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01.03.2012 | Laryngology | Ausgabe 3/2012

European Archives of Oto-Rhino-Laryngology 3/2012

Reliability and efficacy of a new CO2 laser hollow fiber: a prospective study of 39 patients

Zeitschrift:
European Archives of Oto-Rhino-Laryngology > Ausgabe 3/2012
Autoren:
Marc Remacle, Andrea Ricci-Maccarini, Nayla Matar, Georges Lawson, Flavio Pieri, Vincent Bachy, Marie-Cécile Nollevaux
Wichtige Hinweise
The manuscript was accepted as an oral presentation at the 1st congress of the Confederation of European Otolaryngology Head and Neck Surgery 2011. Barcelona, Spain.

Abstract

We present the first series of patients treated by transoral laser surgery (TLS) using the new AcuPulse 40WG CO2 laser with the FiberLase flexible waveguide (CO2 LWG) (Lumenis, Santa Clara, CA) with the objective to test its reliability and efficacy. Patients older than 18 years, with oral, pharyngo-laryngeal or tracheal benign or premalignant lesions were enrolled after signing an informed consent. This prospective study was conducted between October 2010 and May 2011 in two tertiary care university hospitals. Thirty-nine patients were enrolled in the study. The mean age was 47.9 years (range 18–86 years). There were 21 women and 18 men. Thirteen patients had hypertrophy of lymphoid tissue (palatine and or lingual), nine patients had granulomas, four patients had an exudative glottic lesion, three patients had severe dysplasia (glottic and supraglottic), three patients had leukoplakia, two patients had glottal cysts, two patients had laryngeal papilloma, two patients had bilateral paralysis of the vocal folds and one patient suffered from spasmodic dysphonia. Eighty-two percent of the procedures were performed under general anesthesia with laryngo-tracheal intubation. The CO2 fiber passed through a handpiece was used with a microscope in the majority of the procedures. The laser delivery mode parameter used was: SuperPulse or Continuous Wave. Power levels were 3–15 Watts (W), continuous delivery. Each procedure utilized one CO2 fiber which performed adequately throughout the procedure. No complications were noted with the use of this technology. A bipolar cautery was needed to control bleeding in eight procedures; all these procedures were tonsillectomies. The CO2 LWG is a safe and reliable tool for TLS. It is durable enough to last through the entire surgical procedure without the need for replacement. Its use must be tailored depending on the type and location of the lesion, the CO2 lasers tissue effects as well as the surgeon’s experience.

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