Infrared Lasers versus Classical Technique in Tonsillectomy
Authors:
D. Slouka 1,2; P. Poleník 2,3; D. Šmíd 4; O. Hes 2,5; L. Boudová 2,5; Y. Erfremová 6; R. Kučera 7; P. Hošek 8; J. Slípka 1,2
Authors place of work:
ORL klinika Lékařské fakulty Univerzity Karlovy v Plzni
1; Fakultní nemocnice v Plzni
2; Stomatologická klinika Lékařské fakulty Univezity Karlovy v Plzni
3; Chirurgická klinika Lékařské fakulty Univerzity Karlovy v Plzni
4; Šiklův patologicko-anatomický ústav Lékařské fakulty Univerzity Karlovy v Plzni
5; Katedra zdravotnických oborů a ochrany obyvatelstva, Fakulta biomedicínského inženýrství ČVUT v Praze
6; Imunoanalytická laboratoř, FN a LF v Plzni, Univerzita Karlova, Praha
7; Biomedicínské centrum Lékařské fakulty Univerzity Karlovy v Plzni
8
Published in the journal:
Otorinolaryngol Foniatr, 64, 2015, No. 4, pp. 196-200.
Category:
Original Article
Summary
Introduction:
Modern medicine uses a whole range of technically developed devices to reach mini invasiveness and to keep radicality of therapy. Our aim was to determine the benefit of laser medicine to mini invasiveness related to tonsillectomies and its comparison with classic tonsillectomy.
Material and methodology:
Until 2014, it was possible to work with ten laser systems at the ENT department of University hospital in Pilsen. In this study, Ho:YAG laser was compared with classic tonsillectomy and a new type of crystal laser (Er,Cr:YSGG). Patients were divided into two groups of ten respondents. Left-sided tonsillectomy was performed in a classic way. In case of right-sided tonsillectomy, it was realized by using tested devices. Peroperative bleeding, duration of operation as well as postoperative pain were evaluated in each patient (by each side separately). The width of irreversible tissue thermal damage was histologically verified.
Results:
Compared to classic tonsillectomy, the average duration of operation using Ho:YAG laser was shortened by two minutes. Regarding Er,Cr:YSGG laser, it was prolonged by 4.3 minutes. The considerable reduction of perioperative bleeding could be seen in case of Ho:YAG laser. Contrary classic tonsillectomy, postoperative pain was significantly stronger in case of using both lasers.
Conclusion:
Both lasers (Ho:YAG and Er,Cr:YSGG) offer a safe non-complicated method to perform tonsillectomy which is comparable with gold standard (classic tonsillectomy). But overall, it brings no essential benefits to the patient. .
Keywords:
mini invasiveness, tonsillectomy, laser
Zdroje
1. Aksoym, F., Ozturan, O., Veyseller, B, Yildirim, Y. S., Demirhan, H.: Comparison of radiofrequency and monopolar electrocautery tonsillectomy: J. Laryngol. Otol., 124, 2010, 2, s. 180-184.
2. Alexiou, V. G., Salazar-Salvia, M. S., Jervis, P. N., Falagas, M. E.: Modern technology-assisted vs conventional tonsillectomy: a meta-analysis of randomized controlled trials. Arch. Head Neck Surg., 137, 2011, 6, s. 558-570.
3. Auf, I., Osborne, J. E., Sparkes, C., Khalil, H.: Is the KTP laser effective in tonsillectomy? Clin. Otolaryngol. Allied Sci., 22, 1997, 2, 145-146.
4. Bergle, W., Huber, K., Hammerschmitt, N., Hölz, M., Hörmann, K.: Tonsillectomy with the argon-plasma-coagulation-raspatorium - a prospective randomized single-blinded study. HNO, 48, 2000, 2, s. 135-141.
5. Chimona, T., Proimos, E., Mamoulakis, C., Tzanakakis, M., Skoulakis, C. E, Papadakis, C. E.: Multiparametric comparison of cold knife tonsillectomy, radiofrequency excision and thermal welding tonsillectomy in children; Int. J. Pediatr. Otorhinolaryngol., 72, 2008, 9, s. 1431-146.
6. Ferri, E., Armato, E.: Argon plasma coagulation versus cold dissection in pediatric tonsillectomy. Am. J. Otolaryngol., 32, 2011, 6, s. 459-463.
