A novel tool in laryngeal surgery: Preliminary results of the picosecond infrared laser

Abstract

Objectives/Hypothesis: Conventional lasers ablate tissue through photothermal, photomechanical, and/or photoionizing effects, which may result in collateral tissue damage. The novel nonionizing picosecond infrared laser (PIRL) selectively energizes tissue water molecules using ultrafast pulses to drive ablation on timescales faster than energy transport to minimize collateral damage to adjacent cells. Study Design: Animal cadaver study. Methods: Cuts in porcine laryngeal epithelium, lamina propria, and cartilage were made using PIRL and carbon dioxide (CO₂) laser. Lateral damage zones and cutting gaps were histologically compared. Results: The mean widths of epithelial (8.5 μm), subepithelial (10.9 μm), and cartilage damage zones (8.1 μm) were significantly lower for cuts made by PIRL compared with CO₂ laser (p < 0.001). Mean cutting gaps in vocal fold (174.7 μm) and epiglottic cartilage (56.3 μm) were significantly narrower for cuts made by PIRL compared with CO₂ laser (P < 0.01, P < 0.05). Conclusion: PIRL ablation demonstrates superiority over CO₂ laser in cutting precision with less collateral tissue damage

A New Technology for Applanation Free Corneal Trephination: The Picosecond Infrared Laser (PIRL)

“…The key design concept of these experiments is the use of infrared pulses, tuned to one of the dominant vibrational states of the tissue, with pulse durations that are short enough to deposit heat through ultrafast vibrational relaxation but with intensities small enough to avoid plasma formation [ 9 , 16 ]. The pulse width of the PIRL resides in the range of ten to a few hundred picoseconds, which represents a time window between complete thermalization of individual vibrational excitation [ 17 ] and thermoacoustic relaxation time of the excited volume [ 9 ].…”

“…Despite these promising results, there are limitations concerning cutting features and applicability. The current PIRL output beam must be focused to a tight spot in order to achieve a significant photon density for ablation to occur; however, the prototype does not possess any autofocus function [ 16 ]. Hence, suboptimal focusing may occur, leading to decreased ablation efficiency and subsequent deposition of unfocused laser energy as heat.…”

Proteome analysis of tissues by mass spectrometry

“…Pulse durations are one of the most important factors during laser treatment, and whereas microsecond or nanosecond lasers might cause surrounding tissue damage by leakage of deposited energy, picosecond lasers are the least invasive. As such, PIRL was recognized as a tool in laser surgery and for ablation of different tissue types such as corneal tissue (Linke et al, ), kidney (Zou et al, ), vocal folds (Böttcher et al, ; Hess et al, ), tooth enamel (Franjic et al, ) or skin (Jowett et al, ). Also, PIRL can extract intact proteins from biomaterials, and PIRL‐LESI was used for molecular imaging of proteins, phospholipids and small molecules (Zou et al, ).…”

Überblick der Cochleostomieverfahren mit Fokussierung auf neue Laserablationstechniken

“…B. bei Fußplattenperforationen im Rahmen der Stapedotomie bei Otosklerose Anwendung [7,10]. Bislang sind jedoch Laserablationen mit nicht zu vernachlässigender kollateraler Gewebeschädigung verbunden [2]. Dies limitierte bislang die Anwendung an den sensiblen Innenohrstrukturen.…”

“…Die hier aufgezeigten Ansätze sind aber nach Ansicht der Autoren allesamt vielversprechend und sollten unter Berücksichtigung der Weiterentwicklung von Lasern, z. B. dem Picosecond Infrared Laser (PIRL) [2,9], weiterhin durchgeführt werden. Inclusion criteria for this study was the use of a laser to ablate the bone respectively the opening of Cochlear in terms of Cochleostomy.…”