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

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.