7. Fong, M., Clarke, K., Cron, C.: Clinical applications of the holmium:YAG laser in disorders of the paediatric airway. J. Otolaryngol., 28, 1999, 6, 337-343.
8. Gilling, P. J., Fraundorfer, M. R.: Holmium laser prostatectomy: a technique in evolutio. Curr. Opin. Urol., 8, 1998; 1, s. 11-15.
9. Grossenbacher R.: Experiences with CO2-laser-surgery in otorhinolaryngology. HNO, 27, 1979, 12, s. 403-408.
10. Havel, M., Sroka, R., Englert, E., Stelter, K., Leunig, A., Betz, C. S.: Intraindividual comparison of 1,470 nm diode laser versus carbon dioxide laser for tonsillotomy: a prospective, randomized, double blind, controlled feasibility trial. Lasers Surg. Med., 44, 2012, 7, s. 558-563.
11. Leach, J., Manning, S., Schaefer, S.: Comparison of two methods of tonsillectomy. Laryngoscope, 103, 1993, 6, s. 619-622.
12. Maloney, R. W.: Contact Nd:YAG tonsillectomy: effects on weight loss and recovery. Lasers Surg. Med., 11, 1991, 6, s. 517-522.
13. McLaughlin, R. C.: Tonsillectomy by electrocoagulation. Cal. West Med., 43, 1935, 1, s. 39-40.
14. Oas, R. E. Jr, Bartels, J. P.: KTP-532 laser tonsillectomy: a comparison with standard technique. Laryngoscope, 100, 1990, 4, s. 385-388.
15. Pavelec, V., Polenik, P.: Use of Er,Cr:YSGG versus standard lasers in laser assisted uvulopalatoplasty for treatment of snoring. Laryngoscope, 116, 2006, 8, s. 1512-1516.
16. Ryu, S. W., Lee, S. H., Yoon, H. J.: A comparative histological and immunohistochemical study of wound healing following incision with a scalpel, CO2 laser or Er,Cr:YSGG laser in the guinea pig oral mucosa. Acta Odontol. Scand., 70, 2012, 6, s. 448-454.
17. Saito, T., Honda, N., Saito, H.: Advantage and disadvantage of KTP-532 laser tonsillectomy compared with conventional method. Auris Nasus Larynx, 26, 1999, 4, s. 447-452.
18. Sezen, O. S., Kaytanci, H., Kubilay, U., Coskuner, T., Unver, S.: Comparison between tonsillectomy with thermal welding and the conventional ‘cold’ tonsillectomy technique. ANZ J., 78, 2008, 11, s. 1014-1018.
19. Sheahan, P., Miller, I., Colreavy, M., Sheahan, J. N., McShane, D., Curran, A.: The ultrasonically activated scalpel versus bipolar diathermy for tonsillectomy: a prospective, randomized trial. Clin. Otolaryngol. Allied. Sci., 29, 2004, 5, s. 530-534.
20. Slouka, D. et al.: Naše zkušenosti s lasery na ORL klinice v Plzni. Plzeňský lékařský sborník, 28, 2015, 6, s. 337-343.
21. Sugar, A.: Ultrafast (femtosecond)laser refractive surgery. Curr. Opin. Ophthalmol., 13, s. 246-249.
22. Šlapák, I., Máchalová, M., Veselá, M.: Možnosti chirurgického využití Thulium laseru v otolaryngologii u dětských pacientů. Otorinolaryng. a Foniat. /Prague/, 2014, 4, s. 227-231.
23. Tay, H. L.: Post-operative morbidity in electrodissection tonsillectomy. J. Laryngol. Otol., 103, 1995, 3, s. 209-211.
24. Toft, J. G., Guldfred, L. A., Holmgaard Larsen, B. I., Becker, B. C.: Novel tonsillectomy technique. Ugeskr. Laeger., 171, 2009, 1-2, s. 45-49.
Štítky
Audiology Paediatric ENT ENT (Otorhinolaryngology)Článok vyšiel v časopise
Otorhinolaryngology and Phoniatrics
2015 Číslo 4
Najčítanejšie v tomto čísle
- Inflammatory Pseudotumor of Temporal Bone
- Increasing Incidence of HPV Related Oropharyngeal Cancers
- Psychogenic Disorder on Hearing in Children
- Papillary Carcinoma in a Medial Cervical Cyst