The Versatile Contact Nd:YAG Laser in Head and Neck Surgery: An in Vivo and Clinical Analysis

Abstract

Objective: Lasers have been used in otolaryngology as a surgical instrument for more than 25 years, and the CO 2 laser has emerged as the most widely employed surgical laser in use today. However, recent technological advances have made the Nd:YAG laser a challenger as an effective photothermal surgical tool. Study Design and Methods: This is a two-part study. Tissue injury and healing profiles after application of both the CO 2 and Nd:YAG lasers are compared using an in vivo rat tongue model. A prospective clinical review based on the experience of 327 operative cases spanning a 7-year interval using the Nd:YAG laser, highlighting its various applications and associated complications, is detailed. Results: Comparable tissue and healing effects were noted with both lasers in the in vivo rat tongue model with no statistical differences. The clinical application of the laser showed wide versatility in the head and neck with a complication rate of 3%. Conclusion: The Nd:YAG laser has proved equivalent in tissue damage and healing to the CO 2 laser. The Nd:YAG laser has proved itself to be an excellent and perhaps superior laser for use in head and neck surgery. Key Words: Nd:YAG laser, in vivo model, prospective review, head and neck.

Two Consecutive Cases of Persistent Stapedial Artery Managed With a Carbon Dioxide Laser

“…Given its rapid absorption in water, thermal spread of beyond the point of immediate tissue contact is limited to just 0.01 to 0.02 mm. 20 This compares favorably to bipolar diathermy, which is associated with thermal spread of up to 1 to 2 mm. 21 By virtue of its energy transfer properties, use of the CO 2 laser in our 2 patients reduced the risk of unintentional collateral damage to the nearby facial nerve, oval window, and/or cochleovestibular organs.…”

Two Consecutive Cases of Persistent Stapedial Artery Managed With a Carbon Dioxide Laser

“…Given its rapid absorption in water, thermal spread of beyond the point of immediate tissue contact is limited to just 0.01 to 0.02 mm. 20 This compares favorably to bipolar diathermy, which is associated with thermal spread of up to 1 to 2 mm. 21 By virtue of its energy transfer properties, use of the CO 2 laser in our 2 patients reduced the risk of unintentional collateral damage to the nearby facial nerve, oval window, and/or cochleovestibular organs.…”

Outcomes of laser thermal therapy for recurrent head and neck cancer

“…LITT is performed with the Nd:YAG laser, which emits luminous energy in the near infrared portion of the visible spectrum at 1064 nm. The Nd:YAG laser is poorly absorbed by hemoglobin, melanin, and water, which leads to scattering of the laser beam with deep penetration into tissues 9 , 10 . Transmitting laser energy directly through a flexible fiberoptic cable allows the surgeon to deliver more effective localized LITT to inaccessible parts of the body by endoscopic procedures, thereby minimizing undesired tissue damage to adjacent structures, which is the main advantage of this minimally invasive therapy for malignancies.…”

“…The Nd:YAG laser is poorly absorbed by hemoglobin, melanin, and water, which leads to scattering of the laser beam with deep penetration into tissues. 9,10 Transmitting laser energy directly through a flexible fiberoptic cable allows the surgeon to deliver more effective localized LITT to inaccessible parts of the body by endoscopic procedures, thereby minimizing undesired tissue damage to adjacent structures, which is the main advantage of this minimally invasive therapy for malignancies. The Nd:YAG laser is widely used in endoscopic and open surgery because of its photothermal ability to coagulate, cut, vaporize, and ablate tissue.…”

Novel Techniques to Guide the Neodymium-Doped Yttrium Aluminum Garnet Laser Fiber for Laser Surgery of Upper Aerodigestive Tract Squamous Cell Carcinoma

“…When the Nd:YAG laser is used in the noncontact mode, there is less precision, more backward scattering, the homogeneous zone of thermal coagulation and necrosis may extend up to 4 mm deep, and tissue damage is widespread. However, when a contact fiber is used, the Nd‐YAG laser is a safe tool to use in head and neck cancer surgery 5 . The use of a contact fiber improves the efficiency of energy use and reduces back‐scatter.…”

“…However, when a contact fiber is used, the Nd-YAG laser is a safe tool to use in head and neck cancer surgery. 5 The use of a contact fiber improves the efficiency of energy use and reduces back-scatter. Lesser tissue destruction leads to reduced plume generation, and this provides a safer surgical field.…”

Two Consecutive Cases of Persistent Stapedial Artery Managed With a Carbon Dioxide Laser

“…Given its rapid absorption in water, thermal spread of beyond the point of immediate tissue contact is limited to just 0.01 to 0.02 mm. 20 This compares favorably to bipolar diathermy, which is associated with thermal spread of up to 1 to 2 mm. 21 By virtue of its energy transfer properties, use of the CO 2 laser in our 2 patients reduced the risk of unintentional collateral damage to the nearby facial nerve, oval window, and/or cochleovestibular organs.…”

