caa a22 4500 606185690 CHVBK 20210128100833.0 cr unu---uuuuu 210128e20150401xx s 000 0 eng 10.1007/s00405-015-3501-4 doi (NATIONALLICENCE)springer-10.1007/s00405-015-3501-4 Reduction of thermocoagulative injury via use of a picosecond infrared laser (PIRL) in laryngeal tissues [Elektronische Daten] [Arne Böttcher, Stanislav Kucher, Rainald Knecht, Nathan Jowett, Peter Krötz, Rudolph Reimer, Udo Schumacher, Sven Anders, Adrian Münscher, Carsten Dalchow, R. Miller] 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 (59.70µm) and subepithelial (22.15µm) damage zones (p<0.05). Cutting gaps were significantly narrower for PIRL (133.70µm) 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 4.1K in PIRL vocal fold incisions, significantly less than for Er:YAG laser cuts (171.85K; 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. Springer-Verlag Berlin Heidelberg, 2015 Laryngeal surgery nationallicence Er:YAG laser nationallicence CO2 laser nationallicence PIRL nationallicence Damage zones nationallicence Electron microscopy nationallicence Thermography nationallicence Böttcher Arne Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Kucher Stanislav Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Knecht Rainald Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Jowett Nathan Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Krötz Peter Atomically Resolved Dynamics Division, Max Planck Institute for the Structure and Dynamics of Matter, Hamburg, Germany aut Reimer Rudolph Leibniz Institute for Experimental Virology, Heinrich Pette Institute, University of Hamburg, Hamburg, Germany aut Schumacher Udo Department of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Anders Sven Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Münscher Adrian Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Dalchow Carsten Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Miller R. Atomically Resolved Dynamics Division, Max Planck Institute for the Structure and Dynamics of Matter, Hamburg, Germany aut European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/4(2015-04-01), 941-948 0937-4477 272:4<941 2015 272 405 https://doi.org/10.1007/s00405-015-3501-4 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00405-015-3501-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Böttcher Arne Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Kucher Stanislav Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Knecht Rainald Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Jowett Nathan Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Krötz Peter Atomically Resolved Dynamics Division, Max Planck Institute for the Structure and Dynamics of Matter, Hamburg, Germany aut NATIONALLICENCE 700 1- Reimer Rudolph Leibniz Institute for Experimental Virology, Heinrich Pette Institute, University of Hamburg, Hamburg, Germany aut NATIONALLICENCE 700 1- Schumacher Udo Department of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Anders Sven Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Münscher Adrian Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Dalchow Carsten Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Miller R. Atomically Resolved Dynamics Division, Max Planck Institute for the Structure and Dynamics of Matter, Hamburg, Germany aut NATIONALLICENCE 773 0- European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/4(2015-04-01), 941-948 0937-4477 272:4<941 2015 272 405