Optimizing Settings for Office‐Based Endoscopic CO 2 Laser Surgery Using an Experimental Vocal Cord Model
| Autor: | Tim M Klabbers, Floris Heutink, Anouk S. Schimberg, Guido B. van den Broek, Ilse van Engen-van Grunsven, Jimmie Honings, David J. Wellenstein, Rudolf M. Verdaasdonk, Robert P. Takes |
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| Přispěvatelé: | Health Technology Implementation |
| Rok vydání: | 2020 |
| Předmět: |
Models
Anatomic Laser surgery Intraclass correlation medicine.medical_treatment UT-Hybrid-D Flexible endoscopic CO laser Sensory disorders Donders Center for Medical Neuroscience [Radboudumc 12] Thermal expansion law.invention Laryngology 03 medical and health sciences 0302 clinical medicine law Schlieren Original Reports medicine Humans Irradiation 030223 otorhinolaryngology Lead (electronics) Flexible endoscopic CO2 laser Laryngoscopy business.industry vocal cords Thermal Conductivity 030206 dentistry Carbon Dioxide Laser Ambulatory Surgical Procedures Otorhinolaryngology Lasers Gas Continuous wave thermal effects business E‐Only Articles Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] Biomedical engineering |
| Zdroj: | Laryngoscope, 130, 11, pp. E680-e685 Laryngoscope, 130, E680-e685 The Laryngoscope Laryngoscope, 130(11), E680-E685. Wiley-Blackwell |
| ISSN: | 1531-4995 0023-852X |
| Popis: | Contains fulltext : 229910.pdf (Publisher’s version ) (Open Access) OBJECTIVES/HYPOTHESIS: To provide insight in the thermal effects of individual laser settings in target tissues to optimize flexible endoscopic CO(2) laser surgery treatment. STUDY DESIGN: Experimental laboratory study. METHODS: Thermal effects of the CO(2) 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 CO(2) 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, 130:E680-E685, 2020. |
| Databáze: | OpenAIRE |
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