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Otorhinolaryngology; Neurosurgery; Head and Neck Surgery; Laser surgery; Carbon dioxide laser; CO2 laser; Picosecond infrared laser; PIRL; Scalpel; Vocal folds; Phonomicrosurgery; ESEM; Microscopy
Abstract:
A comparison of tissue cutting effects in excised cadaver human vocal folds after incisions with three different instruments [scalpel, CO2 laser and the picosecond infrared laser—(PIRL)] was performed. In total, 15 larynges were taken from human cadavers shortly after death. After deep freezing and thawing for the experiment, the vocal folds suspended in the hemilarynx were incised. Histology and environmental scanning electron microscopy (ESEM) analyses were performed. Damage zones after cold instrument cuts ranged from 51 to 135 μm, as compared to 9–28 μm after cutting with the PIRL. It was shown that PIRL incision had smaller zones of tissue coagulation and tissue destruction, when compared with scalpel and CO2 laser cuts. The PIRL technology provides an (almost) atraumatic laser, which offers a quantum jump towards realistic ‘micro’-phonosurgery on a factual cellular dimension, almost entirely avoiding coagulation, carbonization, or other ways of major tissue destruction in the vicinity of the intervention area. Although not available for clinical use yet, the new technique appears promising for future clinical applications, so that technical and methodological characteristics as well as tissue experiments seem worthwhile to be communicated at this stage of development.
