Diode laser-induced tissue effects

TY - JOUR

T1 - Diode laser-induced tissue effects

T2 - in vitro tissue model study and in vivo evaluation of wound healing following non-contact application

AU - Havel, Miriam

AU - Betz, Christian S

AU - Leunig, Andreas

AU - Sroka, Ronald

N1 - © 2014 Wiley Periodicals, Inc.

PY - 2014/8

Y1 - 2014/8

N2 - INTRODUCTION: The basic difference between the various common medical laser systems is the wavelength of the emitted light, leading to altered light-tissue interactions due to the optical parameters of the tissue. This study examines laser induced tissue effects in an in vitro tissue model using 1,470 nm diode laser compared to our standard practice for endonasal applications (940 nm diode laser) under standardised and reproducible conditions. Additionally, in vivo induced tissue effects following non-contact application with focus on mucosal healing were investigated in a controlled intra-individual design in patients treated for hypertrophy of nasal turbinate.METHODS: A certified diode laser system emitting the light of λ = 1470 nm was evaluated with regards to its tissue effects (ablation, coagulation) in an in vitro setup on porcine liver and turkey muscle tissue model. To achieve comparable macroscopic tissue effects the laser fibres (600 µm core diameter) were fixed to a computer controlled stepper motor and the laser light was applied in a reproducible procedure under constant conditions. For the in vivo evaluation, 20 patients with nasal obstruction due to hyperplasia of inferior nasal turbinates were included in this prospective randomised double-blinded comparative trial. The endoscopic controlled endonasal application of λ = 1470 nm on the one and λ = 940 nm on the other side, both in 'non-contact' mode, was carried out as an outpatient procedure under local anaesthesia. The postoperative wound healing process (mucosal swelling, scab formation, bleeding, infection) was endoscopically documented and assessed by an independent physician.RESULTS: In the experimental setup, the 1,470 nm laser diode system proved to be efficient in inducing tissue effects in non-contact mode with a reduced energy factor of 5-10 for highly perfused liver tissue to 10-20 for muscle tissue as compared to the 940 nm diode laser system. In the in vivo evaluation scab formation following laser surgery as assessed clinically on endonasal endoscopy was significantly reduced on 1,470 nm treated site compared to 940 nm diode laser treated site.CONCLUSIONS: Diode laser system (1,470 nm) induces efficient tissue effects compared to 940 nm diode laser system as shown in the tissue model experiment. From the clinical point of view, the healing process following non-contact diode laser application revealed to be improved using 1,470 nm diode laser compared to our standard diode laser practise with 940 nm.

AB - INTRODUCTION: The basic difference between the various common medical laser systems is the wavelength of the emitted light, leading to altered light-tissue interactions due to the optical parameters of the tissue. This study examines laser induced tissue effects in an in vitro tissue model using 1,470 nm diode laser compared to our standard practice for endonasal applications (940 nm diode laser) under standardised and reproducible conditions. Additionally, in vivo induced tissue effects following non-contact application with focus on mucosal healing were investigated in a controlled intra-individual design in patients treated for hypertrophy of nasal turbinate.METHODS: A certified diode laser system emitting the light of λ = 1470 nm was evaluated with regards to its tissue effects (ablation, coagulation) in an in vitro setup on porcine liver and turkey muscle tissue model. To achieve comparable macroscopic tissue effects the laser fibres (600 µm core diameter) were fixed to a computer controlled stepper motor and the laser light was applied in a reproducible procedure under constant conditions. For the in vivo evaluation, 20 patients with nasal obstruction due to hyperplasia of inferior nasal turbinates were included in this prospective randomised double-blinded comparative trial. The endoscopic controlled endonasal application of λ = 1470 nm on the one and λ = 940 nm on the other side, both in 'non-contact' mode, was carried out as an outpatient procedure under local anaesthesia. The postoperative wound healing process (mucosal swelling, scab formation, bleeding, infection) was endoscopically documented and assessed by an independent physician.RESULTS: In the experimental setup, the 1,470 nm laser diode system proved to be efficient in inducing tissue effects in non-contact mode with a reduced energy factor of 5-10 for highly perfused liver tissue to 10-20 for muscle tissue as compared to the 940 nm diode laser system. In the in vivo evaluation scab formation following laser surgery as assessed clinically on endonasal endoscopy was significantly reduced on 1,470 nm treated site compared to 940 nm diode laser treated site.CONCLUSIONS: Diode laser system (1,470 nm) induces efficient tissue effects compared to 940 nm diode laser system as shown in the tissue model experiment. From the clinical point of view, the healing process following non-contact diode laser application revealed to be improved using 1,470 nm diode laser compared to our standard diode laser practise with 940 nm.

KW - Adult

KW - Aged

KW - Animals

KW - Double-Blind Method

KW - Female

KW - Humans

KW - In Vitro Techniques

KW - Lasers, Semiconductor

KW - Liver

KW - Male

KW - Middle Aged

KW - Muscle, Skeletal

KW - Nasal Obstruction

KW - Prospective Studies

KW - Reproducibility of Results

KW - Swine

KW - Treatment Outcome

KW - Turkeys

KW - Wound Healing

KW - Comparative Study

KW - Journal Article

KW - Randomized Controlled Trial

U2 - 10.1002/lsm.22256

DO - 10.1002/lsm.22256

M3 - SCORING: Journal article

C2 - 24839034

VL - 46

SP - 449

EP - 455

JO - LASER SURG MED

JF - LASER SURG MED

SN - 0196-8092

IS - 6

ER -