Outcomes of laser thermal therapy for recurrent head and neck cancer

“…LITT is performed with the Nd:YAG laser, which emits luminous energy in the near infrared portion of the visible spectrum at 1064 nm. The Nd:YAG laser is poorly absorbed by hemoglobin, melanin, and water, which leads to scattering of the laser beam with deep penetration into tissues 9 , 10 . Transmitting laser energy directly through a flexible fiberoptic cable allows the surgeon to deliver more effective localized LITT to inaccessible parts of the body by endoscopic procedures, thereby minimizing undesired tissue damage to adjacent structures, which is the main advantage of this minimally invasive therapy for malignancies.…”

“…The Nd:YAG laser is poorly absorbed by hemoglobin, melanin, and water, which leads to scattering of the laser beam with deep penetration into tissues. 9,10 Transmitting laser energy directly through a flexible fiberoptic cable allows the surgeon to deliver more effective localized LITT to inaccessible parts of the body by endoscopic procedures, thereby minimizing undesired tissue damage to adjacent structures, which is the main advantage of this minimally invasive therapy for malignancies. The Nd:YAG laser is widely used in endoscopic and open surgery because of its photothermal ability to coagulate, cut, vaporize, and ablate tissue.…”

Novel Techniques to Guide the Neodymium-Doped Yttrium Aluminum Garnet Laser Fiber for Laser Surgery of Upper Aerodigestive Tract Squamous Cell Carcinoma

“…When the Nd:YAG laser is used in the noncontact mode, there is less precision, more backward scattering, the homogeneous zone of thermal coagulation and necrosis may extend up to 4 mm deep, and tissue damage is widespread. However, when a contact fiber is used, the Nd‐YAG laser is a safe tool to use in head and neck cancer surgery 5 . The use of a contact fiber improves the efficiency of energy use and reduces back‐scatter.…”

“…However, when a contact fiber is used, the Nd-YAG laser is a safe tool to use in head and neck cancer surgery. 5 The use of a contact fiber improves the efficiency of energy use and reduces back-scatter. Lesser tissue destruction leads to reduced plume generation, and this provides a safer surgical field.…”

Two Consecutive Cases of Persistent Stapedial Artery Managed With a Carbon Dioxide Laser

“…Given its rapid absorption in water, thermal spread of beyond the point of immediate tissue contact is limited to just 0.01 to 0.02 mm. 20 This compares favorably to bipolar diathermy, which is associated with thermal spread of up to 1 to 2 mm. 21 By virtue of its energy transfer properties, use of the CO 2 laser in our 2 patients reduced the risk of unintentional collateral damage to the nearby facial nerve, oval window, and/or cochleovestibular organs.…”

Outcomes of laser thermal therapy for recurrent head and neck cancer

“…LITT is performed with the Nd:YAG laser, which emits luminous energy in the near infrared portion of the visible spectrum at 1064 nm. The Nd:YAG laser is poorly absorbed by hemoglobin, melanin, and water, which leads to scattering of the laser beam with deep penetration into tissues 9 , 10 . Transmitting laser energy directly through a flexible fiberoptic cable allows the surgeon to deliver more effective localized LITT to inaccessible parts of the body by endoscopic procedures, thereby minimizing undesired tissue damage to adjacent structures, which is the main advantage of this minimally invasive therapy for malignancies.…”

“…The Nd:YAG laser is poorly absorbed by hemoglobin, melanin, and water, which leads to scattering of the laser beam with deep penetration into tissues. 9,10 Transmitting laser energy directly through a flexible fiberoptic cable allows the surgeon to deliver more effective localized LITT to inaccessible parts of the body by endoscopic procedures, thereby minimizing undesired tissue damage to adjacent structures, which is the main advantage of this minimally invasive therapy for malignancies. The Nd:YAG laser is widely used in endoscopic and open surgery because of its photothermal ability to coagulate, cut, vaporize, and ablate tissue.…”

Novel Techniques to Guide the Neodymium-Doped Yttrium Aluminum Garnet Laser Fiber for Laser Surgery of Upper Aerodigestive Tract Squamous Cell Carcinoma

“…When the Nd:YAG laser is used in the noncontact mode, there is less precision, more backward scattering, the homogeneous zone of thermal coagulation and necrosis may extend up to 4 mm deep, and tissue damage is widespread. However, when a contact fiber is used, the Nd‐YAG laser is a safe tool to use in head and neck cancer surgery 5 . The use of a contact fiber improves the efficiency of energy use and reduces back‐scatter.…”

“…However, when a contact fiber is used, the Nd-YAG laser is a safe tool to use in head and neck cancer surgery. 5 The use of a contact fiber improves the efficiency of energy use and reduces back-scatter. Lesser tissue destruction leads to reduced plume generation, and this provides a safer surgical field.…”