryngology Relat Spec 65 (6): 359–365

    Google Scholar 

  17. Plouin-Gaudon I, Lawson G, Jamart J, Remacle M (2005) Subtotal carbon dioxide laser arytenoidectomy for the treatment of bilate vocal fold immobility: long-term results. Ann Otol Rhinol Laryngol 114(2): 115–121

    PubMed  Google Scholar 

  18. Philip CM, Rohde E, Berlien H-P (1995) Nd: YAG laser procedures in tumor treatment. Semin Surg Onc 11(4): 290–298

    Google Scholar 

  19. Schindler A, Palonta F, Preti G et al. (2004) Voice quality after carbon dioxide laser and conventional surgery for T 1 glottic carcinoma. J Voice 18(4): 545–550

    Article  PubMed  Google Scholar 

  20. Steven M, Zeitels MD (1996) Laser versus cold instruments for mikrolaryngoscopic surgery. Laryngoscope 106: 545–552

    PubMed  Google Scholar 

  21. Strong MS, Jako GJ (1972) Laser surgery of the larynx: Early clinical experience with continuous CO2 laser. Ann Otol Rhinol Laryngol 81: 791–798

    PubMed  Google Scholar 

  22. Strong MS, Jako GJ, Vaughan CW et al. (1976) The use of CO2 laser in otolaryngology: A progress report. Trans Am Acad Ophthalmol Otolaryngol 82 (5): 959–602

    Google Scholar 

  23. Vaughan CW (1978) Transoral laryngeal surgery using the CO2 laser. Laboratory experiments and clinical experience. Laryngoscope 88: 1399–1420

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Klinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland

    K. Lüerßen & M. Ptok

  2. Laser-Zentrum Hannover e. V., Hannover, Deutschland

    H. Lubatschowski

Authors
  1. K. Lüerßen
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  2. H. Lubatschowski
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  3. M. Ptok
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Correspondence to K. Lüerßen.

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Lüerßen, K., Lubatschowski, H. & Ptok, M. Erbium:YAG-Laserchirurgie an Stimmlippengewebe. HNO 55, 443–446 (2007). https://doi.org/10.1007/s00106-006-1479-3

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  • DOI: https://doi.org/10.1007/s00106-006-1479-3

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