Reduction of thermocoagulative injury via use of a picosecond infrared laser 
(PIRL) in laryngeal tissues

Böttcher, Arne; Kucher, Stanislav; Knecht, Rainald; Jowett, Nathan; Krötz, Peter; Reimer, Rudolph; Schumacher, Udo; Anders, Sven; Münscher, Adrian; Dalchow, Carsten V.; Miller, R. J. Dwayne

doi:10.1007/s00405-015-3501-4

Item

ITEM ACTIONSEXPORT

Add to Basket

Local TagsRelease HistoryDetailsSummary

Released

Journal Article

Reduction of thermocoagulative injury via use of a picosecond infrared laser (PIRL) in laryngeal tissues

MPS-Authors

/persons/resource/persons136094

Krötz, Peter
Miller Group, Atomically Resolved Dynamics Department, Max Planck Institute for the Structure and Dynamics of Matter, Max Planck Society;

/persons/resource/persons136024

Miller, R. J. Dwayne
Miller Group, Atomically Resolved Dynamics Department, Max Planck Institute for the Structure and Dynamics of Matter, Max Planck Society;

External Resource

https://dx.doi.org/10.1007/s00405-015-3501-4
(Publisher version)

Fulltext (restricted access)

There are currently no full texts shared for your IP range.

Fulltext (public)

There are no public fulltexts stored in PuRe

Supplementary Material (public)

There is no public supplementary material available

Citation

Böttcher, A., Kucher, S., Knecht, R., Jowett, N., Krötz, P., Reimer, R., et al. (2015). Reduction of thermocoagulative injury via use of a picosecond infrared laser (PIRL) in laryngeal tissues. European Archives of Oto-Rhino-Laryngology, 272(4), 941-948. doi:10.1007/s00405-015-3501-4.

Cite as: https://hdl.handle.net/11858/00-001M-0000-0026-B0E6-9

Abstract

The carbon dioxide (CO₂) laser is routinely used in glottic microsurgery for the treatment of benign and malignant disease, despite significant collateral thermal damage secondary to photothermal vaporization without thermal confinement. Subsequent tissue response to thermal injury involves excess collagen deposition resulting in scarring and functional impairment. To minimize collateral thermal injury, short-pulse laser systems such as the microsecond pulsed erbium:yttrium–aluminium-garnet (Er:YAG) laser and picosecond infrared laser (PIRL) have been developed. This study compares incisions made in ex vivo human laryngeal tissues by CO₂ and Er:YAG lasers versus PIRL using light microscopy, environmental scanning electron microscopy (ESEM), and infrared thermography (IRT). In comparison to the CO₂ and Er:YAG lasers, PIRL incisions showed significantly decreased mean epithelial (59.70 µm) and subepithelial (22.15 µm) damage zones (p < 0.05). Cutting gaps were significantly narrower for PIRL (133.70 µm) compared to Er:YAG and CO₂ lasers (p < 0.05), which were more than 5 times larger. ESEM revealed intact collagen fibers along PIRL cutting edges without obvious carbonization, in comparison to diffuse carbonization and tissue melting seen for CO₂ and Er:YAG laser incisions. IRT demonstrated median temperature rise of 4.1 K in PIRL vocal fold incisions, significantly less than for Er:YAG laser cuts (171.85 K; p < 0.001). This study has shown increased cutting precision and reduced lateral thermal damage zones for PIRL ablation in comparison to conventional CO₂ and Er:YAG lasers in human glottis and supraglottic tissues.