Endoscopically Based Endonasal and Transnasal Lasersurgery

Abstract

The endoscopically based endonasal and transnasal laser surgery is a surgical procedure, which offers the ENT-specialist a safe and effective method to cure or to improve a number of diseases of the upper and middle airways. Coagulative lasers are used in contact and noncontact mode. Their light is mainly absorbed by hemoglobin but rarely by water. The laser–tissue interaction is performed via flexible glass fibers. For the delivery of the laser beam we use specially designed applicator sheaths, which incorporate the endoscope, the laser fiber and the suction channel. The procedure is controlled online via the endoscopic image on the monitor (“video-endoscopy”). The patient suffers less trauma using this treatment compared to the standard endoscopic surgery and the procedure is much quicker. Pre- and post-operative rhinomanometric and rhinoresistometric measurements reveal that the air flow rate of the nose can be improved effectively.

Endoscopic Diode Laser Polypectomy and High-Dose Intranasal Steroids in Recurrent Nasal Polyposis

“…In addition, using the diode laser has various objective advantages over nonlaser polypectomy and other laser types applied in endonasal surgery. 17,28 DLPE can be performed as an outpatient procedure using small-sized portable devices at low acquisition, operating, and consumable costs. Besides excellent coagulation and good hemostatic and vaporization effects, the superficial tissue interaction enables preservation of deeper layers and periosteum.…”

“…The laser light was administered in “contact” mode by using a flexible, plastic-clad silica fiber (400- μ m core diameter). The output power for polyp resection was set at 4.6 W. For the delivery of the laser beam we applied a specially designed three-channeled applicator sheath according to Scherer 17 (Wolf, Knittlingen, Germany), which incorporates the laser fiber, the exchangeable endoscope, and the suction channel for the emerging laser plume and pyrolysis products. A rigid rhinoscope (4-mm outer diameter, 25° viewing angle) coupled to a light source was connected to an LCD monitor via a videoendoscopic camera.…”