Thermal damage during thulium laser dissection of laryngeal soft tissue is reduced with air cooling: Ex vivo calf model study

James A. Burns*, James B. Kobler, James T. Heaton, Gerardo Lopez-Guerra, R. Rox Anderson, Steven M. Zeitels

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

31 Scopus citations

Abstract

Objectives: The 2-μm-wavelength thulium laser has recently been shown to be an effective cutting instrument in endolaryngeal surgery, although there is increased thermal trauma as compared with the carbon dioxide laser. This study investigated temperature changes and thermal trauma during thulium laser dissection of laryngeal tissue, with and without air cooling, in an ex vivo model. Methods: A continuous-wave thulium laser (400-μm fiber, 4-W continuous power, 4-second duration) was used to incise 10 calf vocal folds. Paired cooled and uncooled cuts were made in each fold with a dermatologic cooling device. A thermistor inserted into the glottic subepithelium was used to measure tissue temperatures. Thermal damage was analyzed histologically by measuring the depth of the zone of lactate dehydrogenase inactivation surrounding the mucosal incision. Results: The initial vocal fold temperature averaged 24.3°C without cooling and 4.4°C with cooling. The peak temperature during cutting averaged 59.1°C without cooling and 28.0°C with cooling. The thermal damage zone surrounding the cooled incisions was approximately 27% less than that surrounding the uncooled incisions. Conclusions: Air cooling can reduce the extent of thermal trauma associated with thulium laser surgery of the vocal folds, and the high-temperature plume generated during laser cutting is effectively cleared.

Original languageEnglish (US)
Pages (from-to)853-857
Number of pages5
JournalAnnals of Otology, Rhinology and Laryngology
Volume116
Issue number11
DOIs
StatePublished - Nov 2007

Funding

From the Departments of Surgery (Burns, Kobler, Heaton, Lopez-Guerra, Zeitels) and Dermatology (Anderson), Harvard Medical School, and the Center for Laryngeal Surgery and Voice Rehabilitation (Burns, Kobler, Heaton, Lopez-Guerra, Zeitels) and the Wellman Center for Photomedicine (Anderson), Massachusetts General Hospital, Boston, Massachusetts. This work was supported in part by the Eugene B. Casey Foundation and the Institute for Laryngology and Voice Restoration.

Keywords

  • Cooling
  • Dysphonia
  • Hoarseness
  • Laryngoscopy
  • Laser cutting
  • Thulium laser

ASJC Scopus subject areas

  • Otorhinolaryngology

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